The need for protecting and enhancing TB health policies and services for forcibly displaced and migrant populations during the ongoing COVID-19 pandemic

doi:10.1016/j.ijid.2021.03.047

. 2021 Dec:113 Suppl 1:S22-S27.

doi: 10.1016/j.ijid.2021.03.047. Epub 2021 Mar 26.

The need for protecting and enhancing TB health policies and services for forcibly displaced and migrant populations during the ongoing COVID-19 pandemic

Affiliations

¹ Institute for the History of Medicine, University Justus Liebig Giessen, 35392 Giessen, Germany. Electronic address: michael.knipper@histor.med.uni-giessen.de.
² Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: ana_sedas@hms.harvard.edu.
³ Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: Salmaan_Keshavjee@hms.harvard.edu.
⁴ Imperial College London, Department of Infectious Disease, St Mary's Hospital, London, UK; Syria Public Health Network, Syria. Electronic address: a.abbara15@ic.ac.uk.
⁵ Assistance Coordination Unit (ACU), Early Warning Alert and Response Network (EWARN), Gaziantep, Turkey. Electronic address: naser.m@acu-sy.org.
⁶ WHO TB Program, Gaziantep, Turkey. Electronic address: alashawih@who.int.
⁷ Partners in Health, Lima, Peru, and Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: llecca_ses@pih.org.
⁸ Advance Access & Delivery, Durban, South Africa. Electronic address: michaelw@aadglobal.org.
⁹ Department of Infection, Division of Infection and Immunity, University College London NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK. Electronic address: a.zumla@ucl.ac.uk.
¹⁰ Institute for Global Health, University College London, London WC1N 1EH, UK. Electronic address: a.abubakar@ucl.ac.uk.
¹¹ Institute for Global Health, University College London, London WC1N 1EH, UK. Electronic address: m.orcutt@ucl.ac.uk.

PMID: 33775886
PMCID: PMC8752449
DOI: 10.1016/j.ijid.2021.03.047

The need for protecting and enhancing TB health policies and services for forcibly displaced and migrant populations during the ongoing COVID-19 pandemic

Michael Knipper et al. Int J Infect Dis. 2021 Dec.

. 2021 Dec:113 Suppl 1:S22-S27.

doi: 10.1016/j.ijid.2021.03.047. Epub 2021 Mar 26.

Authors

Affiliations

¹ Institute for the History of Medicine, University Justus Liebig Giessen, 35392 Giessen, Germany. Electronic address: michael.knipper@histor.med.uni-giessen.de.
² Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: ana_sedas@hms.harvard.edu.
³ Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: Salmaan_Keshavjee@hms.harvard.edu.
⁴ Imperial College London, Department of Infectious Disease, St Mary's Hospital, London, UK; Syria Public Health Network, Syria. Electronic address: a.abbara15@ic.ac.uk.
⁵ Assistance Coordination Unit (ACU), Early Warning Alert and Response Network (EWARN), Gaziantep, Turkey. Electronic address: naser.m@acu-sy.org.
⁶ WHO TB Program, Gaziantep, Turkey. Electronic address: alashawih@who.int.
⁷ Partners in Health, Lima, Peru, and Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: llecca_ses@pih.org.
⁸ Advance Access & Delivery, Durban, South Africa. Electronic address: michaelw@aadglobal.org.
⁹ Department of Infection, Division of Infection and Immunity, University College London NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK. Electronic address: a.zumla@ucl.ac.uk.
¹⁰ Institute for Global Health, University College London, London WC1N 1EH, UK. Electronic address: a.abubakar@ucl.ac.uk.
¹¹ Institute for Global Health, University College London, London WC1N 1EH, UK. Electronic address: m.orcutt@ucl.ac.uk.

PMID: 33775886
PMCID: PMC8752449
DOI: 10.1016/j.ijid.2021.03.047

Abstract

Disruption of health services due to the COVID-19 pandemic threatens to derail progress being made in tuberculosis control efforts. Forcibly displaced people and migrant populations face particular vulnerabilities as a result of the COVID-19 pandemic, which leaves them at further risk of developing TB. They inhabit environments where measures such as "physical distancing" are impossible to realize and where facilities like camps and informal temporary settlements can easily become sites of rapid disease transmission. In this viewpoint we utilize three case studies-from Peru, South Africa, and Syria-to illustrate the lived experience of forced migration and mobile populations, and the impact of COVID-19 on TB among these populations. We discuss the dual pandemics of TB and COVID-19 in the context of migration through a syndemic lens, to systematically address the upstream social, economic, structural and political factors that - in often deleterious dynamics - foster increased vulnerabilities and risk. Addressing TB, COVID-19 and migration from a syndemic perspective, not only draws systematic attention to comorbidity and the relevance of social and structural context, but also helps to find solutions: the true reality of syndemic interactions can only be fully understood by considering a particular population and bio- social context, and ensuring that they receive the comprehensive care that they need. It also provides avenues for strengthening and expanding the existing infrastructure for TB care to tackle both COVID-19 and TB in migrants and refugees in an integrated and synergistic manner.

