US: Department of Health and Human Services bans undocumented immigrants from taxpayer-funded health services

Three years before the first federally funded community health centers in the US opened their doors to patients of all backgrounds, a 1962 law authorized the creation of new clinics to treat domestic migrant and seasonal agriculture workers.

The Migrant Health Act reflected a recognition that a community’s health depends on all who are a part of it, said historian Beatrix Hoffman, PhD, who studies immigration and health policy at Northern Illinois University. “The more people who have access to care, the better,” she added.

Migrant health centers served as a precursor to community health centers, which treat patients no matter their ability to pay. Today, community health centers across the nation are a major source of primary care for another migrant population: undocumented immigrants. But this could change with new restrictions from the US Department of Health and Human Services (HHS).

On July 10, HHS announced that undocumented migrants will no longer have access to any of the department’s taxpayer-funded services classified as federal public benefits. In addition to community clinics supported by the Health Center Program, this action affects services such as Head Start, certain substance use and behavioral health programs, and the Projects for Assistance in Transition from Homelessness grant program.

The new guidelines were enacted to “strengthen the integrity and consistency of benefit eligibility,” an HHS spokesperson said in a statement to JAMA Medical News. Public health experts, however, warn the change could undermine care through these programs for all patients.

The Rationale

The new policy reverses a prior interpretation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), which allowed undocumented immigrants to access certain federal programs.

The change reflects the “taxpayer friendly” posture of President Donald Trump’s administration, said Ge Bai, PhD, CPA, an accounting professor at Johns Hopkins University and unpaid advisor to the Paragon Health Institute, a think tank founded by former Trump health care advisor Brian Blase. “The administration is facing the increasing deficit and worsening national debt, so they have to find all the ways they can to reduce government spending,” she said.

Undocumented immigrants pay sales tax on their purchases, and many pay income and property tax. Bai noted that these contributions do not make up a significant portion of the tax base. However, federal tax payments from undocumented immigrants totaled $59 billion in 2022, according to a report from the Institute on Taxation and Economic Policy.

The HHS has also stated that these services incentivize illegal immigration. Bai said that would-be migrants consider social programs when debating the risks and benefits of entering the country without authorization. She cited the influx of undocumented immigrants in 2021 through 2023, noting the expansion of the social safety net in response to the COVID-19 pandemic helped spark the migration surge.

Not everyone agrees. Although Hoffman allows that some undocumented immigrants may enter the country seeking specialized treatment, she countered that these cases are extremely rare. “Historically, undocumented people are afraid to access health care because they don’t want to be detected,” she said.

“People don’t migrate to the US to use health services or any other type of public benefit,” said Arturo Vargas Bustamante, PhD, MPP, a public health professor at the University of California, Los Angeles. “People migrate to the US because they have the economic incentive to get jobs.”

As undocumented immigrants tend to use fewer health services than US-born citizens and are ineligible for many federal programs including Medicare, Bustamante argued that their tax contributions subsidize health services for US citizens. A 2022 analysis in JAMA Network Openconcluded that tax contributions and premiums from undocumented immigrants exceeded expenditures by more than $4000 per person.

Bustamante said the benefits of offering services such as vaccinations and prenatal consultations to undocumented immigrants outweigh costs to taxpayers. He doubts the new guidelines will curb health care spending, in part because it could increase reliance on emergency care. Emergency departments remain open to undocumented immigrants because of the Emergency Medical Treatment and Labor Act, which prevents hospitals that receive Medicare dollars, as the overwhelming majority do, from refusing to treat patients in emergency conditions. There, care may be covered by emergency Medicaid that is available regardless of immigration status with qualified expenses varying by state.

An Ounce of Prevention?

Without primary care services through community health centers, Bustamante and others predict that undocumented immigrants will forgo treatment for as long as possible until they require emergency care.

“They won’t go to get medication. They won’t go to get regular checkups. They won’t go to get preventive care,” said Annie Ro, PhD, associate professor at the University of California Irvine Joe C. Wen School of Population and Public Health.

Losing access to primary care leaves people with fewer options to manage chronic conditions, which can lead to new health problems like infectious disease, said Nicole Swartwood, MSPH, who studies public health at Harvard University.

For example, unmanaged diabetes might increase the odds that a latent tuberculosis infection will become active and contagious—and individuals born in many countries outside the US are already at greater risk of tuberculosis.

Homelessness and intravenous drug use are also linked to tuberculosis, Swartwood added. The new restrictions would block undocumented immigrants from HHS services related to those concerns as well.

Meanwhile, community health centers play a role in infectious disease surveillance, including screening for asymptomatic latent tuberculosis. If undocumented patients are barred from these clinics, their condition may not be identified and they may transmit tuberculosis to others. “Nondocumented migrants are not living in isolation,” said Swartwood, adding that they are part of their communities and interact with others.

The Broader Implications

Impaired infectious disease monitoring is just one way the HHS policy may affect more than just undocumented immigrants. Multiple experts said they worry the new rules will sow fear that deters migrants from accessing care even when they qualify for it.

Ro pointed out that many undocumented immigrants have children who are US citizens by birth. “These kids are not targeted by these restrictions, but because their parents are concerned, we’ll probably see a chilling effect within families,” she said.

Determining eligibility could itself pose a challenge for clinics. “Providers are legally bound to provide care when it’s needed, but they’re put in this position where they have to verify somebody’s immigration status,” Ro continued. “That’s not really their job.”

HHS has not yet released program-specific guidance, but Ro fears that calling on understaffed clinics to enforce these restrictions will divert time and resources away from patient care.

“Everyone is going to be affected, not only immigrants themselves, but also migrant families, mixed-status families, and US-born citizens who are going to encounter more expensive health services, longer waitlists, and less provider availability,” Bustamante said.

A Policy Pattern

The HHS rules are not the only rollback of services for undocumented immigrants this year. California, Illinois, and Minnesota have each scaled down or cut eligibility for state Medicaid coverage previously offered to immigrants of any status.

In April, the Idaho state legislature passed HB 135, which excluded undocumented immigrants from services such as food pantries and prenatal care. Controversially, the bill originally required proof of legal status from patients receiving medication at programs funded through Part B of the federal Ryan White HIV/AIDS Program.

“HIV is very treatable, and we have great medications for it,” said Abby Davids, MD, MPH, who treats patients with HIV at a federally qualified community health center in Boise. “But if you lose access to your antiretrovirals, then HIV is universally fatal.”

