MIGRANTS across Europe continue to face barriers to health services and experience a higher burden of certain transmittable diseases, a new report has found.
Populations of people who have migrated and settled in countries within the European Union (EU) and European Economic Area (EEA) are affected by diseases such as HIV, tuberculosis and viral hepatitis at disproportionately higher rates, according to surveillance and monitoring carried out by the European Centre for Disease Prevention and Control (ECDC).
The report, which sets out recommendations for change, cites that legal restrictions, lack of health coverage, language obstacles, stigma, and discrimination all all reduce opportunities for prevention, testing, and treatment while contributing to continued transmission and widening health inequalities.
In 2016, countries globally committed to ending the epidemics of AIDS, tuberculosis and combating viral hepatitis, tuberculosis (TB) and other communicable diseases by the year 2030, under the Sustainable Development Goal (SDG) 3.3.
However, following recent data that showed many countries had missed interim targets to slash disease numbers, this most recent report supports that migrant populations continue to experience structural and social barriers to healthcare and unequal levels of these diseases.
To survey the progress of countries’ efforts to improving these issues, the ECDC predominantly monitored data collected from online questionnaires disseminated to all 30 EU/EEA countries.
The study found that in total, migrants accounted for 47% of all HIV diagnoses across all cases reported across 29 EU/EEA countries in 2024.
Of the 38,249 tuberculosis (TB) cases reported by 30 EU/EEA countries in 2024, 14,400 (38%) involved people of foreign origin.
The share of disease varied widely by country, from below 2% in Bulgaria, Croatia, Latvia, Lithuania and Romania to above 85% in Cyprus, Liechtenstein, Luxembourg, Malta and Norway.
Models estimated that 1.73 million migrants in the 27 EU countries were living with hepatitis B in 2024, while 1.03 million were living with hepatitis C, representing an estimated 2.7% and 1.5% of migrant populations, respectively.
Notably, the report also points to higher levels of some sexually transmitted infections among migrants although was unable to provide a population estimate.
However, they did find that of 67 confirmed cases of congenital syphilis reported in 2024 where the mother’s birth country was known, in 17 (25.3%) of these cases the mother was born outside the reporting country.
The report laid out a number of reasons as to why migrant populations still maintain such heavy disease burden, including that many are vulnerable and generally face poorer health outcomes compared to non-migrants.
Living and working in sub-standard conditions, including overcrowded housing, unstable employment, limited income, and poor working environments may heighten exposure risks and make it harder to seek timely care.
In addition, intersecting social and structural barriers contribute to their vulnerability to diseases, including limited access to health-care services in transit or in host countries, uncertain residence or legal status, language difficulties, stigma, discrimination, and lack of insurance coverage.
Migrants, who make up an estimated 10% of the EU/EEA population, experience a higher burden of HIV, TB and hepatitis B virus and hepatitis C virus infection compared with the general population, and are therefore considered key populations for prevention and control efforts.
However, these inequalities are well documented across European settings. Figures show that migrants have reduced access to PrEP, TB preventative treatments and testing and vaccinations against HBV, including in countries where they should be priority groups.
Many migrants, especially those who are undocumented, face barriers such as limited health-insurance coverage, administrative restrictions, stigma, and fear of deportation which often leave them unable to access testing or treatment.
When they do get access, often initiation of treatment is delayed or interrupted, which results in a worsening of outcomes.
Although the evidence is clear that across the EU/EEA migrants face a greater burden of these communicable diseases, access to prevention, testing and care remains uneven, which only contributes to transmission within these communities and beyond.
While most countries include migrants in their HIV and TB strategies, hepatitis policies mention them less often, while STI policies rarely do. Undocumented migrants are particularly likely to be left out of national guidance.
To help solve this problem and reduce the burden of disease for migrants, the ECDC lays out several recommendations.
It calls for wider access to HIV prevention medication, hepatitis B vaccination and treatment that can prevent TB infection from developing into active disease. It also recommends expanding TB infection screening, particularly where migrants account for a substantial share of TB cases.
It also suggests easier routes to diagnosis could help close the gaps. Community testing, home sampling and self-testing for selected infections, alongside mobile TB screening – which are currently available unevenly across countries – should be made more readily accessible.
Treatment is generally available, but legal and financial restrictions can limit access for undocumented migrants. Even where TB treatment is free, practical barriers can interrupt care. The ECDC recommends stronger support to help people begin and stay in treatment, including language support and coordination across borders.
Finally, the report calls on countries to tackle stigma and discrimination in healthcare and improve data on who can use these services.
Its central message is that including migrants in policy is only a first step: prevention, diagnosis and treatment must also be accessible in practice.
Reference
European Centre for Disease Prevention and Control. Prevention, testing and treatment services for migrant populations in relation to HIV, tuberculosis, viral hepatitis and sexually transmitted infections: availability and access in the European Union/European Economic Area, 2025. Stockholm: ECDC; 2026.
Featured image: kwanchaift
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