The European/Central Asian region has the highest rate of multi-drug- and extensively-drug-resistant tuberculosis (MDR and XDR TB respectively, in practitioner’s jargon) in the world. According to WHO, there are currently an estimated 81,000 people with MDR or XDR TB in the region. Most of them do not receive a proper diagnosis and treatment.
At the national level, health systems often do not have enough capacity to identify and treat cases. The situation is further worsened by the substantial amount of (partially illegal) labor migration in the region. Moving to another country means that diagnoses get hidden or delayed and treatment interrupted.
Drug resistant TB is not purely a health issue. It has economic repercussions as well. Compare the costs of just a few Euro for a normal TB treatment course with thousands of Euro per person for all costs related to dealing with drug-resistant TB. WHO is estimating that we need to invest US $ 5.2 billion over the next 5 years for a reasonable action plan; without it, the final bill will be definitely larger.
Ultimately however at the core of this problem are social determinants of health and inequitable access to health services.
For the above reasons, I welcome next week’s high-level meeting on “Migration and tuberculosis: cross border care and control in Central Asia” in Almaty. I am looking forward to reviewing the outcomes of the meeting and, perhaps most importantly, to helping with the implementation plan coming out of the event. Watch this space for updates.