Davids added that without medication, people living with HIV could transmit the virus to others: “From an individual patient standpoint and from a community standpoint, it’s a really horrific situation.”

The portion of HB 135 restricting HIV treatment was blocked by a federal judge in late June following a lawsuit by the American Civil Liberties Union on behalf of Davids and 5 unnamed patients. The next month, a federal judge granted a preliminary injunction preventing immigration status–based restriction to Ryan White Part B programs until all litigation is settled.

HHS has not responded to requests from JAMA Medical News for comment about how eligibility for Ryan White–funded programs may change because of the new federal guidelines.

Undocumented immigrants can still receive emergency Medicaid in all 50 states, although the Centers for Medicare & Medicaid Services has agreed to share information about Medicaid enrollment with Immigrations and Customs Enforcement, the Associated Press reported in July.

“This administration has been so aggressive in targeting any kind of benefit that would remotely touch the undocumented immigrant population,” Ro said.

Published Online: August 8, 2025. doi:10.1001/jama.2025.12999

Conflict of Interest Disclosures: None reported.

Global study reveals 50 countries still enforce HIV-related travel restrictions

A new global study presented this week at the 13th IAS Conference on HIV Science in Kigali (IAS 2025) has revealed that 50 countries around the world continue to enforce HIV-related travel and residence restrictions, in clear violation of international human rights principles.

The data, shared by the HIV Justice Network through its new platform Positive Destinations, highlights the persistence of discriminatory laws and policies that prevent people living with HIV from freely travelling, working, studying, or settling in many parts of the world.

Despite progress – 83 countries now have no HIV-specific travel restrictions, and many others have adopted more inclusive approaches – 17 countries still impose severe measures such as outright entry bans, mandatory testing, and deportation. These include Bhutan, Brunei, Egypt, Iran, Kuwait, Malaysia, Russia, and the United Arab Emirates. Migrants and students are often disproportionately affected, with some unaware of the rules until after testing or disclosure, resulting in forced returns, loss of income, and separation from families.

Another 33 countries – including Australia, Canada, Kazakhstan, the Philippines, Saudi Arabia, and Singapore – have partial restrictions. These include requirements for HIV testing in visa applications, discretionary decisions based on perceived healthcare costs, and reduced access to essential services. Although these policies may appear neutral on the surface, they continue to disadvantage people living with HIV.

“These restrictions are rooted in outdated public health thinking and perpetuate stigma,” said Edwin J Bernard, HIV Justice Network’s Executive Director. “They obstruct access to healthcare, education, and family life, especially for migrants and refugees.”

   Click on the image to download the poster

In 2024, Positive Destinations documented several cases of deportation based solely on HIV status: Kuwait deported over 100 people, Russia’s Dagestan region deported nine, and Libya deported two. Such practices are increasingly being challenged by legal action. In Canada, for example, a court case led by the HIV Legal Network contests the “excessive demand” clause of immigration law, arguing it violates the country’s Charter of Rights and Freedoms.

However, policy reform has been uneven. Australia raised its health cost threshold for visa eligibility, slightly easing access to temporary stays, but permanent residency remains elusive for many people with HIV. A recent case saw an Italian teacher denied residency due solely to his HIV-positive status.

The study also underscores how HIV-related migration barriers often intersect with other forms of criminalisation and discrimination. In Uzbekistan and Russia, HIV criminalisation laws are paired with mandatory HIV testing for migrants. In the U.S., HIV-positive and LGBTQ+ asylum seekers continue to face mistreatment in detention centres. And in a tragic case in Turkey, a Syrian trans woman was reportedly deported after her HIV status was disclosed and later killed upon return.

The authors of the study call for urgent action: “Eliminating these harmful policies is essential to ending AIDS, achieving universal health coverage, and upholding the dignity and rights of people living with HIV everywhere,” said Bernard.

Positive Destinations, which hosts the updated Global Database on HIV-Specific Travel and Residence Restrictions, is available at www.positivedestinations.info

EP0623 Addressing HIV-related travel restrictions: Progress and challenges in eliminating discriminatory policies by Edwin J Bernard, Sylvie Beaumont, Elliot Hatt, and Sofía Várguez was presented at IAS2025 by Brent Allan at the 13th IAS Conference on HIV Science, Kigali, Rwanda.

US: Doctors report dangerous delays in care among migrants fearing deportation

Since President Trump announced plans for mass deportations and rescinded protections for hospitals and clinics, health care facilities have seen a jump in no-shows.

A man lay on a New York City sidewalk with a gun shot wound, clutching his side.

Emily Borghard, a social worker who hands out supplies to the homeless through her nonprofit, found him and pulled out her phone, preparing to dial 911. But the man begged her not to make the call, she said.

“No, no, no,” he said, telling her in Spanish that he would be deported.

Ms. Borghard tried to explain that federal law required hospitals to treat him, regardless of his immigration status, but he was terrified.

“He said, ‘If I go to the emergency department, that will put me on their radar,’” she recalled in an interview recounting the incident.

Across the country, doctors, nurses and social workers are increasingly concerned that people with serious medical conditions, including injuries, chronic illnesses and high-risk pregnancies, are forgoing medical care out of fear of being apprehended by immigration officials. Since the Trump administration announced plans for mass deportations and rescinded a Biden-era policy that protected spaces like hospitals, medical clinics and churches from immigration enforcement, doctors said they have seen sharp increases in patient anxiety and appointment no-show rates.

If the trend continues, health care officials say, the list of consequences could be long: Infectious diseases circulating unnecessarily; worsening health care costs because of untreated chronic illnesses; and dangerous birth complications for women who wait too long to seek help, among others.

In a survey conducted by KFF, a health policy research organization, 31 percent of immigrants said that worries about immigration status — their own or that of a family member — were negatively affecting their health. About 20 percent of all immigrants surveyed said they were struggling with their eating and sleeping; 31 percent reported worsened stress and anxiety.

A White House spokesman did not respond to messages seeking comment. When the administration announced that it was ending protections at hospitals on Jan. 21, a statement from the Department of Homeland Security said the new policy was intended “to enforce our immigration laws and catch criminal aliens.”

Research has shown that immigration crackdowns are linked with poorer birth outcomes and mental health status, lapses in care, and fewer people accessing the types of public programs that reduce illness and poverty overall.

