Abstract
IntroductionGlobal migration policy discussions are increasingly driven by moral panics – public anxiety about issues thought to threaten the moral standards of society. This includes the development of two Global Compacts – agreed principles to guide an international response – for (1) “Refugees” and (2) “Safe, Regular and Orderly Migration.” While the need to address migration and health is increasingly recognized at the global level, concerns are raised about if this will be reflected in the final Compacts. The Compacts focus on securitization, an approach that aims to restrict the movement of people, presenting potentially negative health consequences for people who move. Globally, concern is raised that migration‐aware public health programming initiatives could be co‐opted through a global health security agenda to further restrict movement across borders. This is particularly worrying in the Southern African Development Community (SADC) – a regional economic community associated with high levels of migration and the largest population of people living with HIV globally; this case is used to explore concerns about the health implications of the Global Compacts.DiscussionCurrent HIV responses in SADC do not adequately engage with the movement of healthcare users within and between countries. This negatively affects existing HIV interventions and has implications for the development of universal HIV testing and treatment (UTT) programmes. Drawing on literature and policy review, and ongoing participant observation in policy processes, I outline how Global Compact processes may undermine HIV prevention efforts in SADC.ConclusionsThe global health imperative of developing migration‐aware and mobility‐competent health responses must not be undermined by moral panics; the resultant international policy processes run the risk of jeopardizing effective action at the local level. Globally, migration is increasingly recognized as a central public health concern, providing strategic opportunities to strengthen public health responses for all. Without mainstreaming migration, however, health responses will struggle. This is particularly concerning in SADC where HIV programmes – including UTT initiatives – will struggle, and key health targets will not be met. Globally, contextually appropriate migration‐aware responses to health are needed, including and a specific focus on HIV programming in SADC.
Highlights
Global migration policy discussions are increasingly driven by moral panics – public anxiety about issues thought to threaten the moral standards of society
I explore the implications of the current global migration policy terrain for the Southern African Development Community (SADC), a regional economic community made up of 15 member states that is associated with high levels of both internal and cross-border migration and a high communicable disease burden, including the largest population of people living with HIV globally [10,11,12,13]
With the aim of offering suggestions for ways to mobilize a regional response to migration and HIV in SADC, I outline the challenges – and strategic opportunities – that result from the current global migration policy terrain. This is done by drawing on a review of research and policy associated with migration and HIV in SADC (13 and Table 1) and my ongoing participant observation within various global, regional and national policy processes
Summary
While health has long been considered an essential component of human and economic development, the health of migrants has remained in the shadows of key global health, migration, and development dialogues and processes, and many migrants still lack access to affordable health services. (IOM, 2017: p. 4). In spite of recent calls at the global level to improve responses to migration and health, and the development of a global research agenda to support this [1,2,3,4], the “unfinished agenda of migrant health for the benefit of all” [5,6] remains a glaring gap in current global, regional and national policy discussions. The resulting tensions within the global community present multiple challenges for the development of improved responses to migration and health In this commentary, I explore the implications of the current global migration policy terrain for the Southern African Development Community (SADC), a regional economic community made up of 15 member states that is associated with high levels of both internal (within country) and cross-border (between country) migration and a high communicable disease burden, including the largest population of people living with HIV globally [10,11,12,13]. This is done by drawing on a review of research and policy associated with migration and HIV in SADC (13 and Table 1) and my ongoing participant observation within various global, regional and national policy processes
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