With nearly one billion migrants worldwide, migration is both a dynamic and a divisive phenomenon facing the world today. Migrants are a heterogeneous group, and the conditions surrounding migration pathways often pose risks to the physical, mental and social well-being of migrants, with certain subgroups being more vulnerable than others. Several determinants of health and tuberculosis (TB) interplay to increase the vulnerability of migrants to tuberculous infection, TB disease and poor treatment outcomes, making them a key population for TB. This article is the first in the State-of-the-Art series of the International Journal of Tuberculosis and Lung Disease on TB and migration. It provides an overview of migration trends, migration pathways and social determinants, and impact on TB. This article outlines a framework for the prevention and reduction of the TB burden among migrants, adapted from the World Health Organization's End TB Strategy, and in accordance with the Stop TB Partnership's Global Plan and the Sustainable Development Goals (SDGs) agenda. The framework highlights the need for migrant-inclusive national TB plans, and calls for action across all three pillars of the End TB Strategy for migrant-sensitive care and prevention, bold intersectoral policies and systems supportive of migrants, and operational research. More research is needed on the TB burden and challenges faced by migrants and on the feasibility and effectiveness of approaches proposed here and the scaling up of models already underway. Political commitment at the highest national and international levels will be critical to intensify action for promoting the health of migrants on the road to achieving the end TB targets. © 2017 The Union.

Migrants Refugees Global Plan Key populations End TB Strategy

Vulnerable Populations vulnerable population treatment response sustainable development health care planning health promotion public health service Human Migration health care policy community care human wellbeing trend study statistics and numerical data medical research social aspect priority journal health status national health service health program Humans migrant conceptual framework tuberculostatic agent tuberculosis Review Incidence feasibility study infection prevention migration infection risk health care access politics world health organization Health Policy Transients and Migrants infection sensitivity clinical effectiveness health care need