The Path Towards Healthy Migrants in Healthy Communities

Sri Lanka - Achieving Universal Health Coverage under the UN’s Sustainable Development Goals (SDGs) is currently high on the global health agenda and to attain the goal of ‘Leaving no one behind’, health systems must account for members of every community, including migrants, writes Dr. Davide Mosca, Head of IOM’s Migration Health Division.

In response to renewed international attention on the link between health and migration, IOM, the World Health Organization (WHO) and the Government of Sri Lanka are this week jointly organizing the 2nd Global Consultation on Migrant Health. This high-level event taking place from 21-23 February 2017 in Colombo, Sri Lanka, will offer participating governments and partners a meaningful platform for multi-sectoral dialogue to commit to enhance the health of migrants.

Guided by three thematic areas, global health, vulnerability and resilience, and development, the Global Consultation will serve as an important milestone to inform future migration frameworks and dialogues such as the Global Compact processes for Migration and Refugees. 

Expected outcomes of the Consultation will include a Colombo Statement – a declaration expressing government support to promote debate and action towards enhancing the health and well-being of migrants and their families throughout the migration cycle. This would also include consolidated elements for a progress monitoring framework, research agenda and actionable policy objectives that enhance the advancement of migrant health as an item on the global health agenda.

We live in an era of unprecedented human mobility, a period in which more people are on the move than ever before. The number of people who migrated across international borders surged by 41 percent in the last 15 years to reach 244 million in 2015.

When one combines the volume of international migration, the large scale of internal migration of an estimated 740 million people worldwide, and the unprecedented and protracted displacement of populations due to unresolved conflicts and natural disasters, we can see that there is urgent need to address the cumulative health needs of people on the move.  

With the global volume of remittances sent home by migrants surpassing half a trillion dollars in 2016, the world is increasingly moving towards the realization that migration is an effective poverty-reduction strategy and an important means to respond to workforce shortages caused by demographic shifts. Yet, despite the clear economic benefits of migration, large groups of migrants remain at risk of social exclusion, discrimination and exploitation.

It is important to emphasize that migrants do not generally pose a health risk to hosting communities and they should never be stigmatized or associated with the risk and stigma of importing diseases.

Rather, it is recognized that conditions surrounding the migration process today, more than ever, can increase the vulnerability of migrants to ill health, particularly for those forced to move and those who find themselves in so called ‘irregular’ situations. In that sense, migration is a social determinant of health.

Most migrants are healthy and young, and migration can actually improve the health status of migrants and their families by providing a safer haven or better education and purchasing power for ‘left behind’ family members, thanks to remittances. However, the migration process can also expose migrants to health risks and many migrants lack access to adequate, equitable health services.

The WHO 2008 World Health Assembly (WHA) Resolution on the health of migrants was an important benchmark in acknowledging the connection between migration and health. It resulted in the first Global Consultation on Migrant Health in 2010 in Madrid, co-organized by IOM, WHO and the Government of Spain, which developed an operational framework to guide Member States and stakeholders on a rights-based, health system strengthening, multi-sectoral approach in addressing health and migration.

Yet, while there is awareness and recognition of the urgent need to adapt policies and programmes across sectors, the health challenges brought by global human mobility continue to rise. Adaptation and development of necessary technical and policy instruments has not kept pace.

Moreover, in many countries, the most important factor governing migrants’ access to health care remains their residency status, which is linked to most countries’ efforts to control immigration. Discriminatory practices that limit entry and residency based on medical grounds also still persist.

Population mobility, which is a critical component for effective public health interventions that prevent, detect and respond to health threats, as envisioned through the Global Health Security Agenda, still requires comprehensive responses that link the health of everyone, regardless of their migratory status, with the health of all. As a consequence, good public health practices of inclusiveness remain overlooked and millions of migrants world-wide are still denied equitable access to health care.

Being and staying healthy is a fundamental precondition for migrants to work, to be productive and to contribute to the social and economic development of their communities of origin and destination.

The international community has a shared responsibility of guaranteeing migrants the right to enjoy the highest attainable standards of health and to contribute to the sustainable development of societies. To quote IOM Director General William Lacy Swing: “Migration is not a problem to be solved, but an opportunity to be managed."