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Is compulsory overseas medical screening of migrants justifiable?

For more than four decades the international Organization for Migration (IOM) has been providing medical screening of prospective migrants according to the admission requirements of resettlement countries. The main reason resettlement countries impose mandatory medical screening is to prevent the entrance of migrants with certain health problems in the belief that they pose a potential public health risk or financial burden to the nation. High rates of communicable diseases among foreign-born residents of industrial countries have raised concern about the impact of international migration on transmission of such diseases and the role and efficacy of medical screening. IOM's experience provides insight into the complex and sensitive problems related to mandatory screening of migrant populations, including: conflicting objectives, epidemiological concerns, uncertain economic benefit, and ethical dilemmas. Medically sound screening mechanisms must be formulated that meet the needs of receiving countries while responding to the epidemiology of disease, the rights of individuals, and the public health concerns of the community.