GA 2018-PlS Presentation Dhavan-Oct2018

09/11/2018
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Leaving No Migrant behind:
Migration and Health Perspectives
Healthy Migrants in Healthy Communities
Dr. Poonam Dhavan
Senior Policy Advisor, Migration Health Division (MHD)
International Organization for Migration (IOM)
World Medical Association General Assembly
Iceland, October 06 2018
I. Introducing IOM, and Migration Health at
IOM
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• UN related organization
• 172 Member States
• Headquarters in Geneva
• 393 offices in more than 150 countries
• Over 10,000 employees
• Committed to the principle that humane
and orderly migration benefits migrants
and societies
The International Organization for Migration
(IOM) is…
From 67 Member States in 1998 to 172 in 2018
IOM Migration Health Division (MHD, 2017)
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II. WHY do we need to focus on Migration
health?
WMA Constituent Member Survey on
Migration Health engagement
• Objective: a joint IOM-WMA survey disseminated to WMA
Consituent members to provide an overview of WMA Constituent
Member involvement / interest in Migration Health.
• How: Survey sent by email by Communications WMA
• Timeframe: 28 August-12 September 2018 (2 weeks)
• Participation: Total of 22 responding Constituent Member Medical
Associations (MAs), of membership total 114 (19%)
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1. Does your Association engage with migration health
issues?
• 15 MAs engage with migration health issues, while 7 MAs do not.
• Selected areas of engagement:
• 13 MAs – The Right to Health: Improving health care access for migrants
• 8 MAs – Physicians in distress: Violence against health workers serving
refugees and other mobile populations in conflict settings
• 7 MAs – Firewalls ensuring confidentiality between doctors and patients
who are migrants
• 9 MAs – Communicable diseases such as HIV/AIDS, TB, and influenza
• 7 MAs – Non-communicable diseases such as diabetes, cancer, and
chronic lung disease
4. Would you like to become more aware of
migration health issues?
2. Is your Association
active in supporting
migrant and refugee
doctors working in your
country?
• 11 MAs are active in
supporting migrant and
refugee doctors working in
their country.
• 10 MAs are not active in
supporting migrant and
refugee doctors working in
their country.
• 16 MAs would like to further
engage with migration
health issues.
• 5 MAs would not like to
further engage on these
issues.
• There is a clear interest from
many MA to further engage
with migration health
issues.
3. Would your Association like to
further engage with migration
health issues?
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Migration as a determinant of health
In addition to legal barriers to health,
migrants face a combination of
geographical, administrative, social, cultural,
economic, behavioral and linguistic barriers
to health services
• Access to health care
• Poor living and working conditions
• Health service delivery, especially
in emergencies
• Health monitoring
• Health care financing
• Migration of health workers and
attacks on health care workers
Key Health Challenges for Migrants
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• Forced displacement and irregular
migration
• Omni present exploitation, abuse,
discrimination –slavery
• Widely used detention practices
Unique health challenges:
Reality:
ØMost migrants are healthy and
usually underutilize services
ØMigrant populations are very
diverse – the health profile of a
migrant depends on the
characteristics of the migration
process at all stages
ØConditions surrounding the
migration process can make
migrants vulnerable
The Myths, the stigma…
Myths:
“Migrants are carriers of
disease”
“Migrants are a burden on
health systems”
“Generous social rights are
a pull factor”
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• Migrants work : 70%
• Migrants contribute to
economies and development
• Migrants contribute more in
taxes and social contributions
than they receive in benefits
• Migrants sent approx. 581
billion USD home/2015. (WB-
KNOMAD)
Migration as a driver for development
x x
proximity for
families
negative
social and
health impact
economic
well-being
foreign
exchange
wins
• The level of development of an area or
community can be a driver of mobility
• Migration can be an opportunity for
development
• Migrants can be contributors to development
in their countries of origin and destination
• Mobile populations are also vulnerable
populations, whose specific needs must be
considered for governments to ‘leave no one
behind’ in development.
Human mobility intersects with sustainable
development
Migration
health
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• “UHC can be universal only if it applies
equally to all people. Equity is central.”
• The SDGs rest on the principle that no one is
left behind
• UHC is not achievable without including
migrants
• 10.7 + 3.8 = Migrant-inclusive UHC by 2030.
A ‘migrant-inclusive’ road to Universal Health
Coverage (UHC)
III. WHERE can we find policy and political
opportunities?
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• Migration and migrants should be
part of the global development and
health debate
• Health of migrants should be part
of the global migration and
development debate
• Whole of government / Whole of
society – approach
Migration and Development – Global Health:
the Interlinkages
The Global Compact for Safe,
Orderly, and Regular Migration
(GCM)
Global Migration Policy
developments…
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Global Compact on Refugees
Global Migration Policy
developments…
Colombo Statement
High-level meeting of the Global Consultation on Migrant Health, Colombo, 23rd
February 2017
“We, the Ministers and Government Representatives,……agree to continue the implementation
of WHA 61.17 and other relevant WHA resolutions and initiatives… To lead in mainstreaming
the migration health agenda within key national , regional and international fora….as guided
by the 2030 Agenda for Sustainable Development.”
Endorsed by over 20 Governments
Global health policy developments on
migration…
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§Global Action Plan
to promote health of
refugees and
migrants (2019)…
§End TB Strategy
§WHO Global NCD
Action Plan
§UHC
§International Health
Regulations
Opportunities to integrate migration health in
global health strategies…
Developing a UHC Priority Benefits Package
What services should be made available and under what
conditions, and how can these be inclusive of migrants?
Monitoring UHC in the SDG era to ensure
migrants are not left behind:
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Building robust and resilient migrant-sensitive health systems to reach
UHC and SDGs
Health Workers Mobility
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IV. HOW can we collectively advance the
migration health agenda?
Migration is…
1. Inevitable – demographics & disasters
2. Necessary – development
3. Desirable – if well-governed
The way forward
“Migration is not a problem to be solved,
but a reality to be managed”
WL Swing (IOM DG, 2008-18)
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Good practices…
Between August 2017 and
January 2018, 199 submissions
were received, covering 85
countries, from 52 Member
States and partners such as the
Office of the United Nations
High Commissioner for Refugees
(UNHCR), the International
Organization for Migration
(IOM) and the International
Labour Organization (ILO).
A Multidisciplinary Approach – Health sector
collaboration with other sectors
Migration &
Development
Regulating
Migration
Migration
Health
Facilitating
Migration
Resettlement, Movement,
Emergency & Post- Crisis
Policy, Research &
Forum Activities
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Changing
perceptions,
with and for
migrants
“…I AM WHAT I AM BECAUSE OF WHO WE ALL ARE…”
Shared responsibility and collective actions are critical