Exploring the link between migration and tuberculosis in Central Asia

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Filed under: Development Health HIV

By Christoph Hamelmann

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.

  • Tedla Mezemir

    Dear Christoph,

    Thank you for such thorough analysis of the migration issue in the region. Migration is the key challenge for our HIV and TB program in Tajikistan. A significant number of Tajik population migrates to Russia and in average about 16% of TB patients in Tajikistan migrates to Russia every year. The main issue as you can imagine is the interruption of the treatment and risk of MDR. This is one of the main contributor to the current very high MDR situation in the country. According to WHO 2011 Global TB report Tajikistan has the second highest ESTIMATED % OF RETREATMENT TB CASES WITH MDR-TB next to Republic of Moldova.Therefore, we believe this workshop will significantly contribute to this main public health challenge.

    • Alberto Colorado

      Dear Tedla,

      I have many years dealing with Trans-border and Trans-National TB/AIDS referrals and case management between the U.S. and Mexico as well with other countries in Latin America. I can share with you the best practices and the politics involved in this kind of programs and issues. You can find me in Facebook as Alberto Colorado or acTBistas. Remember that migrants are not the problem but the Mtb, so we need to find ways to partner with the migrant sender countries, and the migrants receiving countries respect migrants Human Rights.

      • Tedla Mezemir

        Dear Colorado,

        Great to hear from you. That is quite impressive experience and will be good to keep in touch. I will find you on Facebook, I am also reachable at tedla.mezemir@undp.org. Thank you for being very responsive to the matter. Many regards,