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The Contribution of Vulnerability of Labour Migrants to Drug Resistance in the Region: Overview and Suggestions

  • Gulnaz Isabekova
Early Careers Article

Abstract

Despite the increased funding to combat tuberculosis, the disease remains a global concern. One of the reasons is the development of drug-resistant forms of the disease. Post-Soviet states are on the list of the World Health Organization’s high-burden countries, and all have a higher percentage of drug resistance among previously treated patients than among new cases. This article suggests that treatment interruptions among labour migrants is one of the major factors contributing to the persistence of drug resistance in the region. Analysing tuberculosis control programmes implemented by national governments and the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) in Armenia and Kyrgyzstan the study emphasizes the limited consideration of the impact of patient mobility in these programmes. The findings stress the necessity to embrace the social and economic factors that increase the vulnerability of labour migrants to tuberculosis and treatment interruptions. Reviewing the strategies of other countries, this study discusses three possible solutions: pre-entry screening, access to healthcare in the country receiving migrants and cross-country collaboration.

Keywords

Labour migrants Tuberculosis control programmes Multidrug-resistant tuberculosis The Global Fund Post-Soviet 

Résumé

Malgré les financements accrus pour lutter contre la tuberculose, la maladie reste une préoccupation mondiale. L’une des raisons de cette inquiétude est le développement de formes résistantes aux médicaments. Les États post-soviétiques figurent sur la liste des pays à forte charge de morbidité de l’Organisation mondiale de la santé et ont tous un pourcentage plus élevé de résistance aux médicaments parmi les patients précédemment traités que parmi les nouveaux cas. Cet article suggère que les interruptions de traitement chez les travailleurs migrants sont l’un des principaux facteurs contribuant à la persistance de la résistance aux médicaments dans la région. En analysant les programmes de lutte contre la tuberculose mis en œuvre par les gouvernements nationaux et le « Fonds mondial de lutte contre le sida, la tuberculose et le paludisme » (Fonds mondial) en Arménie et au Kirghizistan, l’étude souligne la faible prise en compte de l’impact de la mobilité des patients sur ces programmes. Les résultats soulignent la nécessité de prendre en compte les facteurs sociaux et économiques qui augmentent la vulnérabilité des travailleurs migrants à la tuberculose et aux interruptions de traitement. En examinant les stratégies des autres pays, cette étude examine trois solutions possibles: le dépistage avant l’entrée dans le pays, l’accès aux soins de santé dans le pays d’accueil des migrants et la collaboration entre pays.

Notes

Funding

This work was supported by the Innovative Training Network ‘Caspian’, which is funded by the Marie Skłodowska-Curie actions (MSCA) grant of the European Union in the context of Horizon 2020 (grant agreement no. 642709). This publication reflects only the author’s view. The funding body is not responsible for any use that may be made of the information it contains. The final work on this article was conducted in the context of the Collaborative Research Centre 1342 "Global Dynamics of Social Policy" (Subproject B06 "External reform models and internal debates on the new conceptualization of social policy in the post-Soviet region"), which is funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation).

Compliance with Ethical Standards

Conflict of interest

I hereby declare that there are no conflicts of interest.

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© European Association of Development Research and Training Institutes (EADI) 2018

Authors and Affiliations

  1. 1.University of Bremen, Collaborative Research Centre 1342 “Global Dynamics of Social Policy” and Research Centre for East European StudiesBremenGermany

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