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Symposium: Global Perspective on Migration and HIV/AIDS: Sharing Best Evidences and Practices

in Policy and Research

Migration: the global picture Migrants as a vulnerable population

Rosilyne BorlandInternational Organization for Migration

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Definitions

Health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”

- World Health Organization

Migration health “addresses the physical, mental and social needs of migrants, and the public health needs of hosting communities”

- IOM / WHO

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Which migrants?

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Migrants can be

– Internal or international– Forcibly displaced (natural disaster /

conflict)• IDPs, refugees, asylum-seekers

– Workers• formal / informal / seasonal / sector specific

– Regular and irregular • Legal migration status, identity documents• Within a formal system (e.g. detained,

deported)

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Migrants can be

– At any phase of the migration process• Preparing to move, in transit, in destination,

returnees– Victims of sexual violence / exploitation

• Trafficked persons, exploited labour migrants, SGBV survivors

– Members of key populations• IDU, SW, MSM

– A population vulnerable to HIV– A population which faces barriers in

accessing health services

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Global Statistics

1

1

2

15

51

100

214

740

0 100 200 300 400 500 600 700 800

Traffickked

Asylum seekers

International students

Refugees

Internally displaced

Migrant workers

Immigrants

Internal migrants

MillionsSource: UNDP;ILO;UNHCR;UNDESA;British council; US State Dep

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National AIDS Policy

IOM-UNAIDS Review of National Strategic AIDS Plans

• 84 National Strategic Plans (NSP) reviewed to date

• 92% of those reviewed refer to migration / migrants

• Extremely wide range of terminology

• Migrant

• Mobile Population

• Illegal Migrant

• Internally Displaced Person

• Foreign Businessmen

• Trafficked Person

• Seasonal Migrant

• Roma

• Labour Migrant

• Returnee

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Migration Health: Changing Paradigm

• Link between population mobility and spread of disease: one of oldest public health concerns

• Migration health ≠ border health: health of migrants and their communities

• Stigma and myths about HIV and migration health result in discriminatory policies: HIV entry, stay and residence restrictions

(see hivtravel.org)

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Migration as a ProcessMigrant health profile: • Disease prevalence• Living, working

conditions• Access / barriers to

health services• Violence, exploitation

• Mobility factors (separation from partner)

• Actions, attitudes

throughout the cycle

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Migration as a Social Determinant of Health

Positive or negative impact on migrant’s health depending on the conditions throughout the process

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Responses

Environmental

Structural

Individual

• Combination prevention• Universal access strategies which recognize structural and

environmental factors faced by migrants• Multi-sectoral strategies, multi-country strategies along the

route of migration• Migrant community health workers / HIV peer educators

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Responses

• IOM spaces of vulnerability approach (e.g. ports and transport corridors)

• Migrants’ sexual networks cross regions – varying HIV epidemics, HIV knowledge, risk factors

• Barriers to access health services are key – ensure access to health (HIV within other services)

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Global Policy Framework

• 2009 World Health Resolution 61.17 Health of Migrants – Monitor Migrant Health– Migrant-sensitive Health Systems– Policy and Legal Frameworks– Partnerships, Networks, Multi-country

Frameworks• 2011 Political Declaration on HIV/AIDS

– Explicitly recognizes vulnerability of migrants

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www.iom.int

rborland@iom.int