Addressing health issues and concerns surrounding the migration process has been a keystone of IOM’s work in since 1951. From health assessments to building and strengthening capacities of national health systems, fostering health promotion and protecting migrants’ right to health, IOM’s migration health response underscores its unique and holistic approach to migration management. Together with partners, IOM works to ensure migrants’ health needs are addressed across the whole migration cycle – at pre-departure, during transit and travel, at the destination and upon return home.
IOM’s approach to migration health responds to the key priorities and action points of the Global Operational Framework on the Health of Migrants that is guided by the 2008 World Health Assembly Resolution (WHA 61.17) on the Health of Migrants. This signified a shift in global policy and an increased focus by global actors on prioritizing the migration health agenda.
With the onset of the COVID-19 pandemic in 2020, the topics of health security, equitable access to health services for migrants and host communities and adequate risk communication and community engagement have become high on the agenda. It has become more evident than ever before that Universal Health Coverage – one of the key goals in the United Nation’s 2030 Agenda for Sustainable Development and leaving no one behind – is needed to ensure that healthy migrants can be part of and contribute to healthy communities and sustainable development.
People, particularly the most marginalized and disempowered living in and contributing to equitable and inclusive societies are the main essence of the UN 2030 Agenda for Sustainable Development. It acknowledges the development potential of migration, owing to the intellectual, cultural, human and financial capital that migrants contribute to the social and economic development of their host societies and communities, as well as countries of origin. For migrants to be productive and achieve these purposes, being and staying healthy is a necessary pre-condition.
Embedded within the Department of Migration Management (DMM) but closely inter-linked with the Department of Operations and Emergencies (DOE) and the Department of International Cooperation and Partnerships, the Migration Health Division (MHD) meets the aspirations of migrants and Member States towards the fulfilment of the physical, mental and social well-being of migrants and their family, enabling them and their host communities to achieve social and economic development.
- Migration Health Assessment and Travel Health Assistance
Migration health assessments and travel health assistance for migrants and refugees are among the most well-established migration management services provided by IOM. At the request of the USA, Canada, Australia, New Zealand, United Kingdom, EU, and others, IOM provides an evaluation of the physical and mental health status of migrants to assist them with resettlement, the obtainment of temporary or permanent visas, international employment or enrolment in specific migrant assistance programmes, as well as educational programmes. Reflecting differences in immigration and public policies and practices, there is a diverse range of health assessment requirements among receiving countries, which are tailored to diseases of public health concern and impact. Services within IOM health assessment programmes include tuberculosis diagnostics and treatment or referrals for treatment, laboratory diagnostics and treatment for other conditions of public health concern, counselling, health education, and vaccination.
Travel health assistance is a related service that addresses individual health and safety and manages conditions of public health concern as individuals move across geographical, health system and epidemiological boundaries. Within health assessment programmes, pre-embarkation checks and pre-departure medical procedures are provided to assess migrants’ and refugees’ fitness to travel and provide medical clearance. These measures also ensure that migrants and refugees are referred to appropriate medical services once they arrive in their destination countries. Migrants and refugees who need medical assistance and care during travel are escorted by health professionals to ensure safe travel, transit and handover at the final destination. Pre-departure treatment and other public health interventions are also tailored to meet the needs of migrants and immigration authorities.
Other services, such as assistance within the context of Assisted Voluntary Return and Reintegration programmes for persons with medical needs, and DNA sample collection services for family reunification are cross-cutting with other thematic areas of the migration management portfolio of IOM.
In South-Eastern Europe, Eastern Europe and Central Asia, IOM provides migration health assessment and travel health assistance services to immigrants and refugees through its missions in Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Israel, Kazakhstan, Kosovo 1244, Kyrgyzstan, North Macedonia, Republic of Moldova, Russian Federation, Serbia, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan. The majority of the refugees assisted in the region were bound for the United States, followed by Canada and EU countries. Turkey assisted the largest refugee caseloads, which originated primarily from Syria, while Ukraine assisted the largest caseload of family reunification beneficiaries. Prospective immigrants to Australia, Canada, New Zealand, South Korea, United Kingdom and the United States made up the majority of all migrants assisted by IOM’s health assessment programmes in the region.
