Event highlights
05 June 2024
Some 60 people from 22 countries attended the meeting in person and were joined by approximately 100 further participants connecting online.
Tuberculosis (TB) survivor Stefan Raduţ opened the meeting with a harrowing account of his battle with multidrug-resistant tuberculosis (MDR-TB), which left him with permanent hearing loss as a result of medication side effects. Dr Ute Teichert from the German Federal Ministry of Health then took the podium offering a warm welcome to all participants.
The 2 day programme included 8 sessions covering the following topics:
- Update and overview of the current situation in the European Union/European Economic Area (EU/EEA)
- Supply sourcing and regulatory tools
- Spotlight on MDR-TB medicines
- Supply chain management
- Procurement, sourcing and contracting
- EU tools and developments
- Working together – consolidating the market and the message.
Sessions began with an overview of the seriousness of the situation, particularly concerning drug-resistant TB (DR-TB). Urgency notwithstanding, the small numbers of people involved mean demand has never been sufficient in the European Region to sustain a market for TB medicines. There was much discussion around how manufacturers could be incentivized to stay in the market.
Participants related experiences of high prices, lack of paediatric formulations of medication and delays in procurement. Countries also shared how they had used emergency procurement mechanisms and outlined pooled procurement initiatives. Common threads emerged around the challenge of who is responsible for paying and reimbursing for treatment. Traditionally costs have often fallen to hospitals but with the rise of outpatient care this is less clear. Equally unclear is who pays when the patient is receiving preventive treatment and how a person’s migrant status could affect their care.
Discussions highlighted an urgent need for strengthening the business case, consolidating the market for established TB medicines, producing paediatric formulations and overcoming financing barriers for new patented products.
The meeting concluded with participants agreeing to a shared aspiration to ensure secure and rapid access and availability of quality TB medicines for the latest WHO-recommended TB regimens in all EU/EEA countries, and prioritization of DR-TB and TB preventive treatment. Participants agreed to form a working group to take these important commitments forward.
Event notice
03 June 2024
To address the urgent, ongoing challenges in securing access to TB and DR-TB medicines, WHO/Europe and the Federal Ministry of Health of Germany are organizing this regional meeting. Participants will focus on finding solutions to serious barriers faced by some European Union/European Economic Area countries when seeking to procure vital medicines for TB, in particular DR-TB. Participants will discuss, share insights on, and collectively work towards effective solutions to enhance access and availability.
The objectives of the meeting are to:
- recap challenges and provide a situation update focusing on new developments;
- use the outcomes of the 2022 workshop to review progress and refine and adjust solutions;
- develop and agree on an action plan for the next 6 months; and
- establish a technical working group to follow up on the agreed actions and next steps.
Participants will include:
- representatives from ministries of health and national drug regulatory authorities;
- officers responsible for/coordinating the procurement and supply management of medicines;
- representatives from European institutions and agencies; and
- partner and civil society organizations.
WHO has been recommending the adoption of 6-month, short, all-oral treatment regimens for the majority of patients with multidrug-resistant TB (MDR-TB) since 2022. These regimens, containing bedaquiline, pretomanid, linezolid and moxifloxacin, have demonstrated high levels of effectiveness and safety. They also have the advantage of being short – reducing the duration of treatment from 20 months to 6 months – and involving fewer pills. People with TB find these shorter regimens less difficult to tolerate, making it easier to complete a course of treatment.
The new recommendations are not being implemented universally in the WHO European Region. The high costs of the regimen components in central and western European countries, coupled with the escalating number of DR-TB notifications, place a significant limitation on widespread adoption.
European physicians should be able to offer their TB patients these more tolerable treatment regimens and ensure treatment continuity. Ensuring continuity for highly mobile TB patients is also a way of reducing transmission risk and eliminating this as a further resistance driver.
Several central and western European countries raised these concerns at the 2nd United Nations High-level Meeting on TB during the 78th General Assembly in September 2023 in New York, United States of America. Recognizing the urgency of the situation, WHO and partners are planning to collaborate closely with Member States to collectively address concerns related to access and availability of medicines for TB and DR-TB. As low-incidence countries progress towards elimination, collaborative efforts and coordinated action are necessary.