Keywords: COVID-19; Health services; Migrant; Refugee; Tuberculosis.

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References

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1. Abbara A., Almalla M., AlMasri I., AlKabbani H., Karah N., El-Amin W., et al. The challenges of tuberculosis control in protracted conflict: the case of Syria. Int J Infect Dis. 2020;90:53–59. doi: 10.1016/j.ijid.2019.10.015. - DOI - PubMed
1. Americas TB Coalition . 2020. Peru: Al menos 9 mil personas dejaron de ser diagnosticadas con tuberculosis durante pandemia de COVID-19., Americas TB Coalition. Available at: https://actbistas.org/peru-al-menos-9-mil-personas-dejaron-de-ser-diagno....
1. Business Insider South Africa . 2020. Prime less 5% for honest small businesses – and plus 10% for chancers: Covid-19 help details, Business Insider South Africa.https://www.businessinsider.co.za/help-for-my-business-during-the-corona... Available at:
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[1] Abbara A., AlKabbani H., Al-Masri I., Sahloul Z., Sparrow A. Populations under siege and in prison require investment from Syria’s national tuberculosis programme. Lancet Respir Med. 2018;6(7):e34. - PubMed

[2] Abbara A., AlKabbani H., Al-Masri I., Sahloul Z., Sparrow A. Populations under siege and in prison require investment from Syria’s national tuberculosis programme. Lancet Respir Med. 2018;6(7):e34. - PubMed

[3] Abbara A., Almalla M., AlMasri I., AlKabbani H., Karah N., El-Amin W., et al. The challenges of tuberculosis control in protracted conflict: the case of Syria. Int J Infect Dis. 2020;90:53–59. doi: 10.1016/j.ijid.2019.10.015. - DOI - PubMed

[4] Abbara A., Almalla M., AlMasri I., AlKabbani H., Karah N., El-Amin W., et al. The challenges of tuberculosis control in protracted conflict: the case of Syria. Int J Infect Dis. 2020;90:53–59. doi: 10.1016/j.ijid.2019.10.015. - DOI - PubMed

[5] Americas TB Coalition . 2020. Peru: Al menos 9 mil personas dejaron de ser diagnosticadas con tuberculosis durante pandemia de COVID-19., Americas TB Coalition. Available at: https://actbistas.org/peru-al-menos-9-mil-personas-dejaron-de-ser-diagno....

[6] Americas TB Coalition . 2020. Peru: Al menos 9 mil personas dejaron de ser diagnosticadas con tuberculosis durante pandemia de COVID-19., Americas TB Coalition. Available at: https://actbistas.org/peru-al-menos-9-mil-personas-dejaron-de-ser-diagno....

[7] Business Insider South Africa . 2020. Prime less 5% for honest small businesses – and plus 10% for chancers: Covid-19 help details, Business Insider South Africa.https://www.businessinsider.co.za/help-for-my-business-during-the-corona... Available at:

[8] Business Insider South Africa . 2020. Prime less 5% for honest small businesses – and plus 10% for chancers: Covid-19 help details, Business Insider South Africa.https://www.businessinsider.co.za/help-for-my-business-during-the-corona... Available at:

[9] Cleary K. COVID-19: lockdown takes heavy toll on SA’s TB response. Spotlight. 2020 20 May. Available at: https://www.spotlightnsp.co.za/2020/05/20/covid-19-lockdown-takes-heavy-... (Accessed 30 January 2021)

[10] Cleary K. COVID-19: lockdown takes heavy toll on SA’s TB response. Spotlight. 2020 20 May. Available at: https://www.spotlightnsp.co.za/2020/05/20/covid-19-lockdown-takes-heavy-... (Accessed 30 January 2021)

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The need for protecting and enhancing TB health policies and services for forcibly displaced and migrant populations during the ongoing COVID-19 pandemic

Affiliations

The need for protecting and enhancing TB health policies and services for forcibly displaced and migrant populations during the ongoing COVID-19 pandemic

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