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16 April 2002 By Marie-Francoise Borel in Berlin Europe is facing an alarming trend of re-emerging tuberculosis and the spread of HIV/AIDS, which can fuel each other in areas where both diseases are present, health experts told participants at the 6th European Regional Red Cross Red Crescent Conference in Berlin, which opened on Sunday. Danish Red Cross president Dr. Freddy Karup Pedersen said the increase in tuberculosis (TB) in Eastern Europe and Central Asia was largely due to multiple drug resistance, economic and social factors, and in some countries is believed to be linked to the spread of HIV. Outlining the challenges facing the Red Cross and Red Crescent in the region, he said the incidence of HIV infection was rising faster than elsewhere in the world, mainly because of an explosive increase in injectable drug abuse. "TB initiatives are often linked with HIV-related activities", Dr. Pedersen pointed out, "but the integration should be further strengthened." According to tuberculosis expert Holger Sawert of the World Health Organisation (WHO), Eastern Europe is facing a potential TB/HIV epidemic. Nearly 370,000 new cases of TB were recorded in Europe in 2000, while the Baltic States and the Russian Federation have the highest figures of multi-drug-resistant TB in the world (the most difficult to cure). HIV infection rates have risen sharply in Belarus, Ukraine and the Russian Federation. HIV and TB can exacerbate each other's effects when both diseases are present, since HIV diminishes the body's immune system. This weakened state can therefore trigger the reactivation of a TB infection acquired before the HIV infection and can accelerate the progression of a tuberculosis infection acquired after the HIV infection, Mr. Sawert explained. Statistics for 2001 presented by Michel de Groulard of UNAIDS, showed that there were one million cases in Eastern Europe and Central Asia and 560,000 cases in Western Europe. Of these, 30,000 people were newly-infected in 2001 in Western Europe and 250,000 in Eastern Europe and Central Asia. This remains much lower than in sub-Saharan Africa (28.1 million) and Asia (7 million), but is still a cause for great concern. On a more theoretical level, Gudjon Magnussen, from the Nordic School of Health, traced the evolution of the definition of health and explained that modern concepts of health include notions such as the quality of life and individual perception of one's good or bad health. Other global factors that influence health are the increase in democracy and respect for human and market economies on the level of health services available to a given population. The final speaker on health issues, Professor Marc Gentilini, President of the French Red Cross, reminded the audience that viruses and epidemics knew no boundaries and that health issues today had to be addressed on a global level, not at a national or even regional level anymore. This also entailed, he said, a responsibility for global solidarity, in the context of a worsening world health situation. Prof. Gentilini underlined the potential strength of action of the International Federation, with its global network of National Societies and their volunteers. "We must plead on behalf of the victims," he said. "We must influence governments and public opinion." He proposed that National Red Cross and Red Crescent Societies set up a global network of epidemiological surveillance points. Mr. David Byrne, EU Commissioner for health and consumer protection, outlined plans for the European Union countries to set up a Europe-wide surveillance and control network to detect influenza and other diseases at their earliest stages, as well as the voluntary release of pathogens (bio-terrorism) into the environment. Some 50 Red Cross and Red Crescent societies are participating in the European Conference, which takes place from 14-19 April in Berlin, and is focusing on two main themes: health and migration. Related links Read more about the VIth European Regional Conference |
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