Cross-border TB Control
Migration and Tuberculosis (TB) have been around for millennia and each has carried a substantial burden of social and economic marginalization. Increasingly, these two phenomena have been intersecting and emerging as a major public health challenge requiring coordinated interventions implemented across national boundaries.
On April 5 and 6, 2016, representatives of Kazakhstan’s ministries and government agencies met in Almaty, Kazakhstan, with their counterparts from Tajikistan and Kyrgyzstan to address Migration and Tuberculosis (TB): Cross-Border Control of TB in the Central Asian Region. The purpose of the meetings was development of a coordinated bilateral and, ultimately, region-wide mechanism of TB control in Central Asia.
The Almaty meetings exemplify an unprecedented commitment of these three Central Asian countries to collectively address the challenges posed by high TB burden in the Central Asian region, especially among migrants — one of the most vulnerable groups. Migration is one of critical factors exacerbating TB burden and contributing to the development of drug resistant forms of this disease as nearly seven out of ten migrants diagnosed with TB fail to complete the prescribed treatment for cure due to lack of access to healthcare and support.
With support from Project HOPE – an international non-governmental organization implementing “Addressing Cross-Border TB and TB/AIDS Among Labor Migrants” – a program under a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), Kazakhstan is the first country among the former Soviet states to spearhead the development of a universal system of TB control and care for migrants. As the top seventh migrant-receiving country in the world, Kazakhstan aims to implement such an umbrella framework with consideration of the recommendations by the Wolfheze Consensus Statement of the WHO TB Conference in 2011.
The Wolfheze Statement sets forth minimum standards with respect to TB governance, financing, inter-country data exchange, prevention, diagnostics, treatment, surveillance and monitoring, as well as provision of supportive environment for TB control among migrants. “The objective of the meetings,” said Zhumagali Ismailov, Head of the Kazakhstan National TB Center, “is to create a harmonized and universal system of TB healthcare services that does not differentiate between the Kazakhstan nationals and foreign migrants and is consistent with the principles of the Wolheze Statement.”
The meetings, organized and facilitated by Project HOPE, brought together representatives from ministries and agencies engaged in public health, migration, labor and internal affairs, and national TB centers from Kazakhstan, Kyrgyzstan and Tajikistan, as well as World Health Organization (WHO), International Organization on Migration (IOM), and international and local civil society organizations. The meetings represented the continuation of activities that followed the high-level meeting held in Astana on November 19, 2015, where representatives of ministries and relevant government agencies from Kazkahstan, Kyrgyzstan, Tajikistan, Uzbekistan and Russia had formulated and adopted a one-year Action Plan/Road Map for implementation of coordinated TB control and care program among migrants.