One in five people with tuberculosis in the European region went undetected in 2024, a joint surveillance report from the World Health Organization’s European office and the European Centre for Disease Prevention and Control found. Health Policy Watch reported that only 79 per cent of the region’s estimated infections were diagnosed that year, leaving 21 per cent of patients without treatment. Both agencies released the figures to mark World Tuberculosis Day on 24 March.
“It is a missed chance to treat earlier, prevent suffering and stop further transmission,” said Dr Hans Kluge, the WHO Regional Director for Europe. The report recorded 161,569 newly diagnosed cases across the European region in 2024, a count the agencies said sat well below the true burden. Detection gaps fell hardest on seasonal migrants, people living with HIV and people held in prison.
Drug resistance runs high
Health Policy Watch reported that five countries drove most of the regional burden. Russia, Ukraine, Uzbekistan, Türkiye and Romania each carried an estimated 10,000 or more new infections in 2024. Undiagnosed cases spread the disease further, the report said, because tuberculosis passes from person to person through the air when a sick person coughs.
The resistance figures set the European region apart. Some 23 per cent of new cases showed resistance to standard medicines, a rate the report put at seven times the global average. Displacement from the war in Ukraine has made the problem harder to contain, it said, as interrupted treatment breeds resistant strains. That mix matters to any destination that markets itself on quality of care, because drug-resistant tuberculosis is slower and costlier to treat than the standard form, and harder to treat abroad than at home.
Children slip through
Children carry a large share of the missed cases. Health Policy Watch reported, citing WHO estimates, that 43 per cent of the 1.2 million children who developed tuberculosis worldwide in 2024 were never diagnosed. Within the 30 countries of the European Union and Economic Area, children under 15 accounted for 4.2 per cent of new and relapse cases.
The medical charity Médecins Sans Frontières issued the sharpest warning on children. “Only half of the sick children receive a diagnosis or treatment,” said Dr Cathy Hewison, who heads the group’s international tuberculosis working group. Médecins Sans Frontières is pressing health systems to adopt a 2022 clinical algorithm that lets doctors diagnose children from symptoms when laboratory tests are out of reach. Trials across five African countries doubled the number of children diagnosed and treated, the report said.
A global picture
These regional numbers sit inside a larger one. An estimated 10.7 million people developed tuberculosis worldwide in 2024, and 1.23 million died, Health Policy Watch reported. Most new cases stayed concentrated in South-East Asia, Sub-Saharan Africa and the Western Pacific. The Western Pacific alone recorded about 2.9 million cases and holds three of the five highest-burden countries: Indonesia, the Philippines and China. China and the Philippines together accounted for more than 14 per cent of the world’s multidrug-resistant infections.
Health leaders have pushed decentralised care as the answer, moving diagnosis closer to the people who carry the disease. The WHO has recommended near point-of-care molecular tests and the use of tongue swabs for patients who cannot produce sputum. The report described the devices as portable and battery-operated, able to return a result in under an hour at a fraction of the cost of older methods. “These new tools could be truly transformative for tuberculosis,” said Dr Tedros Adhanom Ghebreyesus, the WHO Director-General, in a statement marking the day.
What the trend line shows
A longer record gives some ground for confidence. Health Policy Watch reported that tuberculosis incidence across the European region has fallen 39 per cent since 2015, that tuberculosis deaths worldwide have fallen 29 per cent over the same period, and that the global treatment success rate for non-resistant cases stands at 88 per cent. The WHO End TB Strategy still targets an 80 per cent cut in incidence and a 90 per cent cut in deaths by 2030.
There is a settled way to read a report like this for medical travel. A destination’s health-security base sits under its marketing, and undiagnosed disease is a standing risk that no brochure discloses. The 21 per cent of European cases that went undiagnosed, and the 23 per cent that resist standard medicines, describe a system’s capacity rather than a single hospital’s, and a foreign patient buys the system as well as the surgeon. The London approval of the Fleming Centre points at the same drug-resistance problem from the research side, and the WHO’s own account of health gains made against falling budgets frames the funding squeeze that surveillance now faces.
The measurable test is close. Whether the point-of-care tests reach peripheral clinics before the next World Tuberculosis Day, and whether the five high-burden European countries narrow the 21 per cent detection gap, will show in next year’s figures rather than in any statement issued to mark the day.
