The World Health Organisation held the fifth Global School on Refugee and Migrant Health in 2024. The theme of the year was “Advancing Universal Health Coverage for Refugees and Migrants: From Evidence to Action.”
It was hosted in Bogotá, Colombia, bringing together leading experts from around the world in both humanitarian medicine and refugee and migrant healthcare. The Global School included examples from all around the world, including but not limited to Sudan, Italy, Palestine, Mexico, Ukraine, Colombia, Venezuela, and Afghanistan.
Over the course of 5 days, 5 different topics in the field of refugee health were explored. I will summarise and reflect on each one as follows.
Day 1 – Promoting Inclusive Primary Healthcare (PHC) for Refugee and Migrant Health Needs and Rights
This day focused on emphasising the importance of having equal access to healthcare, particularly focused on primary healthcare. There were examples from Brazil which focused on collaborative solutions for how migrant healthcare can be integrated into the existing healthcare system, as well from South Sudan which looked at ways of addressing healthcare challenges in an area suffering from conflict.
The experts speaking on this day explained how Primary Health Care (PHC) is the foundation of inclusive health systems. It is especially crucial for refugees and migrants who more often than not contact PHC services first. Moreover, PHC serves a purpose of triaging the health of migrants where resources are limited to ensure those with the most urgent needs are seen to, as well as providing core treatments and services such as vaccines, education, and basic care.
PHC also has a powerful role to play in treating refugees and migrants in their contexts, since primary health systems can be tailored to their specific needs in a culturally and context sensitive way. This helps aid the integration of refugee healthcare into the national health system. There is also emphasis on collaboration between different stakeholders, such as the local community, refugees, government, and humanitarian organisations. This emphasis on tailored healthcare and collaboration between stakeholders intends to create the foundation for an inclusive PHC system.
Day 2 – “Managing the Continuum of Care for Non-Communicable Diseases (NCDs) During the Migration Cycle.”
This second day emphasised that whilst PHC is vital, there is a need to go beyond this and also focus on Non-Communicable Diseases (NCDs), such that the long term health needs of migrants are recognised and addressed consistently.
One key point was made on including NCD health care into primary healthcare services. For example, mental health care could be part of PHC so that needs of displaced people could be met in a tailored way specific to their needs. Moreover, there is a need for barriers to accessing NCD care to be addressed. Some of these barriers are on a policy level, so this would require legislative changes to address these barriers, including extra funding to provide healthcare for NCDs.
Another point was made on tailoring healthcare for refugees, including paying special attention to the most pressing needs they have, such as diabetes, renal failure, and cancer, which all require specific and specialised treatments.
Day 3 – Including Migrants in Comprehensive Health Financing Strategies
The third day focused on the economics and finance of inclusive and equitable health systems. Examples were shared from Colombia, where inclusive financing has been used to integrate refugees into the healthcare system, and Italy, which showed the financial barriers to creating an inclusive healthcare system.
One point made was on reframing healthcare of migrants and refugees as a global public good, meaning to say that responsibility for healthcare should shift from a national to supranational level, ensuring UHC and equal access to healthcare for all displaced populations.
Another financial method explored was having a system of cross-border health insurance, such that health insurance can be applicable abroad to avoid giving migrants extra costs which could be a barrier to them accessing healthcare. Alternatively, a global taxation system where supranational entities contribute could alleviate some of the financial burden on lower and middle income countries, who support the majority of refugees and migrants. These methods could then contribute to a more equitable healthcare system for refugees and migrants.
Day 4 – “Closing the Gap Between Research and Policy Making to Better Address Migrant Health Needs.”
On the fourth day, there was emphasis on evidence, particularly with the aim of ensuring that research is put into practice.
There was an example from Estonia showing how evidence in reviewing health systems can become actionable in improving the healthcare for refugees and migrants. It was recognised there are certain challenges with implementing research into practice. For example, there are significant time lags between finding and creating evidence, and implementation. A suggestion for overcoming this was made to invest more in up-to-date and timely data, which can reform systems and to focus research on the areas most needed, such as in domestic and scientific ecosystems. This means that more attention can be made on the areas where the healthcare of displaced people is most urgent and in a more equitable way, where innovation can benefit a greater number of people as a public good.
Day 5 –“Universal Health Coverage Throughout and Beyond Refugee and Migrant Health Emergency Crises.”
Finally, the Global School ended with a day exploring Universal Health Coverage (UHC). In particular, there was discussion on adapting UHC so that it is more specific to the particular needs of displaced populations, as well as balancing current healthcare systems with the long term view.
One area that was focused on was the mental health of migrants and refugees, with discussion on how greater focus on this area can allow for better integration by enabling them to achieve what they want to.
Moreover, by collaborating cross-team and between different levels, enhancing training, and increasing capacity development, providing UHC can become more sustainable, improve research, and reduce inequalities. The UNGC was cited as an example of an entity which could become a central partner and ensure that the healthcare of displaced populations has a seat in international discussions. Across all levels, the experts highlighted the need to engage the community at the centre of the response, which will foster community trust and ensure that the most urgent needs are addressed with the correct resources.
This cross-team and system collaboration also ensures that data is available and can be transmitted between the teams that need it. It overcomes some of the barriers to accessing healthcare on a legal and policy level, by aiding emergency operations to receive the resources they need to deliver appropriately in their health systems, as well as to monitor how much their services are used. Ultimately, the discussion centred around how to build more resilient health systems.
Overall, this Global School was an enriching experience, particularly in the intersection of these connected topics of refugees and migrations, and healthcare. It highlighted that the healthcare of migrants and refugees is a global, universal priority, such that stakeholders on all levels such as governments, international organisations, and local communities, have a stake in it.
As was mentioned in the Global School, “Migrants are not just numbers, but human beings”.
#healthmigration #saludmigracion
Preeti Kaur 