On the 29th of March, 2022, the European Lung Health Group spearheaded an event in collaboration with the TB Europe Coalition, European Respiratory Society (ERS), and the Global TB Caucus. This webinar was meant to bring together various NGOs that are active in the fight against TB and concerned with lung diseases. A general objective was to assist all concerned by providing further context around the present situation regarding Ukrainian migrants; what this means for the region in general, and how to best give sustainable and meaningful aid in this time of need.
The programme was opened by Michel Kazatchkine, Special Advisor to the WHO Regional Office for Europe, who expressed that the primary focus of the event was to address TB treatment for refugees and migrants, especially in Eastern Europe. This focus was developed via several objectives:
To present statistics and general evidence on how migration affects the health of TB patients.
To understand the current state of the TB response, especially in the context of migrants and refugees.
To discuss why TB must be included in the AMR agenda.
To discuss optimal means of supporting and providing access to healthcare for migrant TB patients.
The first presentation was on Migration and TB in the European region; by Paul Sommerfeld, on behalf of Daniel Kashnitsky. He noted a steady progress in reducing TB over the last five years within Ukraine and general area, but also that the TB Notification rate across the eastern side of Europe is much higher: contrast to Western Europe, which is an area of low-incidence countries.
As TB predominantly affects migrants (among some others), some immediate consequences are concerns about continuity of care, and the maintenance of regular drugs. This could eventually lead to delayed diagnosis and reporting. Among their list of suggestions, Kashnitsky and Sommerfeld called for the creation of emergency HIV and TB drug stock supplies in the European region in cooperation with WHO as an immediate measure:
Afterwards, Askar Yedilbayev & Andrei Dadu outlined the current TB situation within Ukraine. TB is still one of the leading causes of death in Europe, and refugees & internally displaced persons (IDPs) are at increased risk. Most importantly, they took care to note that most migrants do not have infectious diseases, but they must shoulder much of the burden of these diseases regardless. They then presented an ideal trinity for cross-border case management:
Diagnosis
Repatriation/treatment continuity/biosafety
Contact tracing
Following this, Ivan Solovic presented perspectives on “Tackling TB Refugees in Europe'', and opened by discussing the connections between the COVID-19 Pandemic and TB. COVID-19 has reversed years of global progress in tackling TB, and for the first time in over a decade, deaths due to TB have increased. Some practical issues that countries receiving people fleeing from Ukraine should consider are:
Expediting decisions on access to healthcare & healthcare benefits.
Provide Ukrainian language information materials for administrative procedures, healthcare, and prescriptions.
Lastly, he mentioned two necessary steps for the future: Protection for arrivals from Ukraine and meaningful cooperation with WHO.
The final presentation was by Oxana Rucsineanu, discussing “Support for TB and HIV People fleeing Ukraine.''
Opening with Moldova’s perspectives in standing with & supporting Ukrainians, Rucsineanu specified that between Feb 24 and March 24, 339,804 Ukrainian Citizens entered the Republic of Moldova, of which 96,640 remained in the country. Taking these figures into account, she emphasised that TB, HIV, and OST treatments should be available and accessible to people affected by the disease regardless of their legal status, place, and country. A key means of addressing these concerns would be inter-country agreements and cooperation, which should be established to help people get immediate access to SOC (standards of care) regarding AMR, with all respect to human rights. Investments and political will are necessary to make treatments for refugees at no cost, while reducing bureaucracy to expedite the process.
However, SOC may differ from country to country; initial clinical evaluation may be needed. In closing, she emphasised that no stigma and discrimination impeding access to health care should be tolerated.
The programme ended with an address from Baroness Alison Suttie, Co-chair of the Western Europe region of the Global TB Caucus, who presented the Statement of intent on TB care for migrants by members of the Global TB Caucus, for further discussion with and inputs from representatives of civil society and affected communities.
It is our hope that this event not only brings CSOs fighting TB closer together, but also begins the meaningful steps towards a stronger political will to end TB.
Our thanks go out to the following participants and speakers:
MEP Lung Health Group
Civil Society Organisations
Representatives from national authorities and EU
Global MPs
Affected community members
Product Development Partnerships
WHO