Ghana and Kenya- introduction of TB testing

From 5 February 2007, people applying in Ghana and Kenya for visas to come to the UK for more than 6 months have been required to submit a certificate confirming that they do not have infectious tuberculosis (TB). Failure to produce a certificate from an accredited clinic run by the International Organisation for Migration (IOM) will normally result in an application for a visa being refused.
Those who made their visa applications before 5 February 2007 are not required to have a certificate. The costs of the tests will be born by the applicants, except in certain family reunion cases.
Those coming for less than six months do not need to provide a certificate. There are also exemptions from the requirement for children under 11, for people who are settled (have indefinite leave to remain - ILR) in the UK and are returning to the UK ('returning residents') and for people who hold diplomatic passports. Pregnant women are not exempt.
The Home Office have stated that before refusing a visa they will consider exceptional and compassionate reasons that make it urgent for a person to travel. An example of exceptional and compassionate reasons given by the Home Office is when there is a close family member in the UK who is seriously ill. It will be necessary to put the relevant arguments for being allowed to travel in each individual case and people who are allowed to trave will be expected to undergo treatment for tuberculosis in the UK.

Those in possession of a valid certificate will not normally have to undergo testing for TB on arrival in the UK but could still be required to take a test if the Medical Inspector at Port raises any health concerns about them.
The test involves an X-ray, and then follow-up tests if the X-ray indicates a possibility of tuberculosis.

The UK Home Office has already introduced testing for tuberculosis in Bangladesh, Sudan, Tanzania and Thailand. These are a pilot and the testing could be extended to other countries in the future. The fees in these countries are approximately:
Bangladesh and Thailand- £29
Cambodia (applicants are tested in Cambodia but obtain their visa in Thailand) and Tanzania £29
Sudan - £36
Fees for Ghana and Nigeria have not yet been published.

Powers to require TB screening were taken when the UK passed the Asylm and Immigration (Treatment of Claimants etc.) Act 2004. At the time of passing that legislation, the Home Office published the Immigration, Asylum And Nationality Bill Race Equality Impact Assessment New Clause In The Immigration, Asylum & Nationality Bill - Tb Screening Overseas And Limiting Of Appeal (13 October 2005). This described the programme as follows:

When the programme is fully implemented, the policy will apply equally to all
residents of those countries which are both high risk for TB (i.e. have an
annual incidence of over 40 cases per 100,000 population) and send the
greatest numbers of long-term visitors to the UK. In that context the provision is nationality neutral. However, it is likely that some nationalities could be affected by this measure more than others because the overwhelming majority of residents in a particular country are liable to be nationals of that country. It is therefore arguable that the application of this measure amounts to indirect discrimination towards nationals of the countries to which the provision will apply.

The first phase of the programme will apply only to entry clearance
applications made to UKVisas operations in Bangladesh, Sudan, Tanzania
and Thailand (where applications from Cambodia and Laos are also dealt
with). These countries all have high rates of TB and also represent the
various kinds of entry clearance operation we have globally, but represent
relatively low numbers of entry clearance applicants. A decision on the
countries to be included in the next phase of the programme has not yet been made, but we will review the impact of the initial phase after six months to help inform the future roll out of the programme. Where low numbers of infectious cases have been identified through the pre-entry screening we will consider whether this represents a proportionate use of resources both for the applicant and the visa-issuing operation.

We consider that the programme - and by extension the new clause to
the Bill - could amount to indirect discrimination towards nationals of the
countries to which the provision will apply. In this instance, we believe that
the measure is justified by and is proportionate to the public policy objective of reducing the level of imported TB, protecting public health and ensuring public confidence in the migration system. '

The potential for race discrimination was also discussed when the legislation was debated in the UK parliament. It is possible that there will be challenges to the policy on the basis that, because there so many exceptions, it is difficult to show how the measures will protect public health.