TB and migration

While usually fit to travel, migrants may have a higher risk of becoming infected or developing tuberculosis (TB) depending on: the TB incidence in their country of origin; the conditions experienced during their travel (physical stress and contact with infectious cases in camps and prisons); and their living and working conditions in the country of immigration, including access to health services and social protection. The active disease occurs in only a proportion of those infected and in half of the cases 5 years after immigration.

TB is very rarely transmitted from migrants to the resident population due to its low infectiousness and the limited social mixing of the two populations.

In consideration of the higher risk of TB for migrants, it is important to carry out tailored TB screening aimed at early detection and treatment of TB infection and disease. TB must, however, never be used as a reason to limit access to uninterrupted treatment through deportation. The continuum of care must be ensured at all levels and through appropriate cross-border communication and follow-up.

Minimum package of cross-border TB control and care interventions

Universal health coverage should be ensured for refugees and migrants, both documented and undocumented. The WHO European Region is the only one in the world with a consensus document on the minimum package of cross-border TB control and care interventions. These include ensuring access to medical services, irrespective of a migrant's registration status, and a non-deportation policy until intensive TB treatment has been completed.

As part of the implementation of the package, an online platform supports cross-border management of TB cases by facilitating communications among clinicians from different countries (in terms of sharing information for clinical management and contact tracing and referral of patients). This platform was made available as an additional function of the TB Consilium, established through a collaboration between WHO/Europe and the European Respiratory Society.