WHO and ECDC surveillance highlights diagnostic gaps and continued concerns surrounding multidrug-resistant tuberculosis
Tuberculosis remains a significant public-health challenge across the WHO European Region. According to a report released by the World Health Organization Regional Office for Europe and the European Centre for Disease Prevention and Control (ECDC) on March 23, 2026, an estimated one in five people who developed tuberculosis in the region during 2024 were either not diagnosed or were not officially reported to public-health authorities.
The findings highlight an important gap in TB detection and surveillance at a time when drug-resistant forms of the disease continue to present substantial clinical and public-health challenges.
The joint surveillance report provides several important indicators regarding tuberculosis across the WHO European Region:
● Approximately 204,000 people developed TB in 2024
WHO estimates that approximately 204,000 people became ill with tuberculosis across the European Region during 2024.
● Approximately 1 in 5 TB cases were missed
An estimated 20% of people who developed TB were either not diagnosed or were not reported through national surveillance systems.
This diagnostic gap can delay treatment, increase the opportunity for transmission, and complicate efforts to control tuberculosis at the population level.
● Drug-resistant TB remains a major concern
The European Region continues to carry a disproportionately high burden of drug-resistant tuberculosis.
According to the report, approximately 23% of newly diagnosed TB cases were multidrug-resistant or rifampicin-resistant, substantially higher than the global proportion.
● 26,845 RR/MDR-TB cases were laboratory confirmed
More than 26,000 cases of rifampicin-resistant or multidrug-resistant tuberculosis were confirmed across the region during the reporting period.
These cases require more complex diagnostic evaluation and treatment than drug-susceptible tuberculosis.
Multidrug-resistant tuberculosis, commonly referred to as MDR-TB, occurs when Mycobacterium tuberculosis develops resistance to important first-line TB medications.
Resistance can make treatment:
More advanced resistance patterns, including pre-XDR-TB and XDR-TB, can further restrict available treatment options.
For this reason, identifying both the presence of tuberculosis and relevant drug-resistance markers is increasingly important for timely clinical decision-making.
One of the central messages emerging from the WHO/ECDC report is that tuberculosis control depends not only on effective treatment but also on the ability to identify infections early and accurately.
Delayed or missed diagnosis can allow individuals with active pulmonary TB to remain untreated for longer periods, potentially increasing transmission within households and communities.
Improving TB detection therefore requires continued progress in several areas:
● Earlier identification of people with active TB
Rapid access to testing can help reduce delays between initial symptoms, diagnosis, and treatment.
● Improved detection of drug resistance
Identifying resistance-associated markers can help clinicians determine whether conventional TB therapies are likely to be effective.
● Expansion of molecular diagnostic technologies
Molecular diagnostic methods can provide information about the presence of M. tuberculosis and, depending on the assay, resistance-associated genetic markers.
● Greater accessibility to point-of-care testing
Decentralized diagnostic platforms could help extend testing beyond centralized laboratories, particularly in areas where laboratory infrastructure is limited.
● Continued surveillance
Accurate reporting remains essential for understanding disease burden, identifying transmission patterns, and directing public-health resources.
Traditional culture-based testing remains an important component of tuberculosis diagnosis and drug-susceptibility testing, but culture can require significant laboratory infrastructure and extended processing time.
Molecular diagnostic technologies provide another important approach by detecting specific nucleic-acid sequences associated with M. tuberculosis and, in some assays, genetic mutations associated with antimicrobial resistance.
Examples of molecular targets associated with resistance include:
Continued research into additional pathogen-derived and host-response biomarkers may contribute to the development of future diagnostic strategies capable of providing more comprehensive information regarding TB infection and drug resistance.
The continued burden of drug-resistant tuberculosis reinforces the need for diagnostic platforms that can potentially provide actionable results closer to the patient.
An effective point-of-care molecular diagnostic system could potentially integrate several analytical steps into a simplified workflow:
Patient specimen
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Sample preparation
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Mycobacterial disruption
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Nucleic-acid extraction
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Multiplex amplification
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Molecular target detection
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TB detection and resistance information
Such approaches are particularly relevant in decentralized healthcare environments where rapid access to sophisticated centralized laboratories may be limited.
At Applied Biomedical, we believe continued innovation in infectious-disease diagnostics will be important to addressing persistent global health challenges such as tuberculosis and antimicrobial resistance.
The WHO/ECDC findings reinforce the importance of technologies capable of supporting:
Applied Biomedical continues to evaluate technologies and development strategies intended to advance rapid and molecular diagnostic capabilities for infectious diseases.
The increasing prevalence and complexity of drug-resistant tuberculosis underscores the need for continued collaboration among public-health organizations, researchers, diagnostic developers, healthcare providers, and regulatory agencies.
The 2026 WHO/ECDC surveillance findings demonstrate that significant progress has been made in tuberculosis prevention, diagnosis, and treatment, but substantial challenges remain.
The combination of missed TB cases and a high burden of drug-resistant disease makes improved diagnostic access particularly important.
Future progress will depend on continued investment in:
Advances in these areas may help reduce diagnostic delays, support more appropriate treatment decisions, and contribute to broader efforts to control tuberculosis worldwide.
World Health Organization Regional Office for Europe.
European Region misses 1 in 5 TB cases, while drug-resistant strains remain among the worst globally.
Published March 23, 2026.
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