Ghanaians visiting the UK for more than six months are to face tuberculosis screening, as the British Immigration Minister, Ian Byrne, announced new tighter regulations this week.
Targeted screening for the infectious disease has already been introduced at the entry clearance stage in Bangladesh, Sudan, Tanzania and Thailand.
It will now be rolled out to include Ghana - alongside China, Ethiopia, Kenya, Nigeria, Pakistan, Philippines, South Africa and Zimbabwe.
Ministers are also considering implementing the scheme in a "small number" of further countries.
"This policy will benefit the UK's public health by preventing entry to the UK of infectious TB sufferers until they have been successfully treated," said Gary Nichols, 2nd Secretary, Political, Press and Public Affairs, of the British High Commission in Accra.
"It is part of our firm but fair policy on immigration, and will support the Department of Health"s TB Action Plan."
Ghanaians applying for visas for six months or more to the UK will be required to obtain a certificate from an accredited clinic, showing that they are free from infectious TB. If they do not have such a certificate their entry clearance application will normally be refused.
British Immigration has already made arrangements with the International Organisation for Migration to provide the health screening required in the countries where it is currently operational, and will make similar arrangements with the IOM or other suitable international partners for the extended scheme.
Currently, migrants from countries deemed 'high risk’ are screened on arrival in the UK, and the new process is expected to save time at ports of entry, as well as allow migrants to be treated for the infectious disease before entering the country.
The regulations are limited to those applying to stay in the country for six months or longer. TB is usually transmitted through close contact with an infected person over an extended period. A short-term visitor who has TB is at lower risk of passing on the disease to others in the UK than someone who intends to stay in the UK for more than 6 months.
If applicants are found to have TB under the pre-entry clearance scheme, they will not be granted a visa, but will be encouraged to seek treatment instead. After 6 months, they will be free to be tested under the UK’s pre-entry screening scheme again and, if they are found not to be positive for TB, they will be given a certificate.
If they are given a certificate, their previous positive test will have no bearing on their future application. Once arrived in the UK, people who are found to have TB are treated, whatever their status, as it is a public health issue.
"Screening will generate data on infectious TB among travellers to the UK helping us to understand better, and respond more effectively to, the role of migration in TB in the UK," says Mr Nichols.
"Applicants will benefit from the earlier detection of disease. Host countries will benefit from increased detection capacity and raised awareness of the disease.
"We will also be looking at ways to share data on TB rates with host countries to inform their own public health programmes."
In the UK, cases of TB are rare. In Ghana, on the other hand, the Ministry of Health describes tuberculosis as the most common cause of lost healthy lives due to premature deaths. An estimated 10,000 deaths due to tuberculosis occur in Ghana each year.
Whilst Ghana is not ranked amongst the World Health Organisation’s 22 highest risk countries, with 44,733 new TB cases in 2004, Ghana is 13th in Africa for the highest estimated number of new cases per year, according to the WHO Global TB Report 2006.
The HIV/AIDS epidemic is also fueling TB incidence. Approximately 16 percent of adult TB cases are HIV-positive. Impact modelling shows that HIV infection among TB patients could increase to 59 percent by 2009, and an additional 30,000 new TB cases could be attributable to HIV/AIDS annually by 2015.
