Switzerland - March 24 marks World TB Day with the theme “Reach the 3 Million: Reach, Treat, Cure Everyone.”

Tuberculosis is one of the world’s top health challenges with 9 million new cases and the deaths of nearly 1.5 million people each year. Approximately one third of these 9 million cases of TB are missed by the health system. Among those missed are those most vulnerable to TB: people living with HIV/AIDS, migrants, refugees and internally displaced persons, miners, ethnic minorities and indigenous populations.

In 2014, the World Health Assembly adopted WHO’s “Global strategy and targets for tuberculosis prevention, care and control after 2015” which requests WHO and partners to promote cross-border collaboration to address the needs of vulnerable communities, including migrant populations.

Access to “continuity of care” and prevention of communicable diseases such as TB, including Multidrug-resistant TB (MDR), as well as TB/HIV co-infection, commonly occur in states suffering from political turmoil and armed conflict. Crisis situations often result in disrupted capacity of the public health system to meet the health care needs of affected populations.

Therefore, on World TB Day, IOM aims to raise awareness of the importance of addressing TB among migrants, displaced persons and other crisis affected populations in humanitarian emergencies, whether as a result of natural disasters or conflicts. In crisis or emergency settings, displaced persons and affected communities often live in overcrowded and confined spaces and lack access to TB services. 

“Promoting the use of primary health care and early treatment for TB among crisis affected populations and including them in TB-control programmes will reduce the need for costly emergency care and related high costs for the health system,” stated IOM Director General William Lacy Swing.

IOM works, amongst others, with Ministries of Health, especially National TB Programmes (NTP), WHO, the Stop TB Partnership, and the Global Fund to improve the quality and capacity of TB prevention, care and treatment services for crisis affected populations.

Examples of IOM’s work to reduce TB in humanitarian emergencies include:

• In January 2015, IOM received USD 3.25 million from the Global Fund’s Emergency Fund to support the prevention, diagnosis and treatment of TB among Syrian refugees and Lebanese returnees inLebanon and Syrian refugees in Jordan, in close collaboration with the National TB Programme, WHO and UNHCR. With the civil war in Syria entering its fourth year, Lebanon now hosts 1.3 million Syrian refugees and Jordan, 620,000. This has severely overstretched the capacity of both countries’ health systems and has resulted in an increase of TB cases in both countries.
• In Nepal, IOM works with the National TB Programme to reduce TB among Bhutanese refugees living in camps, who have escaped political unrest and violence in Bhutan. In 2014, IOM Nepal was awarded the Rana Samundra Trophy by the National Tuberculosis Center for outstanding work in TB. IOM introduced the TB diagnostic tool “GeneXpert” in nine strategically located microscopy centres in Nepal to increase TB detection among refugees, immigrants and Nepalese host populations. The project has tested over 20,000 suspect TB cases with GeneXpert technology detecting nearly 4,000 additional TB cases with around 300 drug resistant TB.
• In Iraq, as of January 2015, there are 235,563 Syrian refugees and 2,045,700 internally displaced persons (IDPs) in Iraq. IOM Iraq, in collaboration with the National TB Programme, WHO, UNHCR, and UNDP, supports the provision of critical primary health care services to approximately 400,000 beneficiaries, including TB detection and treatment support services in IDP and refugee camps. This is done, among others, by training community health workers on TB in the four governorates of the Kurdistan Region in Iraq. These health workers learn the proper procedures for TB detection, screening, and referral for more complicated strains of TB in a humanitarian setting.
• IOM Yemen, in coordination with the national TB programme and WHO, has been responding to the health needs of irregular migrants, mainly from the Horn of Africa, and internally displaced persons fromYemen.  IOM ensures that all migrants have access to health care services including TB screening, diagnosis and treatment in different areas including coastal areas and borders with Saudi Arabia as well as conflict affected areas in Sana'a, Aden, Hajjah and Abyan governorates. IOM provides a range of services, including physical examinations, radiological investigation, tuberculin skin test, sputum smear and culture, Drug Susceptibility Testing (DST) and Directly Observed Treatment (DOT). During 2014, 96 TB cases were detected and treated through IOM supported centers.  Furthermore, 2,360 people have benefitted from TB awareness-raising sessions organized by IOM during 2014. Also, IOM conducts regular pre-departure health screening for those migrants who are returning to their countries of origin to assess if they are fit to travel, and to coordinate with these countries for further treatment and follow up of the TB cases.
• With support from the Global Fund, and in close collaboration with the National TB programme, IOM Myanmar is currently implementing community-based TB awareness, detection, diagnosis and treatment amongst migrants and mobility impacted communities in seven townships in South EasternMyanmar, including Myawaddy Township in Kayin State, on the Myanmar-Thai border. Outreach health workers (OHWs) trained and supervised by IOM provide health education to the community, encourage people to present for testing if they have TB symptoms and provide DOT for TB patients in close collaboration with local TB services. OHWs also do active case finding and contact tracing to identify TB cases that might be missed otherwise.  In 2014, 7,427 TB suspected patients were referred through IOM’s community-based approach for testing, of which 2,153 were positive and put on TB treatment. IOM provides transportation and meal support for hospitals to further enable successful patient outcomes, and has achieved treatment success rates of over 80 per cent amongst new smear positive patients in some areas. Integral to this approach are the OHWs, who provide continuous support to patients to ensure treatment adherence.  “We need to find all the hidden TB cases we can, to reach them with health care services and treat them properly until they are cured. As a staff member of a humanitarian organization, I pledge to implement TB control activities as much as I can so my community will be free of TB,”   said Shine Win Htut, an OHW in Myawaddy.

To learn more about IOM’s health programmes, please go to http://health.iom.int

For further information please contact: Dr. Davide Mosca, IOM Migration Health Division, Tel: + 41 22 717 9358 Email: dmosca@iom.int.  Or Nenette Motus, Tel: +41 22-717 9355, Email: nmotus@iom.int