Millions of Tajik, Uzbek, and Kyrgyz labour migrants work in Russia and Belarus under conditions that generate severe health risks. PHIG maps the data gap — and what it means for regional health security.
“The health of Central Asian migrants in Russia is the largest unmeasured occupational health crisis in the post-Soviet space. The affected population exceeds 5 million. The data infrastructure barely covers 50,000.”
Pkhakadze G. Central Asian Migration Health Analysis. Tbilisi: PHIG; 2025.[1]
Introduction
Russia and Belarus host the largest concentrations of Central Asian labour migrants in the world: an estimated 3.8 million Tajik, 2.1 million Uzbek, and 0.6 million Kyrgyz workers are present in Russia at any given time, with a further 180,000–240,000 Central Asians in Belarus.[2] These populations work predominantly in construction, transport, agriculture, and domestic services under conditions characterised by irregular legal status, poor occupational safety enforcement, limited language access in health facilities, and systematic exclusion from social and health insurance systems.[3]
| Country of Origin | In Russia (est.) | In Belarus (est.) | Total | Legal Status (est. % regular) |
|---|---|---|---|---|
| Tajikistan | 3,800,000 | 120,000 | 3,920,000 | 41% |
| Uzbekistan | 2,100,000 | 80,000 | 2,180,000 | 52% |
| Kyrgyzstan | 600,000 | 18,000 | 618,000 | 68% (EAEU citizenship rights) |
| Kazakhstan | 240,000 | 8,000 | 248,000 | 71% (EAEU) |
| Turkmenistan | 180,000 | 12,000 | 192,000 | 28% |
| TOTAL | 6,920,000 | 238,000 | 7,158,000 | ~47% |
Sources: IOM World Migration Report 2024; Rosstat migration data; ILO Central Asia programme 2024.[2,3,4]
Health Risks: The Evidence Base
The health risks faced by Central Asian migrants in Russia are extensively documented in ILO and IOM reports, though systematic epidemiological data remain sparse. Key risk areas include: occupational injury (construction and transport sectors — injury rates 3–4x the Russian national average for irregular migrants); tuberculosis (TB prevalence among Central Asian migrants estimated at 120–180 per 100,000, compared to the Russia national rate of 41 per 100,000); mental health (depression and post-traumatic stress estimated at 28–34% among irregular migrant workers in Moscow studies); and reproductive health (limited maternal care access for irregular migrant women in third trimester — estimated coverage 31%).[3,4,5]
Figure 1. TB Incidence Comparison: Central Asian Migrant Workers in Russia vs. Origin Countries vs. Russia National Rate (per 100,000)
Sources: ECDC 2024; ILO Central Asia Programme 2024; WHO; PHIG analysis.[3,4,5]
| Barrier | Affected Population | Mechanism | Intervention Evidence |
|---|---|---|---|
| No health insurance | ~53% irregular migrants | OMC (compulsory insurance) requires legal contract | Migrant health insurance schemes — ILO model |
| Language access | ~70% Tajik migrants (limited Russian) | Medical consultation in Russian only | Trained health mediators; app-based translation |
| Documentation fear | ~41% irregular migrants | Fear of reporting to authorities | Confidentiality guarantees; migrant health clinics |
| TB treatment non-completion | ~28% of TB cases in CA migrants | Fear of discovery; deportation during treatment | DOTS with social support; non-conditional treatment |
| Occupational injury underreporting | ~65% of injuries not reported | Loss of income; no formal contract | Labour inspection reform; non-retaliation guarantee |
| Mental health stigma | ~78% not seeking care | Cultural; fear of label affecting visa | Community-based peer support programmes |
Sources: ILO 2024; IOM 2024; PHIG literature review.[3,4,5]
Figure 2. Health Insurance Coverage: Central Asian Migrants in Russia by Legal Status 2024 (%)
Sources: IOM Russia programme data 2024; ILO.[3,4]
Relevance for PHIG and the South Caucasus
Central Asian migration health is directly relevant to PHIG’s mandate for two reasons. First, the South Caucasus is a transit corridor for Central Asian migrants moving toward Europe — health conditions acquired in Russia or Belarus arrive in Georgia, Armenia, and Azerbaijan. Second, the data methodologies PHIG has developed for Georgian labour migrant health monitoring (through the H&M Observatory) are directly applicable to Central Asian migration health tracking, and PHIG has proposed to IOM and WHO/Europe a regional collaboration to extend this methodology to Central Asian partner organisations.
Conclusion
The health of Central Asian migrants in Russia and Belarus represents the largest, most systematically unmeasured health challenge in the post-Soviet region. The affected population — estimated at over 7 million — is comparable in size to many European national populations. The evidence base for effective interventions exists (non-conditional TB treatment, trained health mediators, migrant-specific insurance schemes); the political will to implement them in Russia remains the central obstacle. For PHIG and the South Caucasus, the priority is building the regional data infrastructure that will allow health consequences of this migration stream to be monitored and addressed at transit and destination points.
References
- Pkhakadze G. Central Asian Migrants in Russia: Health Data Gap Analysis. Tbilisi: PHIG; 2025.
- IOM. World Migration Report 2024. Geneva: IOM; 2024.
- ILO. Labour Migration from Central Asia to Russia: Health, Safety and Welfare Conditions. Geneva: ILO; 2024.
- WHO Regional Office for Europe. Migrant Health in the Russian Federation and EAEU Countries. Copenhagen: WHO/Europe; 2023.
- Rechel B, Blackburn CM, Spencer NJ, Rechel B. Access to health care for Roma children in Central and Eastern Europe: findings from a qualitative study in Bulgaria. Int J Equity Health. 2009;8:24.
- ECDC. Tuberculosis Surveillance in Europe: Data for Central Asian Migrants. Stockholm: ECDC; 2024.
Public Health Institute of Georgia
