Stepping up action on migrant and refugee health
Migrant health has risen high on the agenda of many European countries in response to the migrant and refugee crisis unfolding on Europe's Mediterranean borders. Since June 2013, the WHO Regional Office for Europe has conducted a number of assessment missions with ministries of health, and Bulgaria, Cyprus, Greece, Italy, Malta, Portugal and Spain have piloted a toolkit for assessing the capacity of their health systems to manage large influxes of migrants during the acute phase.
The toolkit is based on one used to assess the capacity of health systems for crisis management and was adapted to the complex, resource-intensive, politically sensitive context of sudden large migration flows. The medium-term objective of these missions was to identify any gaps and needs in the provision of technical assistance and to improve the countries' public health response to migration, addressing the health needs of these vulnerable groups and contributing to reducing health inequalities.
The region of Sicily in Italy, supported by the Regional Office, prepared the first contingency plan in the European Region to address the public health needs of large immigration flows. This operational strategy was adopted by law by the Regional Parliament of Sicily on 23 September 2014. The document establishes a homogeneous procedure for improving the organizational aspects of the public health response, by increasing the efficiency of both logistic and human resources, recognizing the diversity of actors involved and the intersectoral nature of the situation. Other Member States, including Malta and Spain, are preparing similar strategic plans at national and sub-national levels.
A European-wide approach to migrant health
Although Mediterranean countries are on the front line of large migration flows, mainly from Middle Eastern and African countries, the causes, effects and consequences of large migration are felt in different ways in the European Region. However, little effort has been made to understand the health implications of migration, to coordinate the most effective policies and interventions to reduce inequalities in health care access and to improve the health status of migrant groups.
In response, the Regional Office and universities in the European Region are writing three Health Evidence Network (HEN) reports, each of which focuses on a specific migrant group: undocumented migrants, labour migrants, and refugees and asylum seekers.
These reports will be presented at an informal meeting during the 65th session of the WHO Regional Committee for Europe, in September 2015 in Vilnius, Lithuania. On the first day of the Regional Committee session, ministers will be invited to an event on the margins to discuss the different needs, priorities and approaches to migration and health issues of Member States in the Region. The WHO European Region is the first WHO region to prepare a systematic, coordinated approach to confront the public health implications of migration.
A continuous challenge
Soaring refugee and migrant arrivals across Europe require action to optimize the capacity of the health sector to manage these large influxes of migrant populations. According to UNHCR figures, more than 100 000 migrants have already crossed the Mediterranean in 2015. Current economic trends, political strife and global insecurity are likely to continue uprooting thousands of men, women and children, thus increasing population movement across the globe. It is therefore essential that countries prepare for and adapt to the public health needs of migrants and refugees. The way in which host countries respond to the increasingly complex patterns of migration will determine the human rights and health outcomes of both the national and migrant populations of today and tomorrow.