The United Kingdom and Europe are currently grappling with an under-the-radar tuberculosis crisis, labeled as a hidden “white plague.” According to the World Health Organisation, health services are failing to identify or treat about 20% of individuals afflicted by the disease.

Recent statistics highlight the issue’s magnitude. In 2024, the WHO’s European Region saw approximately 204,000 new TB cases. However, fewer than 162,000 of these cases were detected and managed by healthcare systems, leaving a significant number undiagnosed and untreated, thus enabling the infection to continue spreading.

Dr. Hans Kluge, the WHO’s Regional Director for Europe, has expressed concern, noting, “One in five individuals with TB in the European Region remain unnoticed by health services. This is not merely a failure in detection; it’s a missed opportunity to provide timely treatment, alleviate suffering, and curb further transmission.”

A drug resistance emergency

Beyond detection issues, another crisis looms larger. A report published in collaboration with the European Centre for Disease Prevention and Control reveals that drug-resistant TB is becoming increasingly entrenched across the continent.

Nearly 25% of new TB cases in Europe now involve drug-resistant strains, a figure significantly higher than the global average of 3.2%, according to reports. Combating these strains requires more prolonged and complicated treatment regimens and results in a higher mortality rate compared to standard TB.

Compounding the issue, Europe’s patient follow-up systems are reportedly faltering. It is understood that about a fifth of patients discontinue their treatment within a year, providing drug-resistant strains with the opportunity to proliferate unchecked.

Who faces the greatest danger

The WHO’s European Region is a broad geographic territory encompassing 53 nations — the 27 EU member states plus a sweep of eastern Europe and central Asia that includes Ukraine, Russia and Kazakhstan, all of which shoulder a heavy TB burden, reports The Telegraph.

Within that population, certain groups are particularly exposed. Those held in prisons face TB infection rates up to 13 times those seen in wider society. Young children — particularly those under five — are also among the most vulnerable, states the report.

The BCG vaccination programme is said to offer a degree of protection but is typically administered only to children living in areas where TB rates are highest.

What TB does and how it spreads

Unlike some infectious diseases, TB does not pass easily from person to person. It travels in airborne droplets but generally takes root only after sustained indoor contact with someone carrying the infection.

The warning signs — a cough that will not clear, chest pain, persistent tiredness and gradual weight loss — tend to creep up on sufferers and are easily missed or dismissed until the disease has progressed.

Historically the illness carried a grim nickname: the ‘white plague.’ Coined in the 18th and 19th centuries, the term captured the hollowed, bloodless appearance of those the disease consumed — a stark visual contrast to the dark marks left by bubonic plague, from which the Black Death took its name.

A decade’s ambition slipping away

The WHO had set itself a target of cutting TB cases in its European Region by 80 per cent and deaths by 90 per cent within this decade. Current progress makes that goal unreachable.

“We have made progress…but we are still not moving fast enough, and drug-resistant TB remains one of the most serious threats we face,” Dr Kluge said.

The report’s authors are pressing for earlier and more aggressive case-finding, faster treatment initiation and follow-up systems that actually hold — before the gap between ambition and reality grows any wider.