Migrant and refugee populations: a public health and policy perspective on a continuing global crisis

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.

Implications of human activities for (re)emerging infectious diseases, including COVID-19

“…Millions of people live in deplorable conditions, and healthcare facilities in host countries are overburdened; these conditions are suitable for the (re)emergence of infectious diseases [ 70 , 150 ]. Displaced populations are prone to viral and bacterial respiratory infections, nosocomial antibiotic-resistant bacterial infections, cholera, cutaneous leishmaniasis, sexually transmitted infections, poliomyelitis, Chagas, schistosomiasis, hepatitis B and C, meningococcal infections, and VBDs [ 57 , 151 – 154 ]. It would be better to (1) strengthen health systems in all countries; (2) evaluate the detection, containment, treatment and control of infectious diseases, including the implementation of surveillance systems; and (3) devise strategies for epidemics and protect health-supporting infrastructure and health workers during conflict situations and the aftermath, ultimately striving to achieve health equity by key policy actors [ 68 , 81 , 151 , 155 , 156 ].…”

The influence of medical insurance and social security cards on the floating population's settlement intention

“…As their willingness to stay increases, so does the prevention of communicable and noncommunicable diseases in the place of residence. This is because the willingness to stay promotes urbanization, which leads to an increase in global risk factors for infectious and noncommunicable diseases (76)(77)(78). Speci cally, China's public health service system for the oating population is not sound, and there is a lack of disease data from the oating population on infectious diseases and chronic noncommunicable diseases, making it di cult to establish a disease surveillance system (78)(79)(80).…”

Health screenings administered during the domestic medical examination of refugees and other eligible immigrants in nine US states, 2014–2016: A cross-sectional analysis

“…Examinations and interventions provided during the initial resettlement period ensure that refugees and other eligible populations are healthily integrated into receiving communities and are ready to begin work and school. Further, the domestic examination is usually the first contact the individual has with the US healthcare system and possibly the first time he/she is screened for certain health conditions or receives preventive healthcare [8,9].…”