In this episode of In Conversation With, Larissa Otero, senior editor of The Lancet Regional Health Europe, speaks with Professor Christoph Lange (Research Center Borstel, Germany; TB Net) and Professor Liga Kuksa (Latvia's national centre for tuberculosis and lung diseases) about their June 2026 study on long-term outcomes after multidrug-resistant tuberculosis treatment in Latvia. They trace Latvia's path from European MDR TB hotspot, with more than 300 cases a year in the late 1990s, to just 22 cases last year, achieved through centralised expertise, sustained political commitment, and strong surveillance.
Their retrospective national cohort also reveals a striking gap: under WHO definitions, fewer than 5% of patients were classified as cured, yet 77% achieved relapse-free survival on long-term follow-up, raising urgent questions about how treatment success should be defined. The conversation closes with new antimicrobial stewardship standards for TB and why political instability, including the war in Ukraine, still shapes Europe's epidemic.
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