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Treatment, not deportation, to curb TB cases

The threat of deportation for tuberculosis patients seems to be doing more harm than good. There is a more effective approach.

Tuberculosis is gaining ground in the UAE, and one aspect of immigration policy may be part of the problem. Fortunately, there is an easy solution.

Tuberculosis is not common in the UAE but the number of reported cases reached 1,350 last year in Dubai and Abu Dhabi, up from barely 450 in 2009.

To keep this potentially fatal bacterial infection from spreading in the country, the Ministry of Health said last year that any expatriate diagnosed with pulmonary TB would be deported. (Those diagnosed with less virulent forms of the disease can be treated here.)

The policy seemed to many to be appropriate, but then the law of unintended consequences took hold: experts now realise that expatriates, whether here legally or illegally, may choose to shun proper medical treatment for fear of being sent home. Some doctors in Dubai warned of this last year, and The National reported yesterday that there is a growing consensus on the issue.

To the extent that the policy discourages expatriates from seeking treatment, it has just the opposite of the desired effect, leaving people to spread a highly contagious disease, potentially, each time they cough or sneeze. And the reported cases may be only a fraction of the actual number of infections.

Clearly the top priority here must be to control the spread of the disease. Doing that requires early diagnosis, meticulous delivery of the six-month course of treatment and a comprehensive registry of all cases. On all these counts, deportation is counterproductive.

What would be productive is a two-part strategy beginning before anyone boards an aircraft to the UAE.

In May the Ministry of Health began requiring preliminary medical clearance in countries of origin for migrants from South Asian and some other countries, where TB incidence is high. It is too early to say how this is succeeding - much depends on fraud prevention - but the requirement seems to be a sound first step.

To really contain TB, however, the follow-up in this country is vital too: anyone who has TB symptoms should have access to diagnosis, and treatment if needed, without the consequences being deportation.

Only then can the public participate as it needs to in controlling this public health menace.

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