New WHO–ECDC surveillance report reveals tens of thousands of people remain undiagnosed while the Region’s multidrug-resistant TB rates are up to 7 times the global average
Key figures at a glance
WHO European Region
● 161 569 new and relapse tuberculosis (TB) cases were reported from 51 out of the 53 countries of the WHO European Region in 2024, equivalent to 17.2 per 100 000 people.
● WHO estimates that 204 000 people fell ill with TB across the Region in 2024.
● An estimated 1 in 5 cases in the Region remain undiagnosed or unreported – a critical gap in detection.
● 23% of new TB cases in the Region are multidrug-resistant, versus 3.2% globally.
● 51% of previously treated TB cases in the Region are resistant to rifampicin, versus 16% globally.
European Union/European Economic Area (EU/EEA)
● 38 249 cases of TB were reported in 30 countries in 2024, resulting in a notification rate of 8.4 per 100 000 population.
● 4.2% of all new and relapse cases are in children under 15 years of age.
● 3.5% of new TB cases are multidrug-resistant.
● 1 in 5 (22%) people who started on treatment are not evaluated after 1 year; a gap that persists even in children under 15 years of age.
● All 3 extensively drug-resistant TB cases reported in the EU/EEA, from the 2021 cohort, died.
WHO/Europe and the European Centre for Disease Prevention and Control (ECDC) today published the joint “TB Surveillance and Monitoring in Europe 2026” report. The report reveals that the WHO European Region, covering 53 countries across Europe and Central Asia, including the 30 countries of the EU/EEA, continues to fall short of regional and global End TB milestones on 2 fronts: a persistent detection challenge, with 1 in 5 TB cases going undiagnosed or unreported, and drug-resistance levels that remain far higher than in other WHO regions. These twin crises are inseparable. People who are diagnosed late have a higher chance of transmitting TB to others and are harder to treat. More TB transmission may result in high numbers of people with treatment failure, which is a primary driver of resistance. Closing the detection gap and tackling drug resistance are not parallel priorities, but the same fight.
While TB incidence across the Region has fallen by 39% since 2015 and the number of deaths by 49%, both figures fall well below the End TB Strategy’s 2025 milestones of 50% and 75%, respectively. Within the EU/EEA, TB cases have decreased by 33% and the number of deaths by 17%. Most EU/EEA countries, like the Region, will not achieve their 2030 targets, resulting in thousands of new infections and deaths that could be prevented
The detection and follow-up gap
In 2024, 161 569 newly diagnosed TB cases were reported in 51 of the 53 countries in the Region. Only 79% of the estimated new and relapse TB cases in the Region were notified in 2024, meaning many people with TB went undiagnosed or unreported. This gap has direct consequences: undiagnosed individuals cannot access treatment and continue to transmit the disease in their communities. In the EU/EEA, progress remains insufficient. While notification rates have stabilized, diagnostic gaps and a lack of follow-up persist due to limitations in health-care systems. One in 5 people who start TB treatment in the EU/EEA are not evaluated after 1 year, a critical gap that is also present even among children under 15 years of age. These data underscore the need for strengthened efforts in early detection and robust follow-up once people are diagnosed.
“One in 5 people with TB in the European Region are still being missed by health services. That is not only a failure in detection – it is a missed chance to treat earlier, prevent suffering and stop further transmission,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “We have made progress, with TB incidence down by 39% and deaths down by 49% since 2015. But we are still not moving fast enough, and drug-resistant TB remains one of the most serious threats we face. In the words of this year’s World TB Day theme: yes, we can end TB – led by countries and powered by people. By investing in rapid diagnosis, shorter all-oral treatment regimens and stronger follow-up, countries can reach more people earlier, improve outcomes and put us back on track toward our targets.”
“During the past decade, EU and EEA countries have seen the number of TB cases decrease by 33% and the number of deaths by 17%. This progress is the result of the strong commitment in the Member States and of our joint efforts,” said ECDC Director Dr Pamela Rendi-Wagner. “To achieve the 2030 targets, continued efforts and collaboration are needed in early detection and sustained follow-up to support people already diagnosed with TB.”
Drug resistance is a regional emergency
The WHO European Region accounts for a disproportionate share of the global burden of rifampicin- or multidrug-resistant TB (RR/MDR-TB). Drug-resistant strains are substantially harder to treat, require longer and more complex regimens, and carry substantially higher mortality. Across the Region in 2024, there were 26 845 confirmed cases of RR/MDR-TB; the number of cases in the EU/EEA was 817. While globally 3.2% of new TB cases and 16% of previously treated cases are RR/MDR-TB, in the European Region those figures are 23% and 51%, respectively, roughly 7 and 3 times the global average.
In the EU/EEA, 3.5% of TB cases are RR/MDR-TB; however, treatment success for these cases stands at just 56%. Poor MDR-TB treatment outcomes allow drug-resistant strains to persist and spread, underscoring the urgent need for stronger diagnosis and care.
Additional findings
● TB/HIV coinfection. An estimated 23 000 HIV-positive TB cases were recorded in the European Region, with 80% concentrated in the Russian Federation (52%) and Ukraine (28%). Despite high HIV testing rates among TB patients (93%), antiretroviral therapy coverage remains below the WHO universal target.
● Treatment success remains well below targets. The treatment success rate in the Region remains far below targets. The treatment success rates for incident TB and RR/MDR-TB were 74% and 66%, respectively, compared with targets of 90% and 80%. EU/EEA overall treatment success stands at 64% against a WHO target of 90%. For RR/MDR-TB and pre-extensively drug-resistant tuberculosis (pre-XDR-TB) outcomes are substantially worse, with treatment success of 56% and 52%, respectively, and with mortality of 13% and 11%.
● Prison populations at acute risk. In the EU/EEA, people in prison face a TB notification rate of 121.6 per 100 000 – a 13.2-times greater relative risk compared to the general population. Data reporting on TB in prisons remains poor across the Region.
● Children and geographic inequality. Several countries in the Region report a child TB notification rate of over 10 per 100 000 for ages 0–4, illustrating persistent within-Region disparities.
Call to action
WHO/Europe and the ECDC are calling on Member States and European institutions to urgently:
● intensify TB prevention and early case detection to close the 1-in-5 diagnostic gap, with a focus on high-risk and marginalized populations including people in prison;
● scale up access to WHO-recommended rapid diagnostics and drug-susceptibility testing, particularly in high-burden settings;
● expand shorter, all-oral treatment regimens for drug-resistant TB to improve patient outcomes and reduce loss to follow-up;
● strengthen integration of TB and HIV services and improve antiretroviral therapy coverage for coinfected individuals; and
● improve surveillance reporting on HIV coinfection, TB in prisons and treatment outcomes to support evidence-based policy-making and progress toward TB elimination.
The “TB Surveillance and Monitoring in Europe 2026” report is a joint publication of WHO/Europe and the ECDC. Data presented covers the 2024 surveillance year across the 53 countries of the WHO European Region and 30 EU/EEA countries. All TB burden estimates cited are drawn from the WHO Global Tuberculosis Report 2025.
This article was amended on 24 March 2026 to correct errors introduced during the editing process in the quotation attributed to ECDC Director Dr Pamela Rendi‑Wagner.