Global health (security), immigration governance and Covid-19 in South(ern) Africa: An evolving research agenda

Abstract

The Covid-19 pandemic provides a stark reminder of the political tensions associated with the field of immigration and health, highlighting the central role that nationalism, racism and xenophobia play in determining responses to communicable diseases. The blurring of global health, immigration governance, and the global health security agendas has long been recognised. However, an improved understanding of the politics influencing these entanglements, specifically within the context of the Covid-19 response in low- and middle-income country contexts, is urgently needed. This includes – but is not limited to – the immediate concerns surrounding inclusive social, political and medical responses to Covid-19; vaccine nationalism – at both global and national levels; and calls for ‘vaccine passports’. To this end, we draw on the Southern African Development Community (SADC) context – one associated with high levels of diverse population movements and a large burden of communicable diseases – to explore responses to Covid-19. We unpack tensions surrounding the management of migration and the ways in which sovereignty impacts attempts at building regional, coordinated responses to migration and health, and consider how this affects progress towards global health targets. With an initial focus on South Africa, we build on previous work exploring the blurring of global health, immigration governance, and the global health security agendas in SADC, and draw from ongoing research on the governance of migration and health within the region. This includes current and evolving research exploring migration and Covid-19, initiated in March 2020 when the first cases of Covid-19 were identified in Southern Africa. The aim is for these findings to catalyse a new and evolving researh agenda to inform the development and implementation of appropriate pandemic responses in a region associated with some of the highest levels of inequality globally. To this end, an evolving research agenda should be responsive to current needs. We suggest that, in SADC, priority research should focus on improving our understanding of (1) the political factors influencing the (dis)connections between migration and health governance structures in the context of Covid-19, and how to overcome these in the context of a pandemic; and (2) the motivations for and implications of a ‘vaccine passport’ system on movement within and beyond the SADC region. This requires a reactive, cross-disciplinary, regional research network. In a context where funding for research is increasingly inaccessible, this requires innovative, informal, collaborative engagement.

Time, space and health: using the life history calendar methodology applied to mobility in a medical-humanitarian organisation

“…As a medical-humanitarian organisation working with mobile populations in different contexts, Médecins Sans Frontières (MSF) relies heavily on the available health data to design evidence-based interventions, yet detailed information on mobility trajectories and access to health care are not always readily available, particularly in low and middle-income countries [ 4 , 10 ]. To design, monitor and evaluate projects focused on mobile populations, MSF often needs retrospective health data in settings such as refugee camps and shelters, crossing points, detention, and reception centres.…”

The South African Development Community (SADC) and Covid-19: revisiting security community in SADC

“…In maintaining greater peace and security in SADC amidst the Covid-19, policies with the SADC region focus on maintaining peace, preventing conflict and securitising health, even though the individual foreign policies of member states can be problematic with regards to pandemic man-agement more specifically [51].Given that prior to 2013, there was the lack of general consensus amongst the member states on peace-making intervention in Lesotho, Zimbabwe and the DRC. However today, as in the case of the Covid-19 pandemic; Mozambique's Carbo Delgardo insurgency security threat, SADC acted collectively with a common understanding on these matters.…”

An analysis of migration and implications for health in government policy of South Africa

“…Concerns about the ways in which health is increasingly co-opted by approaches to national security and restrictions on movement are well documented by the public health and migration community [ 19 – 22 ], and highlight the importance of bringing together the governance of health and immigration to address the health of migrants. Immigration policy agendas that focus on security concerns linked to migration are often considered by the international public health community to be damaging and xenophobic, impairing the health of migrants by excluding, discriminating and/or blaming migrants as vectors of diseases [ 16 ].…”