“We’re really creating not just very serious health risks, but economic risks in the long run for our country,” said Julie Linton, a pediatrician and member of the committee on federal government affairs for the American Academy of Pediatrics. “These policies are creating very real fear and uncertainty for people and have a tremendous impact on their ability to function on a day-to-day level.”

Many immigrant communities suffer from high rates of chronic conditions such as high blood pressure and diabetes, which, if left untreated, can lead to heart attack, stroke and other grave complications.

That is why doctors worry about patients like Maria, a 47-year-old woman with pre-diabetes, who has been going to the same primary care clinic ever since she arrived in the United States from El Salvador 20 years ago. Even during the first Trump administration’s crackdown on immigration, she continued to seek medical care. But when the protections around hospitals and clinics were rescinded earlier this year, Maria canceled her appointment to have her blood sugar checked, a routine and crucial element of diabetes prevention in patients like her.

“We’re very scared of being in the clinic and having ICE arrive while waiting to be called,” she said in Spanish, referring to U.S. Immigration and Customs Enforcement.

Maria, who asked that her last name not be published, said that she is in a state of “constant anguish.” She said she avoids leaving the house and is working on a plan for the care of her children, who are American citizens, in case she and her husband are deported.

One of their daughters, who is 15, is being treated for fatty liver disease and the other, 11, needs therapy for a developmental condition. Their older daughter has another doctor’s appointment in June. Maria and her husband don’t want to interrupt her care, but they are worried about taking her there themselves. “It’s very complicated,” Maria said. “I can put myself at risk for my children. But if it’s for my own health, I prefer to let it go.”

The consequences of abandoning regular medical care can turn serious quickly, however. Jim Mangia, president of St. John’s Community Health Network in Los Angeles, described one patient with diabetes who stopped showing up for a weekly diabetes education class. When a clinic staff member called the woman, they discovered she was afraid to even go to the grocery store, and had been subsisting for days on tortillas and coffee, he said.

“Thank God we reached her and she came in,” said Mr. Mangia, whose network serves an estimated 25,000 undocumented patients across more than 20 locations. Tests at the clinic showed that her blood sugar had become dangerously high.

“That’s what we’re going to see more and more of,” Mr. Mangia said. “It kind of breaks my heart to talk about it.”

For doctors working in urgent care settings, a drop-off in immigrants has become apparent through some unusual metrics. For example, Dr. Amy Zeidan, an emergency room physician in Atlanta, said that requests for Spanish-language interpretation in her hospital’s emergency department had fallen more than 60 percent from January to February.

Theresa Cheng, an emergency room physician at Zuckerberg San Francisco General Hospital and Trauma Center, said one of her residents had seen an immigrant patient who had suffered multiple facial fractures from an assault, but had not sought care for more than two weeks. “There is tremendous fear,” Dr. Cheng said.

In late January, Dr. Cheng said, she saw a patient who arrived with severely untreated diabetes. The patient, an undocumented woman, said she had waited to receive help because she was scared. She died that day.

Dr. Carolina Miranda, a family physician in the Bronx, spoke of a patient who had been granted asylum but, fearful of ICE, had failed to show up for a doctor’s appointment about a possible brain tumor.

Similar delays or cancellations are arising among pregnant women and new mothers, according to obstetrician-gynecologists around the country. Dr. Caitlin Bernard, an obstetrician in Indiana, said a patient had skipped her postpartum visit, explaining that she would no longer be leaving her house. On an obstetrics floor in a San Diego hospital, multiple staff members said they had seen an overnight drop-off following the inauguration in the number of immigrant women coming in with acute issues during their pregnancies.

“Obviously those women still exist,” said one doctor, who asked not to be identified because her employer forbade her from speaking publicly on the matter. “I fear it’s going to increase maternal mortality over time.”

Many of the children of immigrant parents who have skipped appointments or left medications unfilled are American citizens. But in mixed-status families, parents who are at risk of deportation are often unwilling to take the risk of going to the clinic or pharmacy.

A pediatrician at a health center that cares for underserved populations on the central coast of California reported a 30 percent increase in no-shows for pediatric appointments. Many of those who do bring their children, and are referred elsewhere for specialty care, such as speech therapy, or an autism evaluation, refuse, saying they are too frightened, said the pediatrician, who asked to be unidentified because he wasn’t authorized to speak publicly.

Dr. Tania Caballero, a pediatrician at Johns Hopkins who sees patients at a health center for underserved groups called Baltimore Medical System, said she had encountered parents who had not wanted to go with their babies to the emergency room out of fear, and parents of children with chronic conditions like cerebral palsy, asthma, and Type 1 diabetes who had told her they have stopped getting vital care.

“I tell patients, ‘I can’t control what happens outside of my space, and I can’t control if somebody comes into my space, But you know me. I have the tools, and I want to help you navigate this journey and do it together,’” she said.

Some parents of children in other dire situations — such as those receiving cancer treatment — are hoping that their child’s condition might actually protect them. Some have asked pediatricians for letters explaining their child’s medical requirements, in hopes that immigration officials who detain them might be convinced that the child needs to stay in the United States to survive.

Dr. Lisa Gwynn, a pediatrician in South Florida who serves families from across the Caribbean and South America, said that her plummeting patient attendance rate is particularly worrisome because patients are missing out on childhood vaccines necessary for preventing diseases like measles, pneumonia and whooping cough.

Dr. Gwynn also worries that without coming to see her, children who have experienced severe trauma before coming to the United States aren’t being connected to social workers or psychologists who can help.

“Imagine your children living in a home where everyone’s scared, and they’ve come to this country to not feel scared anymore,” she said. “We know that stress does not fare well for health. Period. Kids don’t perform as well in school, they have mental health issues, depression, anxiety.”

Some medical facilities have said they will comply with immigration officials. NYU Langone, in New York City, sent a memo to employees warning them not to try to protect illegal migrants. But many other health centers and organizations are finding ways to take a stand, telling staff to display “Know Your Rights” information on the walls and to never record their immigration status in a patient’s medical records.”

Last week, the New England Journal of Medicine published an article by two doctors and a lawyer detailing how physicians can continue to provide health care and lawfully push back in the face of some ICE requests.

The St. John’s clinic network in Los Angeles recently launched an ambitious home visitation program in which a doctor, nurse and medical assistant visit patients where they live to perform exams and deliver medications. They aim to inform all 25,000 of their undocumented patients of this option.

