A medical staff conducts malaria testing at an IOM clinic in Myanmar. Access to diagnostic services is a key component in the fight against malaria as early detection and prompt treatment prevents deaths and reduces transmission.© IOM 2013 

By Colin Ward, Nenette Motus and Davide Mosca

Today’s globalised world is witnessing unprecedented human mobility and migration trends. There are 214 million international migrants, along with 740 million internal migrants. One out of 7 persons is on the move. The increasingly multi-directional massive movements of people with marked feminisation raises complex implications on global health throughout the phases of migration – before departure, during travel and transit, at destination and upon return.

As societies become more culturally and ethnically diverse, migrants’ health is often determined by factors outside the health sector. Migrants and mobile populations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Thus migration is considered a social determinant of health for migrants and other marginalized and vulnerable groups.

IOM staff doing registration of patients at the Malakal POC (Protection of Civilians) clinic.  ©  IOM 2014

Migrant labour is an integral part of many country economies such as in the mining, transportation and construction industries, or in health care or domestic work. Development is contingent upon a healthy workforce and thereby healthy migrant and mobile populations. Health in the post-2015 Development Agenda should highlight the importance of migrants’ health as a crucial enabling factor in sustainable and equitable economic development.

Malaria poses a global threat to this progress and growth. As of 2011, 99 countries and territories faced on-going transmission of malaria. It is the fifth leading cause of death from infectious disease worldwide, and the second leading cause of death in Africa. There were 216 million cases of malaria worldwide in 2010, 174 million cases in the African Region. Migration is often cyclical and seasonal. When populations move from low malaria transmission areas to high transmissions areas, they are more susceptible than the resident population.

Migration from these high transmission areas to the low transmission area can expose previously malaria-free vectors to the disease.vii This cycle of re-introduction threatens progress towards malaria elimination and the control of artemisinin resistance.

IOM waiting area in Malakal, South Sudan's Protection of Civilians (POC) clinic.  ©  IOM 2014

Increasingly governments and health actors are recognising the need for a wide-ranging approach to migration and health. In addressing malaria control and elimination among migrants and mobile populations, several considerations need to be in place. These include access to vector control programming and services, prevention and early access to malaria diagnosis and treatment using culturally-understood methods as well as surveillance of artemisinin resistance. Efforts should be directed towards implementation of integrated interventions through multi-lateral partnerships across health and non-health sectors.

More dialogue is needed to enhance understanding of migrants’ right to health and the concept that health and social costs are reduced when healthy migrants are fully integrated into their host communities. Furthermore, these discussions should take place at all levels of government as addressing malaria across the migration continuum requires critical inter-country coordination for sharing of information and good practices among all key stakeholders.

You can read the full position paper here:  A Global Report on Population Mobility and Malaria: Moving towards elimination with migration in mind