Migrant health key in TB fight
March 24th, 2014
03:14 PM ET

Migrant health key in TB fight

By Martin Cetron and Davide Mosca, Special to CNN

Editor’s note: Martin Cetron MD is director of the Centers for Disease Control’s Division of Global Migration and Quarantine. Davide Mosca is director of the Migration Health Division, International Organization for Migration. The views expressed are their own.

Today’s ease of travel means more people are on the move than ever before – more than 232 million people across the globe are considered migrants, playing an important role by filling jobs in sectors that face a shrinking national workforce. In the process, they frequently enrich societies with their skills, entrepreneurship, and cultural diversity.

Unfortunately, many also originate from countries that have high rates of tuberculosis and fewer health resources. World TB day, being marked today, offers an important moment to take stock of where we stand – and why this is a problem not just for developing countries, but also for rich nations including the United States.

Of the nine million people around the world who get sick with tuberculosis each year, a third do not get treatment. It is this reality that forms the basis of this year’s theme – reaching the “three million,” through a TB test, treatment and ultimately a cure for all.

The challenge, of course, is that many of the missing three million live in the world’s poorest, most vulnerable communities, nations that often don't have the resources to fight TB. These migrants frequently face high exposure to TB infection because of overcrowded and unhealthy living and working conditions in their home countries. As a result, tuberculosis rates are high among foreign-born groups in many industrialized countries, including here in the U.S.

That is why health experts increasingly see migration as a key factor to consider as they develop programs to control the spread of TB.

Unfortunately, in addition to the personal costs, the high rate of TB-related illness and death among people living outside their home country can have devastating economic effects at every level – from individual households to society as a whole. Those with the disease may not be able to bring home a much needed income, send money back to their families in their home country, or contribute to society as they struggle with TB illness.

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All this means that we need to think about migration in new, smarter ways. For a start, we have a responsibility to ensure that the human rights of migrants are respected, including their right to health and safety as they leave their birth country and settle elsewhere. Doing so requires a careful balancing act between the legitimate concerns of governments to ensure health security with the need to protect the health of individual migrants.

With this in mind, the U.S. Centers for Disease Control and Prevention and the International Organization for Migration have been working closely for more than 50 years to provide health assessments and TB treatment for migrants coming to the United States. For example, we help prevent disease and ensure immigrants and refugees receive the treatment they need for TB, including through the new TB screening guidelines rolled out during the past several years, guidelines that are already succeeding in identifying additional cases of TB and making sure immigrants and refugees get the care they need prior to their arrival in the United States.

The problem is that TB prevention and control efforts often overlook the specific needs of migrants and how they differ from others who have TB. Delays in diagnosing TB among this group – and lapses in treatment – are common, in part due to the difficulty those suffering face in accessing affordable healthcare, lack of health education, cultural beliefs, stigma, and marginalization. And, because many migrants are among the missing three million, the absence of TB prevention and control strategies tailored for them remains a barrier to eliminating TB around the world.

Ultimately, supporting the health of this vulnerable group makes sense from financial, social and public health perspectives, and our hope is that we can move toward eliminating TB as a public health problem in the next two decades. Acknowledging and addressing the needs of migrants is a good place to start.

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Topics: Health • Immigration

soundoff (10 Responses)
  1. Joseph McCarthy

    This article here makes an excellent case for Communism in third world countries and the blatant failure of the U.S. and it's crony allies to do anything about the spread of TB. We shelled out billions of dollars year after year on this problem and yet it only got worse through the years! We need a laissez-faire foreign policy.

    March 24, 2014 at 5:01 pm |
    • Judge Jean Boyd in Texas

      You should be tared and feathered for your blatant lack of political correctness, Joseph! Although what you said above is true, we don't want too many people here knowing it. someone might wise up and I myself intend to remain politically correct!

      March 25, 2014 at 11:39 am |
    • Lance Buckmaster

      You nailed it, Joseph. Thank you. I'm sick and tired of all of this stupid political "correctness" and the foreign aid which seems to benefit only the elite in these countries!

      March 25, 2014 at 11:57 am |
    • Chris Roem

      Why do all three of these posts have the same avatar? Why would 1 person pretend to be 3?

      March 25, 2014 at 1:54 pm |
  2. chrissy

    Joseph, many months ago i brought up this subject when our congressional clowns refused to work on a new resolution towards immigration reform! Now the outcome of no one doing NOTHING towards fixing that problem are comming front and center. And the usual haters will blame Obama as they always do but had congress just ONCE in the past 6 years attempted to do their jobs this might not have become such a big prob! Of course ppl comming to this country illegally do not have the inoculations that US citizens have! The countries many of them come from dont have running water or toilets even!

    March 25, 2014 at 10:38 am |
  3. Timmy Suckle

    I kissed my way up to CEO at a health insurance company. Now I take over $1,000,000 of your health care dollars for NO VALUE ADDED to your health care. And that’s just me. Now think about how many other CEOs, VPs, Directors, Managers, etc. are at my company alone. Now multiply that by thousands of others at hundreds of other health insurance companies. From 10 to 25% of your health care dollars go towards administration that adds NO VALUE to your health care. But my company’s PAC dollars will continue to fool you little people into thinking that a single payer system will be bad. Little people like you are so easy to fool. Little people also don’t realize that a single payer system is the ONLY system that would allow little people (as an entire country) to negotiate better health care prices. Little people don’t realize that the Medical Cartels already know that. And that is the reason why the Medical Cartels spend so much PAC money from the hospitals and doctors lobbying against a single payer system. Some little people say that a single payer system would cost you little people more. But if that were true, then wouldn’t the hospitals and doctors WANT that extra money? Yes they would. So why do the Medical Cartels lobby against a single payer system? It’s because the Medical Cartels know it would allow little people to negotiate better health care prices. And that’s what the Medical Cartels are afraid of. Period.
    But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easily fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
    Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $117,000 level. Now I only pay 1.17% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.

    March 25, 2014 at 5:20 pm |
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