In the New York area, a hospital association suggested designating a “hospital liaison” who can be paged to quickly usher an agent into a private office, and then ask to see a signed warrant, which would then be reviewed by in-house counsel.

At the emergency room of University Hospital, a safety net facility in Newark, staff members hand out cards, in Spanish and other languages, reminding patients of their rights. “You have the right to refuse consent for immigration or the police to search yourself, your car or your home,” the cards state.

But even there, the fear is palpable. Annalee M. Baker, an emergency physician, said she had seen a young woman who said her partner had beaten her until she was unconscious. Covered in welts and bruises, she had waited hours to come in. The reason given: she was terrified that her partner would be deported.

Dr. Baker also treated a minor who had been stabbed; she had needed his parents’ consent to treat him, but the boy had been skittish about providing any details about them, out of fear they might be caught in the immigration dragnet.

Still, it is the people who never come in at all that haunt Dr. Baker the most.

“The tragic message to these people is: Be a shadow and hope that you do not die.”

Sarah Kliff contributed reporting.

Emily Baumgaertner Nunn is a national health reporter for The Times, focusing on public health issues that primarily affect vulnerable communities.

Nina Agrawal is a Times health reporter.

Jessica Silver-Greenberg is a Times investigative reporter writing about big business with a focus on health care. She has been a reporter for more than a decade.

Botswana: New research shows healthcare worker face ethical challenges in the provision of healthcare to migrants

“No, it is not a breach of my oath because it is beyond my control; I use the policies that are in place.” Ethical challenges faced by healthcare workers in the provision of healthcare to cross-border migrants in Botswana

Abstract

Background

With a growing global population of migrants, understanding the complex dynamics between healthcare providers and policy restrictions is crucial for ensuring equitable access to healthcare. The main objective of this qualitative study was to explore the ethical challenges faced by health care providers in the provision of health care to migrants.

Methods

We conducted in –depth interviews with 11 healthcare providers, which were analysed using thematic analyse. Atlas ti software was used to analysis the data.

Results

Healthcare workers reported facing ethical challenges as a result of not being able to provide medical care to migrant patients because healthcare policies deny them access to healthcare. These policies make it difficult for healthcare professionals to fulfil their duties in accordance with their oath. Failure to provide healthcare to migrant patients can cause moral distress for healthcare workers and affect their well-being. Reporting migrant patients to the police was mentioned as another ethical challenge, which is a breach of confidentiality. Several healthcare providers have developed strategies to address the limitations of migrants’ access to healthcare, including encouraging migrants to access healthcare from their home country and using private healthcare facilities.

Conclusions

Health policies influence the way health care providers carry out their tasks, which can either positively or negatively impact access for vulnerable migrant groups. To address the challenges faced by healthcare providers in implementing their professional ethics, inclusive policies should be introduced, and human rights and ethics training should be provided, as well as ongoing dialogue to ensure that healthcare providers fulfil their professional obligations toward all migrant patients.

The full study is available at: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-025-01195-4

Increased risk of tuberculosis and HIV co-infection for migrants in the Uganda EU/EAA

Adult migrants in the UK and EU/EEA have worse TB outcomes than non-migrants

New research published today in the European Respiratory Journal found that adult migrants in the UK and EU/EEA fare worse on a range of TB outcomes than non-migrants in those countries.

Researchers led by Dr Heinke Kunst, Reader in Respiratory Medicine at Queen Mary University of London and Honorary Consultant in Respiratory Medicine at Barts Health NHS Trust, conducted a systematic review of current evidence on diagnosis of active TB in migrants entering the European Union/European Economic Area (EU/EEA) and UK.

The work, titled “Tuberculosis in adult migrants in Europe: a TBnet consensus statement” was delivered in collaboration with TBnetscientists with key contribution from Professor Christoph Lange, Professor of Respiratory Medicine.

The review included the clinical presentation and diagnostic delay, treatment outcomes of drug sensitive TB, prevalence and treatment outcomes of multidrug/rifampicin-resistant (MDR/RR)-TB and TB/HIV co-infection.

It showed that migrants have an increased risk of extrapulmonary tuberculosis (TB infection that occurs in organs other than the lungs) compared to pulmonary tuberculosis. It also showed that migrants have an increased risk of tuberculosis and HIV co-infection compared to non-migrants.

The findings also showed an increased risk for multi drug-resistant/rifampicin resistant tuberculosis in migrants with TB when compared to non-migrants with TB. Further to this, migrants with drug susceptible tuberculosis (TB which is not resistant to treatment drugs such as rifampicin) had an increased risk for unfavourable treatment outcomes when compared to non-migrants.

This is the first systematic review to show that migrants with tuberculosis in the UK and EU/EAA have worse outcomes compared to non-migrants with tuberculosis. Based on these findings and expert opinions consensus, the researchers provided recommendation statements to guide the management of migrants with tuberculosis in these countries.

Consensus recommendations include screening of migrants for tuberculosis/latent tuberculosis infection (LTBI) according to country data; a minimal package for tuberculosis care in drug susceptible and multidrug/rifampicin drug resistant tuberculosis; implementation of migrant-sensitive strategies; free healthcare and preventive treatment for migrants with HIV co-infection.

Dr Kunst said: “Migrant populations entering Europe have poorer tuberculosis outcomes than native populations. As cases of tuberculosis are rising in Europe, we need urgent robust strategies to strengthen screening, rapid diagnosis, and treatment in these hard-to-reach populations.”

Migrant-sensitive strategies have been shown to be effective to improve migrant health. These include availability of interpreters and language-appropriate written materials, healthcare provider training in culture-sensitive issues, health education of migrants, strengthening community engagement and social support.

Interestingly, there was no evidence on use of migrant sensitive strategies to improve outcomes of migrants with tuberculosis in the UK and EU/EEA. The researchers hope that the findings may influence public health policy nationally and internationally. Migrant sensitive strategies should be included into routine care of migrants not only for migrants with tuberculosis but also those with other infectious diseases such as viral hepatitis.

Tuberculosis research at Queen Mary

This work complements existing tuberculosis research at Queen Mary in migrants and tuberculosis. Dr Kunst has conducted The CATAPULT trial (Treatment of latent tuberculosis infection in migrants in primary care versus secondary care) funded by Barts Charity recently published in the European Respiratory Journal. The trial showed that the treatment of latent tuberculosis infection in recent migrants to the UK can be safely and effectively managed within primary care when compared to specialist secondary care services at a lower cost. Read more.

