Tuberculosis: Migration Doesn’t Have to Be a Barrier

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[ Graphic from the WHO that illustrates the need for TB treatment globally. ]

[Editor’s Note: Yesterday, March 24th, was World TB Day. Migrant Clinicians Network has worked hard for many decades to reduce the barriers that people have to accessing and completing treatment for TB, even while on the move. Learn more about Health Network here [2].]

Tuberculosis is curable, easy to diagnose, and easy to prevent. Despite these simple facts, 1.3 million people around the world died last year of TB. Here in the US, over 9,000 cases of TB are identified each year. Despite widespread suffering and death, funding to eliminate TB remains shockingly low, below levels to effectively address the need. Clinicians still rely on 100-year-old diagnostic tools. But, this World TB Day, there’s reason to be optimistic: last year’s UN High Level Meeting on Tuberculosis [3] elevated the concern to world leaders, while new drugs may promise the prevention of tuberculosis and death [4] in people with HIV infection. There may be a road ahead for TB elimination. And Health Network, MCN’s virtual case management program, is a critical component.

Migration continues to be a barrier to care for people with Tuberculosis -- but it doesn’t have to be. Without case management, patients may discontinue treatment, which encourages the development of deadly mutations like multidrug-resistant TB that require punishing, expensive treatments of toxic medications. MDR-TB is spreading worldwide.

But MCN has a solution. Health Network, MCN’s virtual case management program, can help push forward TB treatment among people who might otherwise be lost to follow-up. In a study, Health Network was found to be highly cost effective [5]; the study determined how many Quality Adjusted Life Years (QALYs) were saved and the number of active TB cases that were averted via the virtual case management as a result of Health Network’s above-average treatment completion rate for mobile patients.

Health Network began as TBNet, a virtual case management program specifically for patients with TB, before expanding to accept patients with any ongoing health concern. Over the years, hundreds of patients with TB have managed to complete care because we helped them connect with the health department or TB program in their next location, made sure they could get to their appointments, and transferred records, in the US and all around the world. This week, a Health Network case study was featured in the New England Journal of Medicine [6], a demonstration that our case management program continues to be innovative and indispensable. As we work toward TB elimination, Health Network is an important model to show us how we can get there with mobile patients, because migration should never be a barrier to care.

Deeper Dive:

Read “Eradicating Tuberculosis: Deliana Garcia at the United Nations. [7]”

Learn how Health Network works [2].