Advocating for Change: Addressing Barriers To Tuberculosis Care for Immigrants and Refugees in Canada.

Tuberculosis (TB) disproportionately affects immigrants and refugees in Canada, who accounted for 80% of active TB cases in 2023 despite making up only 23% of the population. This commentary highlights the urgent need to address systemic barriers that hinder access to timely and effective TB care across the cascade, from screening and diagnosis to treatment completion. Drawing on recent policy reports and emerging evidence, this paper focuses on four main intersecting challenges: language barriers, limited cultural competency among providers, healthcare system inefficiencies, and misinformation. These barriers not only delay diagnosis, but also undermine treatment adherence and trust in the healthcare system. This commentary calls for scalable, equity-driven interventions including improved interpretation services, and tailored community-based education to TB-specific training for healthcare providers. To advance Canada's TB elimination goals, we must center the lived realities of immigrants and refugees, whilst strengthening the responsiveness, accessibility, and continuity of care within the Canadian healthcare system.