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High volume of international migration calls for the establishment of financial and organizational mechanisms that would ensure provision of treatment for tuberculosis (TB) among migrants. In the case of countries like Russia where budget funding goes for TB treatment, the need is acute as delivering these services is affected by social perception that they should be provided to taxpayers only. While official policies in Russia promote voluntary medical insurance as a way to cover their health care needs, the problem is that neither voluntary medical insurance, nor the National Medical Insurance Plan, extend to cover the treatment of infectious diseases, such as TB making proposal of possible alternatives to these delivery vehicles appropriate. The paper aims to discuss these issues.

The analysis includes review of survey results on the extent of medical insurance coverage among migrants as well as legal provisions concerning access to medical care among migrants in Russia and some other migrant-receiving countries.

This exercise illuminates the public health risks and economic consequences related to inadequate access to medical help among migrants. Availability of medical insurance even among socially integrated segment of this group is limited. Also of notice is that citizens of Belarus as opposed to others are granted access to the full range of TB services in Russia.

Using this precedent, the authors propose an alternative mechanism – Inter-State Medical Insurance Fund – to be established by governments of CIS countries, with national allocations covering the provision of medical help to labor migrants from the respective countries in Russia.

Influx of labor migrants into Russia makes it necessary to put TB prevention measures in place, both inside and outside of Russian borders. While inside Russia TB response is premised on testing migrants applying for work or residence permits for diseases of public significance, millions of migrants – specifically, those working without completing necessary paperwork – evade this requirement. In light of that, the purpose of this paper is to propose introducing disease screening in migrant-sending countries, i.e. testing of potential migrants for infectious diseases in local medical institutions certified by Russian authorities.

To support the proposal, the authors provide review of official data on TB prevalence among migrants in Russia as well as publications on international experience with conducting disease screening in migrant-sending countries.

Available studies demonstrate that conducting disease screening programs in migrant-sending countries is associated with earlier detection of TB cases, shorter period of infectiousness and hospitalization, and significant savings in health budget.

Taking into account this experience, the authors propose introducing disease screening programs in CIS both under current legal arrangements and with the requirement for labor migrants to produce medical certificate when entering Russia being introduced. The need for trans-border cooperation in assuring positive health outcomes among labor migrants is also highlighted.