Dubai may stop deporting expatriate TB cases

Abu Dhabi health officials watching the emirate closely as it considers opting out of 'outdated' federal law on tuberculosis victims.

Dubai is likely to stop deporting expatriates with tuberculosis, according to a senior health official. Officials in Abu Dhabi say they are watching Dubai closely, and would also support a change. Under federal law, any expatriate who tests positive for the infectious disease must be deported. Dubai is now considering opting out of this law.

Dr Ali al Marzouqi, the head of public health and safety at the Dubai Health Authority, said all the health authorities were in agreement that the law was outdated and drove cases underground. "Everyone agrees," he said yesterday. "It is not unlikely that Dubai will change its rules and stop deporting people. We have seen that this is not that effective and the population has changed a lot since the law was introduced."

Officials from the Ministry of Health and the health authorities in Dubai and Abu Dhabi met last week to unify their treatment guidelines for the disease, which date back to 2002. There were 434 cases of TB last year in Dubai and Abu Dhabi alone. Of these, all but 93 were expatriates who were deported. The current law does not state whether patients should be treated for their TB before deportation, and handling of cases varies between emirates and even individual doctors.

Everyone applying or renewing their work or residency visa must undergo a medical fitness test that screens them for a number of deportable diseases including HIV/Aids, leprosy and TB. According to the Ministry of Health, in 2007, the latest year for which figures are available, there were 81 cases of TB registered in the Northern Emirates. Dr al Marzouqi said officials at last week's meeting discussed the importance of early TB detection and "complete treatment", which would help reduce its spread. The risk of deportation meant expatriates were instead tempted to avoid diagnosis, increasing the risk of spreading the disease, he said. Another problem is that each emirate has a different regime for reporting, treating and following up positive cases. All the authorities are working to create one set of guidelines based on international standards. If left untreated, TB can be fatal. There are a number of complications associated with the TB bacteria such as lung damage and meningitis. It can be treated with antibiotics. Dr Salim Abid, the manager of public health and research at HAAD, said the authority would be watching Dubai closely and would "welcome any change in the law". "Both in terms of follow-up for positive cases and the long-term future of these cases," he said. "There is no good reason why they should be deported." That sentiment was echoed by Dr Bassam Mahboub, the head of the Emirates Respiratory Society. "It's easily treated," he said. "Once you identify TB, then you can treat it and you don't need to deport." A 1981 federal law on the "prevention of communicable diseases" set out the country's health and deportation rules. It required doctors to report cases of HIV/Aids, tuberculosis, syphilis, among others, to the Ministry of Health within 24 hours. An update to the law in 2008 ordered officials to "remove all positive cases" of people with HIV/Aids, old or new cases of TB, leprosy and syphilis, hepatitis B and C. In Abu Dhabi last year there were 145 registered cases of syphilis, 93 of them in expatriate patients. Of almost 1,000 cases of hepatitis B and C, three quarters were expatriates. [e-mail]