Worldwide, millions of refugees and migrants, such as low-skilled migrant workers, live in vulnerable situations and are in poorer health than the populations of their host countries, especially when their living and working conditions are poor. This is one of the conclusions of the first WHO world report on the health of refugees and migrants, which indicates that this serious problem has serious consequences and will make it difficult to achieve the Sustainable Development Goals related to the health of these populations.
dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said: “Almost one in eight people is a migrant and in total there are almost 1 billion migrants in the world. Migration has a major impact on health and well-being, and refugees and migrants remain among the most vulnerable and neglected groups in many countries. This report, which for the first time takes a global look at the health of these people, calls for urgent and coordinated action to ensure that refugees and migrants around the world can access health services that address their needs. In addition, it underscores the urgent need to address the root causes of migration and to radically re-engineer health systems to adapt to the growing dynamics of our world.
Drawing on a comprehensive review of the literature from around the world, this report shows that the health of refugees and migrants is not inherently worse than that of the host population, but rather that their health deterioration is due to the impact of various factors, such as deficiencies in education, income, housing and access to services, which are reinforced by language, cultural, legal and other barriers and by the intertwining of all these factors throughout life.
The report affirms that the experience of migration and displacement largely determines people’s health and well-being, especially when combined with other factors. For example, a recent meta-analysis involving more than 17 million participants from 16 countries across five WHO regions found that migrant workers use fewer health services and are at higher risk of work-related accidents compared to their non-immigrant counterparts. In addition, the data indicates that many of the world’s 169 million migrant workers work in dirty, dangerous and demanding jobs and are at greater risk of workplace accidents, injuries and work-related health problems than native workers. This situation is exacerbated by the fact that they often have limited access to health services.
On the other hand, the report highlights important gaps in data and information systems on refugee and migrant health; Although there is a large body of data and evidence, it is fragmented and does not allow comparisons between countries and over time. In some cases, data on groups that are moving can be separated from the rest in the global datasets used to track the SDGs, but migration statistics often do not show health data, and in health there is usually no data on the parameters that relate to the SDGs Migration situation. All of this makes it difficult to track and monitor the progress made towards the SDG targets related to refugee and migrant health.
dr Zsuzsanna Jakab, WHO Deputy Director-General, said: “We need to work harder to improve the health of refugees and migrants, but if we really want to make a difference, we urgently need to invest in improving the quality, relevance and completeness of data on health of these populations. We need robust data collection and monitoring systems that truly reflect the diversity of the world population and the experiences of refugees and migrants around the world, and serve to inform more effective policies and interventions.”
Although the lack of data comparing refugee and migrant health across countries and over time often makes it difficult to formulate policies that promote health equity, frameworks and standards are available that recognize and meet the health needs of refugees and migrants. However, disparities in health outcomes continue to be observed, which the report says are mainly due to poor and ineffective policy implementation.
dr For his part, Santino Severoni, Director of the Health and Migration Program at WHO, pointed out: “The limits of health are not those of countries. Therefore, the migration situation should not be a reason for discrimination, but a fundamental element for the elaboration of strategies to develop and strengthen health care, social and economic protection. We need to realign current health systems to integrate and include refugees and migrants, based on the principles of primary care and universal health coverage.”
Refugees and migrants can bring innovative ideas to change the economy and society. The report highlights the tremendous contributions made by frontline refugee and migrant health workers in the COVID-19 response; Its participation in several countries of the Organization for Economic Co-operation and Development (OECD) should be highlighted. Its importance is so great that in some countries up to half of the medical and nursing staff are foreigners.
By establishing inclusive health systems that respect the principle of the right to health for all and universal health coverage, people in need of these services can be quickly identified and helped before many problems become serious. The strength of health systems depends on their weakest link, and engaging refugees and migrants is a worthy investment to contribute to the development and well-being of societies around the world.
Note to the editor:
Quotes from the signers of the World Report:
“By showing that migration and displacement impact the health of billions of people who have been forced to leave their homes, it enables us to address these issues on the basis of universal health coverage and the principle that everyone has a right to it have to contemplate enjoying complete physical, mental and social well-being, and not merely being free from disease or infirmity, as stipulated in the 1946 WHO Constitution”.
Ban Ki-moon, President of the Ban Ki-moon Foundation for a Better Future and Eighth Secretary-General of the United Nations.
“The material, economic and psychological problems posed by the migration and displacement of groups of people and their integration into host communities are often neglected, misunderstood or overlooked. That is why I am pleased that this report brings together the available global data on the health of international migrants and displaced persons into one must-read document.”
Abdulrazak Gurnah, writer and professor, Nobel Prize in Literature (2021)
“This report shows that the most effective way to meet the health needs of refugees and migrants in the short, medium and long term is to have integrated health systems and to include refugees and migrants in systems that provide services to host communities. Despite the significant resources and technical improvements this may require, it has been shown that including all people in health systems brings great benefits to all, both refugees and migrants and the host population.
Midori de Habich, former Minister of Health of Peru