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National policies for delivering tuberculosis, HIV and hepatitis B and C virus infection services for refugees and migrants among Member States of the WHO European Region

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journal contribution
posted on 2023-05-03, 15:21 authored by Rebecca F Baggaley, Joshua Nazareth, Pip Divall, Daniel Pan, Christopher A Martin, Mikhail Volik, Nicole S Seguy, Askar Yedilbayev, Marge Reinap, Elena Vovc, Antons Mozalevskis, Andrei Dadu, Elisabeth Waagensen, Krista Kruja, Tyrone Reden Sy, Laura Nellums, Manish Pareek

Background/objective

Refugees and migrants to the World Health Organization (WHO) European Region are disproportionately affected by infections, including tuberculosis (TB), human immunodeficiency virus (HIV) and hepatitis B and C (HBV/HCV) compared with the host population. There are inequities in the accessibility and quality of health services available to refugees and migrants in the Region. This has consequences for health outcomes and will ultimately impact the ability to meet Regional infection elimination targets.


Methods

We reviewed academic and grey literature to identify national policies and guidelines for TB/HIV/HBV/HCV specific to refugees and migrants in the Member States of the WHO European Region and to identify: (i) evidence informing policy and (ii) barriers and facilitators to policy implementation.


Results

Relatively few primary national policy/guideline documents were identified which related to refugees and migrants and TB [14 of 53 Member States (26%), HIV (n = 15, 28%) and HBV/HCV (n = 3, 6%)], which often did not align with the WHO recommendations, and for some countries, violated refugees' and migrants’ human rights. We found extreme heterogeneity in the implementation of the WHO- and European Centre for Disease Prevention and Control (ECDC)-advocated policies and recommendations on the prevention, diagnosis, treatment and care of TB/HIV/HBV/HCV infection among migrants across the Member States of the WHO European Region.


There is great heterogeneity in implementation of WHO- and ECDC-advocated policies on the prevention, diagnosis, treatment and care of TB/HIV/HBV/HCV infection in refugees and migrants across the Member States in the Region.


Conclusion

More transparent and accessible reporting of national policies and guidelines are required, together with the evidence base upon which these policy decisions are based. Political engagement is essential to drive the changes in national legislation to ensure equitable and universal access to the diagnosis and care for infectious diseases.

Funding

National Institute for Health and Care Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and Leicester NIHR Biomedical Research Centre (BRC)

History

Author affiliation

Department of Respiratory Sciences, Leicester NIHR Biomedical Research Centre, University of Leicester

Version

  • VoR (Version of Record)

Published in

Journal of Travel Medicine

Volume

30

Issue

1

Publisher

Oxford University Press (OUP)

issn

1195-1982

eissn

1708-8305

Copyright date

2023

Available date

2023-05-03

Spatial coverage

England

Language

English