Abstract
The 2015–2017 global migratory crisis saw unprecedented numbers of people on the move and tremendous diversity in terms of age, gender and medical requirements. This article focuses on key emerging public health issues around migrant populations and their interactions with host populations. Basic needs and rights of migrants and refugees are not always respected in regard to article 25 of the Universal Declaration of Human Rights and article 23 of the Refugee Convention. These are populations with varying degrees of vulnerability and needs in terms of protection, security, rights, and access to healthcare. Their health status, initially conditioned by the situation at the point of origin, is often jeopardised by adverse conditions along migratory paths and in intermediate and final destination countries. Due to their condition, forcibly displaced migrants and refugees face a triple burden of non-communicable diseases, infectious diseases, and mental health issues. There are specific challenges regarding chronic infectious and neglected tropical diseases, for which awareness in host countries is imperative. Health risks in terms of susceptibility to, and dissemination of, infectious diseases are not unidirectional. The response, including the humanitarian effort, whose aim is to guarantee access to basic needs (food, water and sanitation, healthcare), is gripped with numerous challenges. Evaluation of current policy shows insufficiency regarding the provision of basic needs to migrant populations, even in the countries that do the most. Governments around the world need to rise to the occasion and adopt policies that guarantee universal health coverage, for migrants and refugees, as well as host populations, in accordance with the UN Sustainable Development Goals. An expert consultation was carried out in the form of a pre-conference workshop during the 4th International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on 20 June 2017, the United Nations World Refugee Day.
Highlights
The current global refugee crisis peaked in 2015–2016, and by late 2017 the number of people attempting to cross borders globally – still high – was receding
For purposes of ease of reading, and because we believe that the current nomenclature is arbitrary, in this paper we will use the International Organization for Migration’s (IOM) definition, and refer to a migrant as “any person who is moving or has moved across an international border or within a State away from his/her habitual place of residence, regardless of (1) the person’s legal status; (2) whether the movement is voluntary or involuntary; (3) what the causes for the movement are; or (4) what the length of the stay is.”
According to Migration Integration Policy Index (MIPEX), even well-performing host countries such as Germany or Sweden only achieve around 70% health equity [93]
Summary
The current global refugee crisis peaked in 2015–2016, and by late 2017 the number of people attempting to cross borders globally – still high – was receding. This dynamic sequence of events can be divided into six stages, each characterised by shortages and medical implications (Table 1) Even if, and it is hardly ever the case, healthcare may be available and relatively accessible when migrants arrive in a host country, this rarely compensates the months and years spent in either a risk-ridden and often prolonged transit phase, or at the point of origin [42]. Exposure to conflict and war has a lasting impact on mental health Due to these life events, the prevalence of psychiatric disorders in refugee populations is much higher than in those not forcibly displaced [14, 43,44,45]. Infectious diseases The prevalence of certain chronic parasitic diseases in asymptomatic migrants reflects, in general, the
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