The prevention and management of infectious diseases such as the Human Immunodeficiency Virus (HIV) and tuberculosis remain a high priority in many European countries. The EU is committed to play an important role in achieving target 3.3 of the United Nations’ Sustainable Development Goals, which is to end the epidemics of Acquired Immunodeficiency Syndrome (AIDS), tuberculosis and other communicable diseases by 2030 (European Commission, 2018).
Although HIV is preventable through effective public health measures, significant HIV transmission continues in Europe with nearly 30 000 newly-diagnosed cases reported in EU countries in 2016. In some countries such as Latvia and Malta, rates of HIV transmission have increased in recent years (see indicator “New reported cases of HIV/AIDS and tuberculosis” in Chapter 3).
HIV weakens the human immune system, leaving those affected vulnerable to infections and other health issues including tuberculosis or hepatitis C. The most advanced stage of HIV infection is AIDS. Early testing for HIV allows infected individuals to be put on treatment quickly leading to earlier viral suppression, thus allowing them to continue to live a normal life and to avoid infecting others.
6.25 shows the percentage of late diagnosis among newly diagnosed HIV cases in 2016. The Czech Republic, the Slovak Republic and Belgium report the lowest proportion of late diagnosis cases among newly diagnosed HIV infections, with percentages of 18% or less. The proportion in Romania, Greece, Italy, Lithuania and Malta is two-times greater (at 36% or more). The high rates in some countries suggest that screening and testing services need to be substantially improved to identify and treat HIV cases earlier, particularly among at-risk populations.
Tuberculosis also remains an important public health issue in some European countries. Although the number of new cases of tuberculosis has generally declined over the past decade, further efforts are needed to prevent the spread of this disease in some countries (see indicator “New reported cases of HIV/AIDS and tuberculosis” in Chapter 3).
6.26 shows the percentage of new tuberculosis cases and relapses with successful treatment outcome after 12 months. Sweden, the Netherlands, the Slovak Republic, Romania and Bulgaria have rates of 85% or more of successful treatment outcomes, while Croatia has the lowest success rate. Success rates are driven by the availability of treatment programmes, patient adherence, and the proportion of multi-drug resistant tuberculosis infections.
Drug-resistant tuberculosis can occur when the drugs used to treat the condition are misused or mismanaged, including where people do not complete a full course of treatment, providers prescribe the wrong treatment or where proper treatments are not available. Multi-drug resistant tuberculosis requires longer and more intensive treatment and is associated with lower success rates.
6.27 shows the percentage of newly diagnosis tuberculosis cases classified as being Rifampicin-resistant or multi-drug resistant. While a number of countries did not report any case, the Baltic countries (Estonia, Lithuania and Latvia) reported the highest proportions of multi-drug resistant cases in 2016.
