Human Mobility & Tuberculosis
“Tuberculosis is not simply an infectious disease, it is also a disease of poverty, social vulnerability and marginalization. Every effort should be made to ensure provision of equitable TB services for migrants that respect their rights, while upholding national and international health legislation.”
- Ambassador William L. Swing, IOM Director General -
Tuberculosis is one of the world’s main health challenges with 9 million new cases and nearly 1.5 million deaths each year. Approximately one third of new cases are missed by the health system and occur in populations which are most vulnerable to TB including migrants, Internally Displaced Persons (IDPs), refugees and other crisis-affected individuals due to poor nutrition status, poor living and working conditions, low education and awareness, and low health-care access.
Emergencies such as natural disasters, conflict-related humanitarian crises and migration crises result in disruption of the capacity of public health systems to meet the health care needs of affected populations. Forced displacement often results in relocation to camps or other temporary settlements where risk factors such as overcrowding, malnutrition, substance abuse, social exclusion, disruption of regular health care and poor health seeking behavior make affected populations more vulnerable to TB. Additionally, emergency health responses traditionally focus on acute disease threats such as measles and cholera outbreaks leaving chronic conditions such as TB unattended until too late.
The collapse of health systems in emergencies decreases access to TB awareness, prevention and continuity of care at points of origin, transit and travel, at destination and upon return within and across borders.
It is critical to address concerns of limited identification of TB cases, inadequate TB provision services, interruption of drug supply, irregular drug intake, increase in treatment defaulting, low cure rate, higher number of patients with relapse and an increase in Multidrug-resistant (MDR) TB among others.
IOM’s TB in emergencies programme is based on extensive experience with TB prevention, diagnostic and treatment services under its Migration Health Assessments and Travel Health Assistance programme for immigration and refugee resettlement and TB REACH programmes worldwide. Guided by the 2014 WHO End TB Strategy, IOM supports National TB Programmes (NTPs) under the Ministry of Health in non-crisis and crisis situations. Activities are coordinated and consistent with national protocols and regulations to ensure accountability to nation health authorities.
IOM provides a comprehensive range of TB screening related services, including physical examinations, radiological investigation, tuberculin skin test, sputum smear and culture, drug susceptibility testing (DST) and directly observed treatment (DOT). TB treatment is provided either directly by IOM or through a referral system, in partnership with National TB Programmes (NTPs).
IOM TB activities in emergencies aim to reduce avoidable morbidity and mortality through awareness, preventive and curative services in line with NTP and recognized humanitarian priorities and in close coordination with the WHO and health cluster coordination mechanisms.
Addressing TB among migrants: Four key building blocks