The European union standards for tuberculosis care: Do they need an update?

Background: The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed the European Union Standards for Tuberculosis Care (ESTC) published in 2012. The ESTC aim at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB) on the basis of the 2 nd edition of the International Standards for TB Care (ISTC) published in 2006. The Standards are designed as a living document that will be revised as technology, resources and circumstances change. Objectives: The 3 rd edition of the ISTC was recently published; this prompted the ECDC and the ERS to compare the third version of the ISTC and the ESTC to see what the differences are and to evaluate if a revision of the ESTC is necessary. Results: No relevant differences between the ESTC and 3 rd edition of ISTC were found in Standards 9, 13, 14, 17, 19, 20, and 21. For the standards were differences were identified, our analysis showed that the differences in the recommendations consistently could be attributed to the different setting (EU vs. global) in which they are to be applied. Conclusion: As new evidence is rapidly growing, a revision of the ESTC will make sense in about two years. The critical elements that will require a modification of the current standards will be represented mainly by the following factors: the WHO post-2015 Strategy; the progressive implementation of the Framework Action Plan for TB elimination in the EU; and, the introduction of new drugs in the EU.