Dr Kunst has conducted a NIHR funded study on evaluating uptake of latent tuberculosis infection screening in migrants (Uptake, effectiveness and acceptability of routine screening of pregnant migrants for latent tuberculosis infection in antenatal care) and Prof. Adrian Martineau leads a tuberculosis research programme to develop a new diagnostic test for latent tuberculosis infection.

Surveying ECDC report presents the results of survey on HIV prevention and barriers among migrants in the EU/EEA

HIV and migrants in the EU/EEA – Monitoring the implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia: 2024 progress report

This report presents the results of a survey among EU/EEA Member States in relation to the HIV epidemic among migrants and current national prevention interventions, policies and barriers to the public health response.

Executive summary

Background

In 2023, migrants accounted for almost half of new HIV diagnoses in the European Union and European Economic Area (EU/EEA) remaining a key population affected by HIV across the European region. Migrants living with HIV face numerous intersecting stigmas related to their HIV and migration status, as well as broader racial and cultural discrimination. Moreover, access to health services for undocumented migrants is not universally guaranteed in the EU/EEA, which hinders HIV prevention, testing and treatment services for this group and could contribute to HIV transmission in these communities, including post-migration acquirement of HIV.

For this report, migrants are defined as ‘people born abroad’ (i.e. those born outside the reporting country, regardless of place of HIV acquisition or diagnosis). This categorisation encompasses a broad range of individuals, some of whom may also be included in other key populations such as men who have sex with men, people who inject drugs, or sex workers. It includes those who have migrated from within the EU/EEA as well as those who have come from outside the region and will be diverse in terms of socio-demographic and socio-economic characteristics including ethnicity, nationality, migration status, gender, income, and educational level.

Methods

ECDC monitors the implementation of the 2004 Dublin Declaration [1,2]. Between February and May 2024, ECDC implemented an online survey among EU/EEA Member States to collect the most recent data from 2023. The survey contained specific questions in relation to the HIV epidemic among migrants, in addition to questions relating to the current national prevention interventions, policies and barriers to the public health response. This report presents the results of the survey.

Status of implementation of combination prevention

Combination prevention is an approach that combines biomedical, behavioural, and structural interventions and strategies for HIV prevention, working on different levels, including individual, community, and societal/national levels, into one comprehensive programme. Key findings include:

  • Twenty-seven countries of the EU/EEA reported having a national HIV prevention strategy to reduce the number of new HIV infections. Of those, 89% (24 countries) reported that their strategy specifically mentioned migrants as a key population to whom actions and services are targeted.
  • Only seven countries reported medium-to-high coverage of condom and lubricant provision programmes targeting migrants.
  • Pre-exposure prophylaxis (PrEP) availability in the EU/EEA has improved significantly since 2016. While data on the number of migrants accessing PrEP was generally limited, other findings suggest that PrEP may be inaccessible to many migrants: 13 countries reported difficulties in reaching both documented and undocumented migrants with PrEP, and three more countries reported difficulties in reaching only undocumented migrants. Seven countries reported that PrEP was not accessible for undocumented migrants, and in at least five more countries, it was accessible only at cost or through private providers.
  • The vast majority of countries reported no restrictions on access to testing for undocumented migrants. They also reported the availability of different testing interventions which might facilitate access to testing for undocumented migrants. However, no data to support this assumption were available. It should also be noted that self-testing and community-based testing were not universally provided across EU/EEA countries and these need to be scaled up to reach key migrant populations.

Progress in reaching the continuum of HIV care targets

The continuum of HIV care is a conceptual framework that provides a snapshot of the critical stages in achieving viral suppression among people living with HIV. Only five out of 30 countries provided full data to monitor all stages of the continuum of care for migrants. Key findings include:

  • There is progress for migrants along the continuum of HIV care across the EU/EEA, but limited available data suggest that only some countries were meeting one or more of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets to be achieved by 2025:
    • Approximately 93% of migrants living with HIV in the EU/EEA knew their HIV status (based on
      reporting from six countries).
    • Of migrants diagnosed with HIV, 84% had initiated antiretroviral treatment (ART), (based on
      reporting from nine countries).
    • Of the migrants on treatment, 95% were virally suppressed (based on reporting from nine
      countries).
  • As of 2023, only Luxembourg was meeting the 2025 substantive target of 86% viral suppression among all migrants estimated to be living with HIV, followed by Belgium, which was within 5% of the target.

Conclusions and recommendations

Progress has been made in the implementation of combination prevention and in reaching the continuum of HIV care targets for migrant populations in the EU/EEA. Recommendations include implementing migrant-tailored, nonstigmatising, linguistically and culturally appropriate HIV prevention programmes for all migrant populations, scaling up testing services, in particular community-based efforts including self- and home testing, and strengthening links between HIV support services and other services such as social services to meet patient needs.

Only five countries within the EU/EEA reported data for all stages of the continuum of care. Countries should continue to improve monitoring and surveillance data for HIV in migrant populations, to inform decision-making on the provision and targeting of prevention, testing and care services.

The full report can be downloaded here: HIV and migrants in the EU/EEA – Monitoring the implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia: 2024 progress report (2023 data)

Australia: Migration policies for People with HIV perpetuate criminalisation and expose them to harm

David Carter Delivers Keynote at the Australasian HIV&AIDS Conference

Health+Law’s research lead David Carter, delivered a keynote address at the recent ASHM HIV Conference in Sydney, exploring the controversial past and present of HIV criminalisation in Australia. His urgent, provocative address challenged us to consider how current legal and policy processes in migration law recreate conditions of criminalisation, producing serious health and other harms for people living with HIV. 

Talking to Health+Law researchers in an interview about legal issues, Sergio*, a man in his thirties originally from South America and living with HIV, described the experience of migration to Australia:

I didn’t have to face any court, but I [did] have to prove that I wasn’t a bad person just because I have HIV […] I [had] to prove myself to someone else, who probably is not living with HIV, that I was not a bad person, and I was a good citizen and I deserve to be here.

The migration process is a complex one – and this complexity is amplified for people living with HIV.  Sergio’s reflections express a particularly grim aspect of this process for migrants, especially those living with HIV.

