The Director’s Corner

The Director’s Corner

Refugees and migrants do not cause health crises

A message from José Luis Castro for World Refugee Day, 20 June 2016

It is appropriate that World Refugee Day on 20 June coincides with the eve of the 7th Union Europe Region Conference in Bratislava, Slovakia, when 600 delegates will be convening in the city to share their experiences and knowledge in all areas of lung disease.

The theme of the conference is ‘Leave no one behind – know, share, act in the treatment of lung diseases.’ But presently, vulnerable populations are being left behind, and for migrants and refugees suffering from TB and other deadly diseases, not only are they being excluded from treatment due to their circumstances, they are also being stigmatised.

Scaremongering by some of the world’s leading politicians include accusations that migrants bring disease with them, leading to cataclysmic predictions. Only last week, Nigel Farage, leader of British political party UKIP, was calling for migrants with HIV to be banned from the UK.* We in the TB community need to get a grip on this debate, present the facts and ensure that inaccurate or misleading statements are challenged at every opportunity.

The 7th Union Europe Region Conference will be looking at some of these issues (see conference programme here) – and with good reason. The European Centre for Disease Prevention and Control (ECDC) and the World Health Organization in Europe estimate that 340,000 Europeans developed TB in 2014. A quarter of all 480,000 patients suffering from multidrug-resistant TB (MDR-TB) were in Europe. This is an alarming number, which particularly affects marginalised populations including migrants and refugees. For the latter, because of their living conditions, TB is often diagnosed late (if it is diagnosed at all) and it is harder to complete a course of treatment. These facts continue to challenge TB elimination.

Let me be clear, refugees and migrants do not cause epidemics or disease. But their circumstances may make it difficult for them to recognise the symptoms of TB, access healthcare services, follow a treatment or attend regular appointments. It is a human right that care and treatments be made available to all individuals with TB. Practically, this means quality surveillance, targeted screening, monitoring, evaluation, and research amongst this group of people and the promotion of universal healthcare access.

To help aid efforts to manage TB cases across borders in Europe, the European Respiratory Society (ERS) and the World Health Organization (WHO) have established an online platform that encourages clinicians to share case notes with each other when a patient has moved countries. It is the first platform in Europe that exchanges patient data on TB. It is these kinds of innovative yet practical solutions that can make the difference.

If the treatment options are not available to this group, then there could be a rise in the number of cases of both the disease – including MDR-TB – and deaths from the disease. This is not the fault of populations; it is the responsibility of the TB community and our health systems to deal with the reality of this situation in order to impact on the disease. If we really want to eliminate TB, then we simply can’t afford to leave anyone behind.


José Luis Castro
Executive Director
The Union



The 7th Union Europe Conference takes place in Bratislava, Slovakia 22-24 June. Information here:

Conference sessions of interest relating to this article (full conference programme here)

Thursday 23 June (12-1330):

Plenary lecture: Giovanni Battista Migliori, European Respiratory Society Secretary General: The ERS/WHO/Union ER survey on management practices on refugees in the European Region.

Friday 24 June:

0830-1000 – Ethics and Human Rights – why they matter in TB (Nisha Ahamed)
0830-1000 – New technologies in TB diagnosis and TB treatment in condition of immigration gain (Anna Starshinova)
1330-1500 – TB in Special Populations:
Alberto Matteelli - TB prevention in asylum seekers entering Italy
Pierpaolo de Colombani - TB in European prisons- current epidemiology and trends
Lena Fiebig - Tuberculosis in Germany: a declining trend coming to an end
Ivan Solovic - TB in Roma people
Zohar Mor - TB in Israeli migrants