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Europe Struggles to Meet Tuberculosis Targets Amid Rising Drug Resistance

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Tuberculosis remains a public health issue in Europe as the region falls behind elimination targets, according to a new report by the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC). The report warns that one in five cases goes undiagnosed, while drug resistance continues to exceed global averages.

Although the overall number of TB cases has declined, progress toward elimination remains insufficient. Tuberculosis, an infectious disease spread when an individual with pulmonary TB expels bacteria through coughing, is the leading cause of death from a single infectious agent worldwide. Common symptoms include a persistent cough lasting more than two weeks, fever, night sweats, and weight loss.

Across the WHO European Region, which covers 53 countries in Europe and Central Asia, TB incidence has fallen by 39 percent since 2015, and deaths have dropped by 49 percent. These figures fall short of the WHO’s End TB Strategy 2025 milestones of 50 percent reduction in cases and 75 percent reduction in deaths.

Within the European Union, cases have decreased by 33 percent and deaths by 17 percent, insufficient to meet the 2030 targets. Health authorities note this gap has led to thousands of preventable infections and fatalities. In 2024, more than 160,000 newly diagnosed TB cases were reported, while the estimated actual number of cases was 204,000, meaning only 79 percent were officially notified.

Hans Kluge, WHO Regional Director for Europe, said undiagnosed cases represent missed opportunities to treat patients earlier and curb transmission. “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,” he said. Delayed diagnosis increases treatment difficulty and heightens the risk of spreading the disease.

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Drug-resistant tuberculosis remains a major challenge. Multi-drug resistant TB among new and previously treated cases stands at 23 percent and 51 percent, respectively, far above the global averages of 3.2 percent and 16 percent. Standard treatment for non-resistant TB typically lasts six months with success rates above 85 percent, but resistant variants require longer, more complex regimens with lower success rates.

Most European countries now report low TB incidence, with notification rates below 10 per 100,000. The disease mainly affects vulnerable populations, including migrants, prison inmates, and people with HIV co-infections. Ralf Otto-Knapp of the German Central Committee against Tuberculosis warned that lower overall case numbers in Western Europe have led to decreased attention, making it harder to combat multidrug-resistant TB. “We must strengthen treatment and prevention services, ensure easy access to new medicines and foster cross-border cooperation,” he said.

The report underscores that without urgent action on diagnosis, treatment, and drug resistance, Europe risks falling further behind its TB elimination goals, putting vulnerable communities at heightened risk.

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Experts Call for Stricter Fireworks Rules as Injuries Rise Across Europe

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Fireworks remain a popular feature of public celebrations, but health experts are calling for tighter regulations and greater public awareness as thousands of people suffer injuries each year.

In an opinion article published in the medical journal The BMJ, researchers from the University of California, Los Angeles (UCLA), warned that the dangers of fireworks are often underestimated and represent a significant public health concern.

Common injuries include severe burns, blast damage caused by shockwaves, traumatic brain injuries, amputated fingers and permanent loss of sight. Children, young men, rural communities and people from lower-income backgrounds are among those at greater risk. Bystanders can also be injured without handling fireworks themselves.

The authors are urging governments and health organisations in the United States and elsewhere to strengthen safety rules and invest in public education.

They recommend encouraging people to attend professionally organised displays rather than setting off fireworks at home. Medical and public health organisations could also challenge social media content that promotes private fireworks use.

The researchers propose school-based awareness campaigns for primary and secondary pupils, using real-life accounts and images of people injured by fireworks. They also suggest placing graphic injury warnings on packaging, similar to health warnings on cigarette packets.

Thousands seek medical treatment across Europe

Available figures highlight the scale of the problem, although many European countries do not maintain national records of firework-related injuries.

The Netherlands systematically collects data on incidents. During the 2025-2026 New Year celebrations, an estimated 1,239 people received emergency medical treatment at hospital emergency departments or out-of-hours general care services. This was 7% higher than the previous year.

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Italy’s Ministry of the Interior reported 283 injuries during New Year’s Eve celebrations, including 54 people who required hospital treatment.

Healthcare professionals say more countries need systematic reporting systems to establish the full extent of the injuries and identify where prevention measures are most needed.

Fireworks imports continue to grow

The health concerns come as the European fireworks market expands. Eurostat data published in December 2025 showed that the EU imported 120,000 tonnes of fireworks from outside the bloc in 2024, worth €406.7 million. Import volumes increased by 9.5% and their value by 21.5% compared with 2023.

A separate European Commission working document put the value of EU pyrotechnic imports at a record €452 million in 2024. The Netherlands accounted for 37% of extra-EU imports, followed by Germany at 35.6% and Poland at 7.4%.

Different rules across member states

EU legislation sets common safety requirements and divides consumer fireworks into four categories according to their hazard and intended use. Member states can impose stricter national restrictions on their sale, possession and use.

Minimum ages vary by category. Very low-hazard products, including some sparklers and party poppers, can generally be used from age 12, while certain low-hazard outdoor fireworks have higher age limits. Medium-hazard products intended for large open spaces carry a minimum age of 18 and require specialist knowledge.

Countries including the Netherlands, Germany, France and Italy have adopted additional restrictions, reflecting different national approaches to fireworks safety.