Indeed, as Scientia Associate Professor David Carter, Health+Law’s research lead, argued in an invited keynote at the 2024 Australasian HIV&AIDS Conference hosted by ASHM Health in September this year, the experience of people living with HIV seeking to migrate to Australia is part of Australia’s long history of the criminalisation of HIV.  Speaking to delegates from Australia, New Zealand, Asia and the Pacific at Sydney’s International Convention Centre on Gadigal Country, David reminded the audience that criminalisation is a policy approach, that doesn’t just use the criminal law. To show this he set out five stages of criminalisation that are also evident in the migration process for those living with HIV.

First, as he explained, criminalisation characterises specific behaviour as harmful or carrying a risk of harm to the community. In this case the harm presented is, to quote Australian migration law, that a person’s HIV care represents a ‘significant cost to the Australian community or prejudice [to] the access of Australian citizens or permanent residents to health care or community services’.

Second, criminalisation creates a suspect population, made up of people thought to warrant suspicion because they come to be associated with the potential harm.

Third and fourth, this suspect population attracts surveillance from the state, with a hierarchy created within the suspect population whereby some members are subject to further and intensified surveillance.

Fifth, and finally, some members of this suspect population are subjected ‘to the most severe forms of the state’s coercive and punitive authority’, including investigation, more intensive supervision, detention or arrest, and in some cases, criminal or civil proceedings.

The criminalisation of HIV has a long and storied history, going back to the very early days of the AIDS crisis. Vocal members of HIV-affected communities, legal and human rights advocates and many others have argued strongly against criminalisation, viewing it as draconian and as an approach to public (health) policy with very negative consequences for HIV epidemics.

In Australia, arguments against HIV-specific criminal offences have been broadly successful, and yet the ‘temptation’ to criminalise – as the very first Australian National HIV Strategy described it – continues to emerge in some policy responses to HIV and other communicable diseases.

In 1987, when the authors of the first national HIV strategy were writing, they were warning against measures including compulsory universal HIV testing, the closure of gay venues, criminal penalties for HIV transmission, and limitations on the movement of HIV positive people, including forced quarantine. Today, HIV criminalisation is operating in Australian migration policy and law.

‘This contemporary criminalisation of HIV begins’, David argued, ‘like all criminalisation, with the characterisation of behaviour in terms of harm and risk of harm’. He continued, arguing that:

This characterisation of migrating while HIV positive as harmful establishes, and in-turn enlivens, the suspect population management and criminalising processes of our medical border […] This criminalising logic establishes an adversarial relationship between the person living with HIV and the state, and between them and members of the Australian community, whose access to health care it is alleged may be prejudiced by providing care for a person living with HIV who wishes to migrate.

Among the many negative effects of this process is that it can discourage migrants living with HIV from engaging in testing, treatment and HIV care. Interviews conducted by Health+Law as part of our national legal needs (LeNS) study confirm that this is happening. They show that many migrants living with HIV in jurisdictions across Australia experienced an alienating and hostile environment: a ‘threat environment so elevated’, as David described it in his keynote, that they frequently described withdrawing from HIV care and community life as a coping mechanism.

Unfolding the history of ‘unjust and unhelpful’ HIV criminalisation in Australia, David outlined how the current legal and policy conditions that prospective migrants living with HIV face in Australia today work to recreate conditions of criminalisation and expose both individuals and the community to multiple health harms.

You can read more about David’s keynote in The Medical Republic’s coverage of the conference.

US: Restrictive immigration policies would undermine Public Health and economic stability

Expected Immigration Policies under a second Trump administration and their health and economic implications

Introduction

Immigration was a central campaign issue during the 2024 Presidential election with President-elect Trump vowing to take strict action to restrict both lawful and unlawful immigration into the U.S. Such actions would have stark impacts on the health and well-being of immigrant families as well as major economic consequences for the nation. As of 2023, there were 47.1 million immigrants residing in the U.S., and one in four children had an immigrant parent.1 Increased immigration boosts federal revenuesand lowers the national deficit through immigrants’ participation in the country’s economy, workforce, and through billions of dollars in tax contributions.

This issue brief discusses key changes to immigration policies that may take place under the second Trump administration based on his previous record and campaign statements, and their implications. President-elect Trump has indicated plans to restrict and eliminate legal immigration pathways, including humanitarian protections, and deport millions of immigrants, which would likely lead to separation of families, negative mental and physical impacts for immigrant families, and negative consequences on the nation’s workforce and economy.

Expected Policy Changes

Elimination of Deferred Action for Childhood Arrivals (DACA) Program

The future of the DACA program remains uncertain due to pending litigation, and President-elect Trump has indicated plans to eliminate it, which would lead to over half a million DACA recipients losing protected status. DACA was originally established via executive action in June 2012 to protect certain undocumented immigrants who were brought to the U.S. as children from removal proceedings and receive authorization to work for renewable two-year periods. During his prior term, President-elect Trump sought to end DACA but was blocked by the Supreme Court in 2020. The Biden administration issued regulations in 2022 to preserve DACA protections. In September 2023, a district court in Texas ruled the DACA program unlawful, preventing the Biden administration from implementing the new regulations while the case awaits a decision in the Fifth Circuit Court of Appeals. Under pending court rulings, while the Department of Homeland Security (DHS) is accepting first-time DACA requests, it is unable to process them. DHS is continuing to process DACA renewal requests and related requests for employment authorization. After the attempt to end DACA failed in 2020, the Trump administration saidthat it would try again to eliminate DACA protections, and, if the pending court ruling finds the program unlawful, the administration is unlikely to appeal the decision. There are over half a million active DACA recipients, a majority of whom are working and many of whom have U.S.-born children, who could be at risk of deportation if the program is eliminated.

A recent health coverage expansion to DACA recipients also is subject to pending litigation and would, if eliminated, leave many DACA recipients without access to an affordable coverage option. In May 2024, the Biden administration published regulations to extend eligibility for Affordable Care Act (ACA) Marketplace coverage with premium and cost-sharing subsidies to DACA recipients, who were previously ineligible for federally funded health coverage options. The regulation became effective November 1, 2024, allowing for enrollment during the 2025 Open Enrollment Period. In August 2024, a group of states filed a lawsuit against the federal government alleging that the ACA Marketplace coverage expansion for DACA recipients violates the Administrative Procedure Act. The case is currently under review at a district court in North Dakota and a decision is expected in the coming months. Elimination of the expansion could leave the nearly 100,000 uninsured DACA recipients it is estimated to cover without an affordable coverage option.