- Health Promotion and Assistance for Migrants
Inadequate access to health services and the unfavourable conditions in which many migrants live and work make them subject to a variety of health risks. These are of particular concern to vulnerable groups, such as irregular migrant workers, victims of trafficking and exploitation, displaced persons, refugees and representatives of ethnic minorities, such as the Roma population of Europe. In the SEEECA region, health systems are facing shortages and imbalances in the geographical distribution of the health workforce brought about by emigration of health professionals to Western Europe and other OECD countries.
Despite decreasing trends globally, Tuberculosis (TB), including drug-resistant TB, HIV/AIDS and other sexually transmitted infections in Eastern Europe and Central Asia are increasing, putting migrants at risk, and, considering the high mobility in the region, make the issue of migrants’ health a priority. Also, the rising trend of non-communicable diseases, from substance abuse and metabolic diseases to cardiovascular conditions among the general population reflects a potential trend among well-integrated migrants as well as their family members. Policy and programmatic gaps, particularly in compliance with the international standards on human rights and in mainstreaming migration health in the public health approaches of governments are impeding migrants’ right to health.
IOM’s Health Promotion and Assistance for Migrants programmes are specifically designed to facilitate the access of migrants to high-quality health services regardless of their migration status and promote evidence-based programming and development of migration health policies through operational research. IOM works with partners in advocating, designing and delivering interventions on mental health and psychosocial support (MHPSS), intercultural communication, TB, HIV/AIDS, COVID-19, non-communicable diseases, emerging and re-emerging diseases, sexual and reproductive health and rights, and maternal and child health. Projects address social determinants of health and health development, labour migration, border management, health and social protection of trafficked persons, assisted voluntary return and reintegration of migrants, environment and climate change.
- Migration Health Assistance for Crisis Affected Populations
Humanitarian crises produce increasingly complex and often large-scale migration flows and mobility patterns, which typically expose affected populations to significant vulnerabilities and generate serious and longer-term migration management challenges. In disasters or crisis situations, health systems, depending on their health infrastructure and services, may suffer from acute to chronic setbacks in their capacities, and often lack adequate resources to provide the much-needed services to displaced persons or migrants. Logistical support, procurement, rapid deployment and transport of medical supplies and equipment, as well as support to service providers in disasters or emergencies is critical.
The SEEECA region has been affected by the global health emergency caused by COVID-19 in 2020, with health systems reaching their capacity limits, and the need to improve disease surveillance systems, contribute to risk communication and provide mental health and psychosocial support to counter the multidimensional stress caused by the pandemic.
Displacement and conflict lead people in need of health assistance in various contexts in the region. The conflict in Ukraine has left internally displaced and populations close to the line of contact and in the non-government controlled areas with impeded access to quality health services and has an impact on the mental health of the displaced population.
Turkey and the Western Balkan region in 2015 saw an unprecedented rise in the number of migrants crossing borders on land and at sea towards Europe, which has lessened in the intervening years. Driven by conflicts and insecurity in the Middle East and East Africa, as well as deep-rooted socio-economic problems, poverty and human rights violations in their countries of origin, this mass mixed-migration flow of people carried with it an enormous economic, political and social impact for host and transit countries. The health implications of these mass movements rest mainly on the burden to health, security and immigration services who manage the situation. Ensuring access to health and psychosocial services in accordance with international humanitarian and human rights standards and principles can be daunting tasks for governments in the region.
In addition, countries in South-Eastern Europe, Eastern Europe and Central Asia face a variety of natural hazards, among which floods and earthquakes have the most impact, and which may have significant health consequences. The World Bank has reported that close to 500 significant floods and earthquakes have hit Europe and the Central Asian region in the past three decades with 50,000 fatalities, affecting nearly 25 million people and resulting in over billion USD in damages.
As a formal partner of WHO and member of the Inter-Agency Standing Committee’s Global Health Cluster and the Global Outbreak Alert and Response Network, IOM responds to humanitarian and public health emergencies, and supports health system recovery and resilience by alleviating suffering, saving lives and protecting human dignity throughout the migration cycle and mobility continuum. Health support is an essential part of IOM’s humanitarian mandate, and it is recognized as one of the 15 sectors of the IOM's Migration Crisis Operation Framework.