World Tuberculosis Day 2025

Each year, the World Health Organization (WHO) selects a theme for the day. The theme for 2025 is "Yes! We Can End TB! – Commit – Invest – Deliver“

TB is relatively rare in Iceland, with approximately one case diagnosed per month or every other month (6–20 cases annually). Between 2015 and 2024, a total of 109 TB cases were reported in the country. Among these 22 cases (20%) were detected during residence permit screenings, 23 cases (21%) involved individuals with Icelandic citizenship, and 64 cases (59%) were diagnosed among foreign-born residents due to symptoms or contact tracing.

Most Icelandic-born individuals diagnosed with TB are believed to have contracted the disease locally, either in early life (for those born before 1960) or recently. It is relatively uncommon for Icelandic citizens to trace their infection to time spent abroad.

TB is a disease subject to registration in Iceland, meaning that all cases must be reported to both the European Centre for Disease Prevention and Control (ECDC) and WHO. If TB is detected in children or a contagious case is identified in an adult, contact tracing is conducted to find the source of infection and other potential exposured persons.

In 2024, Iceland recorded 8 TB cases, fewer than in 2022–2023 and similar to 2021. No cases of drug-resistant TB were reported in 2024. TB disease was diagnosed among homeless individuals, who are particularly vulnerable to developing TB disease if infected due to increased risk for limited healthcare access and poor nutrition. Delayed diagnosis and treatment interruptions pose serious risks for bad outcomes among socially vulnerable individuals, including those with mental health issues including substance use disorders.

How Can Iceland Further Reduce TB Cases?

Commit

WHO urges countries to implement its TB guidelines and policies, strengthen national TB response strategies, and ensure adequate funding for TB control. Iceland follows WHO guidelines but also adapts them to the country's situation, where TB incidence is very low. However, recent cases among vulnerable populations highlight the need to remain vigilant. TB transmission is more likely if cases go undetected for long periods, particularly among individuals without stable housing or access to healthcare.

Invest

WHO advocates for investment in TB innovations. New diagnostic methods, medications, and vaccines are under development, but many do not reach the market due to funding shortages. Iceland has recently improved access to more precise TB diagnostic tools, which are especially useful for screening immunocompromised individuals and those previously vaccinated against TB. The Chief Epidemiologist and Landspítali (National University Hospital of Iceland) have also worked to ensure access to new, effective medications for drug-resistant TB.

Deliver

Policies alone are not enough; they must be actively implemented. WHO’s key priorities include:

• Identifying TB infections early and using preventive treatments.

• Diagnosing active TB cases as soon as possible.

• Ensuring effective TB treatment that is as patient-friendly as possible.

In Iceland, extensive contact tracing is conducted when contagious TB cases are identified. The primary responsibility lies with primary healthcare centers and Landspítali, with support from the Chief Epidemiologist when needed. All individuals diagnosed with TB infection are offered preventive treatment unless there is a compelling reason to avoid it. If treatment is not possible, infected persons are monitored for 1–2 years with chest X-rays and given appropriate treatment if the infection progresses to active disease.

People diagnosed with contagious TB in Iceland have commonly had symptoms for three months or longer, increasing the risk of further transmission. At least three TB patients in the past five years likely contracted the disease domestically, with no known link to previous cases. Additionally, at least two individuals with known exposure either declined screening or refused preventive treatment. Ensuring proper follow-up and access to TB evaluations is crucial. However, there are no clear guidelines on medical record alerts for TB risk that all emergency care providers can access.

Most TB patients in Iceland receive outpatient treatment from infectious disease specialists at Landspítali. Some patients require hospitalization due to the severity of their illness or drug-resistant TB, while others are admitted because they lack suitable housing for isolation. In recent years, Landspítali has arranged temporary housing for some TB patients who needed isolation but did not require hospitalization.

Directly Observed Therapy (DOT) is commonly used in countries with higher TB burden, where healthcare workers ensure that patients take their medication. However, DOT has been rarely used in Iceland, and it remains unclear which institution would be responsible for its implementation. Inadequate TB treatment can lead to further transmission and drug resistance, making it vital to secure access to care and adherence support for all TB patients.

See Also:

• World TB Day 2025 – WHO

• Cost-effectiveness of active TB screening in low-incidence countries: A systematic review (Eurosurveillance, 2008–2023)

• ECDC TB Reports for Europe

• TB Testing Guidelines (Icelandic)

• TB Screening & Contact Tracing Guidelines (Icelandic)

• TB Guidelines for Healthcare, Social Services, and Sanitation Workers.

The Chief Epidemiologist