The EUobserver.com has posted a new story by Honor Mahony about the new fight currently underway in several eastern European countries against new multidrug resistant TB and extreme drug resistant TB. Mahony’s article examines the history behind the evolution of these new strains of drug-resistant TB. He writes that the collapse of the Soviet Union and the emergence of 15 countries from under Soviet rule was “matched by a complete breakdown in the public health care system. This triggered a sharp rise in TB cases.”

Compounding the problem, as Mahony notes, was that “there was suddenly no nurses to chivvy people into taking the full course of antibiotics.” Along with the lack of health care workers “unregulated pharmacies sold expensive drugs without prescriptions and in dubious combinations.” People infected with TB either failed to complete the standard six-month treatment program or “took the wrong medication from the beginning.” The result was that “this allowed naturally mutating bacteria to evolve to fight the drug. When patients fell ill for a second time, it was with a resistant strain. This toxic combination of circumstances took the three Baltic states to the brink of an uncontrollable outbreak towards the end of the 1990s.”

Mahony writes that, “outside help as well as a commitment at home have recently seen the countries—particularly Estonia and Latvia—make headway with the problem.” The same cannot be said for Romania, which has “the highest number of TB cases in the EU [European Union]. And the highest number of drug resistant cases, with about 1,000 to 1,200 diagnosed every year.” In the article, Gina Popescu, head of the Romanian TB program, calls the issue “one of medical urgency.” She notes that “27-28 percent of patients suffering from drug-resistant TB abandon their treatment early. One TB sufferer, if left untreated, can infect up to 15 people in one year.”

While the cases of multidrug resistant TB are still negligible in Western Europe, the figures are trending upwards according to Mahony. “In 2008, 23 of the 30 ECDC [European Centre for Disease Prevention and Control] states registered cases of MDR- [multidrug resistant] TB. Of the 27 high-burden countries listed by the WHO [World Health Organization], 15 are in Europe, a loose category that includes Kazakhstan, Russia, and Belarus. Four are in the EU.”