Population movement is a challenge for refugees and migrants as well as for the receiving population

Statement by Dr Zsuzsanna Jakab, WHO Regional Director for Europe

The large influx of refugees and migrants to countries of the WHO European Region, which has escalated in the past few months, calls for an urgent response to their health needs. Actions are needed between and within countries as well as among sectors. 

Adequate standards of care for refugees and migrants into Europe are not only important for population health but are fundamental for protecting and promoting their human rights as well as those of the host communities. This is in the full spirit of Health 2020, WHO/Europe's framework for health and well-being and of World Health Assembly resolution WHA61.17 on migrants' health, a milestone in WHO global work in this area.

To date in 2015, about 350 000 refugees and migrants have reached European countries, adding to the almost 2 million who have taken shelter in Turkey.

In spite of a common perception that there is an association between migration and the importation of infectious diseases, there is no systematic association. Communicable diseases are primarily associated with poverty. Refugees and migrants are exposed mainly to the infectious diseases that are common in Europe, independently of migration. The risk that exotic infectious agents, such as Ebola virus or Middle East respiratory coronavirus (MERS-CoV), will be imported into Europe is extremely low, and experience has shown that, when it occurs, it affects regular travellers, tourists or health care workers rather than refugees or migrants. 

Europe is well prepared to respond to such events. While we should remain vigilant, this should not be our main focus. We should focus on ensuring that each and every person on the move has full access to a hospitable environment and, when needed, to high-quality health care, without discrimination on the basis of gender, age, religion, nationality or race. This is also the safest way to ensure that the resident population is not unnecessarily exposed to imported infectious agents. WHO supports policies that provide health care services to migrants and refugees, irrespective of their legal status. 

Refugees and migrants are not a homogeneous group, and we must ensure that our care systems respond to their diverse needs. This is particularly relevant for refugees and migrants who are exposed to violence, including gender-based violence, sexual violence and forced prostitution. It is also relevant for sexual reproductive health and rights, mother and child health, diabetes, cardiovascular diseases, mental health, emergency care and protection against vaccine-preventable diseases.

A good response to the challenges of people on the move requires health system preparedness and capacity, including robust epidemiological data and migration intelligence, careful planning, training and, above all, adherence to the principles of equity and solidarity and to human rights and dignity.

High-quality care for refugee and migrant groups cannot be addressed by health systems alone. Social determinants of health cut across sectors such as education, employment, social security and housing. All these sectors have a considerable impact on the health of refugees and migrants.

Health issues related to population movement have been on the WHO agenda for many years, especially in the European Region. We must ensure that our health systems are adequately prepared to provide aid to refugees and migrants while at the same time protecting the health of the resident population. This requires cooperation among the countries of origin, transit and destination.

The WHO Regional Office for Europe is providing technical and on-site assistance to affected countries, with assessment of and support to their capacity to address the health needs of refugees and migrants. In addition, the Regional Office is providing policy advice on contingency planning, training of health personnel and delivery of emergency kits, each covering the needs of a population of 10 000 for 3 months.