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One in Four Teenagers Worldwide Does No Weekly Exercise, Study Finds

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Around 240 million adolescents worldwide did not take part in physical activity on any day of the week in 2025, with girls falling further behind boys, according to a major global study published in The Lancet Global Health.

The research found that teenagers averaged 2.7 active days per week, a figure that remained unchanged between 2010 and 2025. Only 14 per cent, or about one in seven adolescents, reported being active every day.

The study analysed 389 surveys covering 3.2 million young people aged 11 to 17 across 140 countries. The data represented approximately 59 per cent of the global adolescent population.

Researchers defined an active day as one on which a teenager completed at least 60 minutes of moderate-to-vigorous physical activity. This follows the recommendation of the World Health Organization (WHO), which counts activity at school, during travel and in leisure time.

The findings raise concerns about progress towards the WHO’s target of reducing the proportion of adolescents who fail to achieve 60 minutes of daily activity by 15 per cent between 2010 and 2030. The researchers found that no country or region was currently on track to meet the goal.

A clear gender gap emerged from the data. Boys averaged three active days per week in 2025, compared with 2.4 days for girls. The difference widened as girls grew older, suggesting that existing opportunities and programmes were not reaching them equally.

Geographical differences were also substantial. Adolescents in Central and Eastern Europe and Central Asia, East Asia and the Pacific, and high-income Western countries averaged around four active days each week. In these regions, between 6.9 and 7.7 per cent of teenagers reported no physical activity at all.

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In contrast, young people in Latin America and the Caribbean, the Middle East and North Africa, Oceania, South and Southeast Asia, and sub-Saharan Africa averaged approximately two active days per week. The share reporting complete inactivity ranged from 22.7 to 33.1 per cent.

Finland, Canada and Serbia recorded the highest activity levels, with adolescents averaging between 4.5 and 4.8 active days weekly. Cambodia, Jordan and Madagascar were among the least active, averaging between 1.7 and 1.9 days.

The study’s authors linked these differences partly to structural conditions. Wealthier countries generally have more resources to support physical activity policies, provide public spaces and develop safe routes for walking and cycling.

The researchers said adolescence is an important period for establishing habits that influence health throughout adulthood. Regular exercise supports physical and mental wellbeing, but existing programmes are failing to reach large numbers of young people.

They called for stronger policies tailored to local conditions, with schools and neighbourhoods made more supportive of everyday activity. They also urged governments to address barriers affecting girls, including restrictive gender expectations, safety concerns and limited access to suitable sports and recreational activities.

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Health Groups Urge WHO to Tighten Drinking Water Nitrate Limits Over Cancer Risks

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A coalition of 85 international health and environmental organisations has urged the World Health Organization (WHO) to revise its drinking water standards for nitrate, warning that exposure to levels below the existing limit may be associated with colorectal cancer and premature births.

In an open letter sent on Tuesday, the groups called on the United Nations health agency to include nitrate in its forthcoHealth Groups Urge WHO to Tighten Drinking Water Nitrate Limits Over Cancer Risks

ming review of drinking water guidelines. Signatories include Greenpeace International, the World Organization of Family Doctors (WONCA) and the European Environmental Bureau.

The organisations argue that the WHO’s current nitrate limit is based on standards established decades ago and does not adequately reflect more recent scientific evidence about the potential effects of long-term exposure.

Nitrates and nitrites are naturally occurring compounds found in soil, water and food. However, human activities, including the use of agricultural fertilisers, manure runoff and poorly maintained septic systems, can increase nitrate concentrations in water supplies.

The current WHO guideline sets the maximum acceptable nitrate concentration at 50 milligrams per litre (mg/L), equivalent to 11.3 mg/L when measured as nitrate-nitrogen. The standard dates back to 1958 and was originally designed to prevent methaemoglobinaemia, commonly known as blue-baby syndrome. The condition reduces the blood’s ability to carry oxygen and can be fatal in infants.

The organisations say the existing threshold does not account for epidemiological research linking prolonged exposure to lower nitrate concentrations with other health risks, particularly bowel cancer and adverse pregnancy outcomes.

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“Studies now link nitrate in drinking water, at levels well below the current WHO limit, to bowel cancer and premature birth,” said Pratyush Kumar, chair of WONCA, in a joint statement.

Amanda Larsson, Greenpeace’s global project lead for agriculture, said access to safe drinking water should be treated as a basic guarantee rather than a privilege.

The coalition also cited a report commissioned by the Danish government last year, which concluded that the existing international standard was insufficient to protect public health. The expert panel recommended reducing the nitrate limit to 6.0 mg/L.

Denmark has committed to adopting the lower threshold, although it has not announced a timetable for implementation. The organisations said this creates a growing difference between international guidance and national drinking water policies.

Most governments use WHO recommendations as the basis for their own drinking water standards, making changes to the agency’s guidelines important for wider regulatory reform, the letter said.

The appeal was issued on World One Health Day, which highlights the links between human, animal and environmental health.

The signatories also called on governments to reduce pollution from intensive livestock farming and support producers in adopting more environmentally sustainable agricultural practices.

They said stronger protections against nitrate contamination were needed to safeguard drinking water supplies and reduce potential health risks, particularly for children and pregnant women.

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