Changes to Public Charge Policy

President-elect Trump could reinstate changes to public charge policy that he made during his first term, which led to increased fears and misinformation among immigrant families about accessing programs and services, including health coverage. Under longstanding immigration policy, federal officials can deny entry to the U.S. or adjustment to lawful permanent resident (LPR) status (i.e., a “green card”) to someone they determine to be a public charge. During his prior term, President-elect Trump issued regulations in 2019 that broadened the scope of programs that the federal government would consider in public charge determinations to newly include the use of non-cash assistance programs like Medicaid and the Children’s Health Insurance Program (CHIP). Research suggests that these changes increased fears among immigrant families about participating in programs and seeking services, including health coverage and care. Prior KFF analysis estimated that the 2019 changes to public charge policy could have led to decreased coverage for between 2 to 4.7 million Medicaid or CHIP enrollees who were noncitizens or citizens living in a mixed immigration status family. The Biden administration rescinded these changes. However, as of 2023, a majority of immigrant adults said in a KFF survey that they were “not sure” about public charge rules, and roughly one in ten (8%), rising to about one in four (27%) of likely undocumented immigrant adults, said they have avoided applying for assistance with food, housing, or health care in the past year due to immigration-related fears (Figure 1). As of November 2024, President-elect Trump has not indicated whether his administration plans to reinstate his first term changes to public charge policy.

 

Expanded Interior Enforcement Actions

President-elect Trump has indicated that his administration plans to carry out mass detentions and deportations of millions of immigrants, including long-term residents, which could lead to family separations and negative mental and physical health consequences. President-elect Trump has stated that he will declare a national emergency and use the U.S. military to carry out mass deportationsof tens of millions of undocumented immigrants residing in the U.S., many of whom have been living and working in the country for decades. Such a policy could lead to family separations as well as mass detentions, which can have negative implications for the mental health and well-being of immigrant families and also put their physical health at risk. Tom Homan, who was the director of U.S. Immigration and Customs Enforcement (ICE) during the first Trump administration and has been selected as the incoming administration’s “border czar”, has said that it is possible to carry out mass deportations without separating families by deporting an entire family unit together, even if the child may be a U.S. citizen. As was the case during his first term, he may also carry out workplace raids as part of mass deportation efforts. Research shows that such raids can lead to family separations, poor physical and mental health outcomes for immigrant families, negative birth and educational outcomes for the children of immigrants, and financial hardship due to employment losses. Prior KFF research shows that restrictive immigration policies implemented during the first Trump administration, including detention and deportation led to increased fears and stress among immigrant families and negatively impacted the health and well-being of children of immigrants, most of whom are U.S. citizens.

Mass deportations could also negatively impact the U.S. workforce and economy, where immigrants make significant contributions. Immigrants have similar rates of employment as their U.S.-born counterparts and play outsized roles in certain occupations such as agriculture, construction, and health care. Research has found that immigrants do not displace U.S.-born workers and help foster job growth through entrepreneurship and the consumption of goods and services. Further, federal data show that unemployment rates for U.S.-born workers have not decreased between 2022 and 2023 and have remained similar to those for immigrant workers. In addition, immigrants, including undocumented immigrants, pay billions of dollars in federal, state, and local taxes each year. Mass deportation of immigrants could lead to workforce shortages in key sectors which could have negative economic consequences including an increase in the cost of essential goods such as groceries. Vice President-elect Vance has stated that immigrants are responsible for the U.S. housing crisis. While some studies show a link between immigration and rising housing costs, in general, economists are skeptical of immigration being a primary driver. Mass deportation of immigrants could also worsen housing shortages since immigrants make up a significant share of construction workers. Workplace raids can exacerbate existing labor shortages and have a negative impact on the local economies of the communities where they take place. Further, research shows that without the contributions undocumented immigrants make to the Medicare Trust Fund, it would reach insolvency earlier, and that undocumented immigrants result in a net positive effect on the financial status of Social Security. There also is likely to be a significant cost to taxpayers for the government to carry out large-scale detention and deportations.

Ending Birthright Citizenship

President-elect Trump has stated that he will sign an executive order to end birthright citizenship for the children of some immigrants despite it being a guaranteed right under the U.S. Constitution, which would negatively impact the health care workforce and economy. This proposed action would limit access to health coverage and care for the children of immigrants since they may not have lawful status. It could also have broader ramifications for the nation’s workforce and economy, potentially exacerbating existing worker shortages, including in health care. KFF analysis of federal data shows that adult children of immigrants have slightly better educational and economic outcomes than adult children of U.S.-born parents and make up twice the share of physicians, surgeons, and other health care practitioners as compared to their share of the population (13% vs. 6%) (Figure 2). Other research also has found that children of immigrants contribute more in taxes on average than their parents or the rest of the U.S.-born population, and that their fiscal contributions exceed their costs associated with health care, education, and other social services.

 

Reinstatement of “Remain in Mexico” Policy

President-elect Trump has stated that he will reinstate the “Remain in Mexico” border policy and that he may use military spending to carry out stricter border enforcement, which would leave an increased number of asylum seekers facing unsafe conditions at the border. The first Trump administration implemented Migrant Protection Protocols, often referred to as the “Remain in Mexico” policy, in 2019. Under this policy, asylum seekers were required to remain in Mexico, often in unsafe conditions, while they awaited their immigration court hearings. The Biden administration ended this policy in 2022, following some legal challenges, although it implemented a series of increasingly restrictive limits on asylum eligibility in 2023 and 2024 in response to a high number of border encounters. President-elect Trump said he plans to reinstate the Migrant Protection Protocols. He also has indicated that he will deploy the National Guard, as well as active duty military personnel, if needed, to the U.S.-Mexico border, although details of the plan remain unclear. Heightened military presence at the border can lead to increased fears among immigrant families living in border areas and using part of the military budget for border security could face legal challenges.

