European Union Standards for Tuberculosis Care


ECDC and the European Respiratory Society (ERS) have developed the European Union Standards for Tuberculosis Care (ESTC). These standards are tailored to EU/EEA settings and are in line with accepted international principles and guidance outlined in the International Standards for Tuberculosis Care and the WHO Compendium of Tuberculosis Guidelines and Associated Standards. The standards are available in all EU/EEA official languages and are updated periodically as new scientific evidence becomes available.


The International Standards for Tuberculosis (TB) Care define the essential level of care for managing patients that have or are suspected to have tuberculosis. The standards also address care for people at increased risk of developing the disease. The ESTC were created as the low incidence of TB in the region, capacity and resources in the EU/EEA permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment than international standards. The goal of the standards is to help public health experts, clinicians and healthcare programmes in TB prevention and control, bridging current gaps in the case management of TB in the EU/EEA.

2017 update

A survey conducted in 2016 among ECDC contacts and members of ERS involved in the management of TB in the EU concluded that the ESTC are widely utilised and valued in Member States. An update was requested to integrate recent developments in TB diagnosis, treatment and prevention. Consequently, the ESTC were reviewed and updated integrating evidence-based recommendations from recently published international guidelines and policy documents. The update of the ESTC was conducted as a joint endeavour with ERS, consulting experts from international societies and organisations, national TB programmes, civil society and affected communities. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and co-morbidities and public health and prevention.

On 17 August 2018 the World Health Organization (WHO) released a rapid communication document, ‘Key changes to treatment of multidrug- and rifampicin-resistant tuberculosis’. In the communication, WHO recommends a revised grouping and ranking of the drugs used to treat multidrug-resistant TB. This revision affects the EU-specific requirements of Standard 12 included in the ESTC. Consequently, a correspondence ‘European Union standard for tuberculosis care on treatment of multidrug-resistant tuberculosis following new World Health Organization recommendations’ addressing the changes to ESTC 12 was published in European Respiratory Journal.

The ESTC is a user-friendly guide for clinicians and public health workers to help them achieve optimal diagnosis, treatment and prevention of TB. For further information or feedback on the ESTC, please contact

Download the ESTC