Health and migration
Dr Margaret Chan
Director-General of the World Health Organization
Honourable ministers, distinguished delegates, Dr Danzon, ladies and gentlemen,
The European Union is becoming increasingly engaged in regional and international health issues, which is a most welcome trend. I was glad to see that the first EU health strategy, issued under the Portuguese Presidency, acknowledges the global dimensions of health.
WHO has a long history of collaboration with the EU, mainly through its Regional Office for Europe. This collaboration is being intensified in rewarding ways, especially for global health.
As one of the most highly developed regions in the world, Europe has much to share. This concerns resources, but also policies and strategies devised to tackle difficult health problems.
Ladies and gentlemen,
Today, health is being shaped by powerful forces that transcend national and regional borders. The problems facing public health are big, complex, and increasingly international. More and more, international action, in a spirit of solidarity, is needed to address these challenges.
WHO welcomes the EU as an important regional and international partner.
WHO is particularly grateful for EU cooperation with developing countries, especially through the EUROMED partnership in the Mediterranean region, and the Coutonou agreements in Africa.
Work of the EU also strengthens global defence against the threat posed by emerging and epidemic-prone diseases. These diseases are a prime example of our universal vulnerability, and of the absolute need for shared responsibility and collective action.
Together, these EU initiatives acknowledge the intrinsic value of health and its contribution to economic and social development. They embody our collective responsibility to pursue better health in inclusive ways.
In this context, the Portuguese Presidency of the EU is to be congratulated for putting migrant health on the agenda.
The conclusions of this conference underscore the political dimensions and the responsibilities shared among all EU member states, the EU Commission, and many organizations, including WHO.
The issue of health and migration has concerned WHO for a number of years. Most recently, this concern has focused on the huge problems caused by globalization of the labour market and the mass exodus of health workers from the countries that invested in their training.
Many developing countries no longer have sufficient numbers of health workers to provide the most essential health care. This critical shortage undermines our collective ability to meet the health-related Millennium Development Goals.
But there is another dimension to the health and migration issue, which is felt most especially in Europe.
What are the special needs of migrants who leave their homes seeking a better life elsewhere? Are their health needs being met? Are their lives actually getting better? What are their unique vulnerabilities? What is our collective duty in responding to these needs?
This issue was discussed at the WHO Regional Committee for Europe, held in Belgrade earlier this month. The high mortality among mothers and children in migrant populations jeopardizes the ability of some European countries to meet the health-related Millennium Development Goals.
This gives you an idea of the scale of the problem and the serious place it holds on the health agenda.
The health of migrants is also on the agenda for the WHO Executive Board in January 2008. This will allow us to look at the problem in its international dimensions.
Here are some of what I consider the international dimensions.
In addressing the health of migrants, we confront both the broad determinants of health and the broad definition of health used by WHO.
A focus on the health needs of migrant populations fits with the growing concern about inequalities in health outcomes. Gaps in health outcomes are important, regardless of whether these differences occur between countries or within countries.
Without question, migrants are a vulnerable group. An inclusive society gives priority to unmet health needs, especially in vulnerable groups. Migrant populations are likely to have unmet health needs and may also have particular mental health needs.
They may face language and cultural barriers. They may face discrimination. They may be locked into menial jobs. They may leave their homes only to find a bleak future.
Taking care of the health needs of migrant populations is also in the best self-interest of host countries. In Europe as elsewhere, many infectious diseases, such as HIV/AIDS and multi-drug resistant tuberculosis, can cross borders via population movements.
Populations movements – to flee conflict, to seek a better life in another country, to leave rural areas for the promise of urban life – are a growing reality of life in the 21st century.
These movements occur throughout the world. But Europe is perhaps the best-placed region to take a hard look at the health needs of migrants, to gather the evidence, and to work out lines of action, also at the policy level.
Solutions being worked out in conferences such as this one can lead the way internationally.
I hope that the conclusions and proposed lines of action arising from this conference will be reflected in the policies, legal instruments, and programmes of the European Union. This would be a major step forward for the migrants themselves, and for the countries of origin, transit, and destination.
In this regard, the next EU-Africa summit could prove critical in establishing a firm – and healthy – way forward.
Again, let me congratulate the Portuguese Presidency for having made migration a priority issue, and for promoting a global approach to the many problems it embodies.
In the interest of greater coherence and fairness in development policies, the health of migrants deserves greater priority.
Ladies and gentlemen,
As you may be aware, I regard improvements in the health of women and of the African people as a measure of the overall effectiveness of all WHO programmes and policies.
I place great importance on the ongoing negotiations for a joint EU-Africa strategy and for the forthcoming EU-African summit. It is admirable when one of the most affluent regions of the world lends some of its wealth – also in the area of experience and expertise – to the region in greatest need of support.
As my last remark, let me quote from the Millennium Declaration’s statement about the challenge of globalization. “Those who suffer or who benefit least deserve help from those who benefit most.”
This is true for the people of Africa. This is also true for migrant populations – in Europe and internationally.