Restrictions on Humanitarian Protections

President-elect Trump said he plans to significantly limit the entry of humanitarian migrants into the U.S. during his second term by restricting refugee limits, shutting down the CBP One application for asylum seekers, and eliminating Temporary Protected Status (TPS) designations for immigrants from some countries.  During his first term, President Trump set the annual refugee admissions ceiling at its lowest levels, ranging from 50,000 in 2017 to a historic low of 18,000 in 2020. The Biden administration increased the limit to 65,000 in 2021, a level close to the annual ceilings prior to the first Trump term, and further increased the limits in 2022 and 2024 in response to humanitarian concerns. It is likely that President-elect Trump will reduce the admissions ceiling for refugees in his second term. The President-elect has also said that he will close the CBP One application created by the Biden administration which allows asylum seekers to seek lawful entry to the U.S. by making an interview appointment with the DHS. While there have been implementation challenges with the CBP One application, shutting down the application could lead to “mass cancellation of appointments” and possibly an increase in attempts to cross the border outside of ports of entry. President-elect Trump also has indicated that he will roll back TPS designations for some immigrants, including those from Haiti. TPS designations protect immigrants from countries deemed unsafe by the DHS from deportation and provide them with employment authorization but do not provide a pathway to long-term residency or citizenship. As of March 2024, over 860,000 immigrants from 16 countries were protected by TPS. Loss of TPS would put people at risk for deportation, which could contribute to family separation which in turn can have negative impacts on the mental and physical health of immigrant families, and broader negative consequences for the workforce and economy.

Endnotes
  1. KFF analysis of 2023 American Community Survey 1-year Public Use Microdata Sample.

Research papers explore challenges in HIV care for migrants and refugees, highlighting social and structural barriers

Report reveals how nations downplay migrants HIV care

A study has revealed how countries across the world have downplayed the health of international migrants who face barriers while accessing HIV care along the migration routes.

In many countries, the study shows that people on the move are confronted with stigma related to migration status, racialism, discrimination and unfavourable policies that run health care systems.

The study focused on migrants who are not aware of their HIV status but are either infected with or are vulnerable to acquiring HIV, and migrants who know their positive status and require linkage and adherence to HIV treatment.

“Migration is a common phenomenon and will remain an important health determinant when attempting to successfully strengthen health systems, including the access to continuity of HIV care,” the journal published by Lancet notes.

The worst hit are the undocumented migrants who due to fear of deportation and stigma may never seek HIV care from a health facility.

Although documented migrants have the right to access health care in some countries, they might still face barriers while accessing HIV care.

In some countries, documented migrants reportedly faced verbal abuse and discrimination in healthcare settings and were denied access to treatment even when they had the right to it, or were charged higher fees.

According to the study, the migration trajectory, including a pre-migration period in departure countries and transition periods before arriving at destination countries, presents HIV-related risks for migrants.

“Along this trajectory, migrants are likely to face different risk-inducing social, physical, political, and economic environments. Migrants’ departure countries might contribute to their overall determinants of HIV including specific vulnerabilities, practices around safer sex, and health-care seeking,” it reads in part.

The study cites a case where migrants arriving from countries with a patriarchal culture where sex is considered taboo, such as Arab countries, have been reported to experience a high burden of gender-related stigma associated with a high likelihood of acquiring HIV and delayed testing.

Additionally, the report says that experiences and familiarity with healthcare systems in departure countries might also shape migrants’ practices around seeking HIV care in transition or destination countries.

In the context of forced displacement, the research states that challenges related to accessing HIV care during the transition stage are major points of concern, especially where some migrants have to reside in refugee facilities in transition countries for long periods, which might substantially delay their access to HIV care.

These 2 research papers are part of the Lancet SERIESHIV in Migrant Populations Online first accessible freely after registration: 

Humanising and optimising HIV health care for refugees and asylum seekers

Interventions to ensure access to and continuity of HIV care for international migrants: an evidence synthesis

 

Vietnam: Vietnam and IOM sign MoU to promote migrant inclusion in National Health Systems

IOM and Ministry of Health sign partnership to promote migrants’ health

The International Organisation for Migration (IOM) and the Ministry of Health (MoH) on Wednesday afternoon strengthened their collaboration in promoting the health and well-being of migrants.

HÀ NỘI — The International Organisation for Migration (IOM) and the Ministry of Health (MoH) on Wednesday afternoon agreed to strengthen their collaboration in promoting the health and well-being of migrants by signing a new Memorandum of Understanding (MoU).

Under the MoU, they also agreed to promote migrants’ inclusion in national health systems and policies.

The MoU reflects nearly 40 years of collaboration between IOM and MoH, which began in the early 1980s.

Over the years, this partnership has grown from IOM health assessment programmes for populations moving to destination countries to public health efforts that facilitate better access to healthcare services for migrants and strengthen cross-border disease control and public health emergency response and preparedness.

Việt Nam has become a significant source of migrants, particularly those seeking employment opportunities abroad.

Recent data shows a resurgence in international labour migration, with approximately 155,000 Vietnamese citizens securing employment abroad last year alone, equivalent to nearly a third of the new workers entering the labour market.

Similar to other countries in the ASEAN region, the burden of health issues in Việt Nam remains complex, including infectious diseases, occupational health hazards and injuries, mental health challenges, non-communicable diseases such as cardiovascular disease and diabetes and maternal and child health problems.

Infectious diseases like human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), tuberculosis (TB) and malaria continue to be significant concerns.

Achieving Universal Health Coverage (UHC) remains a challenging goal and presents an even greater challenge for migrants.

Recent studies conducted by IOM in the region have highlighted the challenges faced by cross-border migrants in accessing healthcare, including language barriers, discrimination, financial constraints, lack of health insurance across borders and lack of official cross-border referral mechanisms for migrant patients.

They can be made even more vulnerable in pandemic situations due to inadequate access to needed health care and services, as shown during the COVID-19 pandemic.

Park Mi-Hyung, Chief of Mission of IOM in Việt Nam, stressed the importance of this collaboration to ensure the health and well-being of migrants, aligning with the goals of the Global Compact for Safe, Orderly, and Regular Migration (GCM) and the Sustainable Development Goals (SDGs).

“In a world where an increasing number of people are on the move, collaborations and partnerships are crucial to enhance the health and well-being of migrants. Healthy migrants contribute to healthy communities,” she said.

Nguyễn Tri Thức, Deputy Minister of Health, said that in recent years, the MoH and IOM have actively cooperated in many areas related to ensuring the health of migrants, including raising awareness of migrants’ health, strengthening bilateral cooperation in cross-border tuberculosis control and preparing for and responding to public health emergencies.

In addition, he said, IOM supported enhanced regional cooperation last year through regional workshops on migration and migrant health.

Goal 3 of the United Nations Sustainable Development Goals is good health and well-being.

“I hope we will continue to promote closer cooperation to successfully implement the United Nations Sustainable Development Goals,” said Thức. — VNS