Universal health coverage is a human right and migrants must not be excluded
Last week I had the privilege of attending a two-day thematic session and multi-stakeholder hearing of the global compact for migration organised by the United Nations.
The global compact will be an intergovernmentally negotiated agreement to cover all dimensions of international migration.
The thematic sessions I attended on the first two days discussed the contribution of migrants and diasporas to all dimensions of sustainable development, including remittances and portability of earned benefits.
This is the first time I’ve attended a meeting at the UN and it was thought-provoking to hear government representatives discussing the good, and not so good, examples of their work in this area.
In the current climate of unilateralism and populist politics, it was inspiring to see nations coming together to try and address the challenges associated with international migration.
On the third day I attended an informal interactive multi-stakeholder hearing. Having seen how the previous two days had worked – essentially pre-prepared speeches delivered by governments - I was doubtful about just how interactive the session would be.
I was wrong though, and from the start it was obvious that this stakeholder meeting would be very different from the last two days, with many more speakers from civil society and academia.
I therefore quickly decided to speak up about the serious omission of health and universal healthcare access in the compact. I wrote something quickly and pressed the speaker button at my desk.
About 10 minutes later I got the opportunity speak. Here is what I said:
Thank you moderator for the opportunity to speak.
I am a public health physician and academic here on behalf of the University College London-Lancet Commission on Migration and Health which aims to obtain, appraise and present evidence on current issues in migration and health.
As recently stated by the new Director General of the WHO: “Universal health coverage is a human right.”
The Global Compact on Migration is a unique opportunity to contribute towards addressing health as a human right. I would like to echo panellist member Prof Marc Schenker's sentiments that the exclusion of health from the thematic sessions of the compact is a significant oversight.
Universal health coverage will not be achieved unless the hundreds of millions of migrants globally are included during all stages of their journey.
Achieving this requires commitment to the following human rights based approaches to health:
Firstly, access to healthcare should be non-discriminatory. No migrant should be denied access, or provided differential access to care based on ethnicity, colour, sex, or documentation.
Secondly, healthcare and public health interventions need to made available to all migrants at every point in the migration process.
Thirdly, health and public health facilities must be accessible to migrants - barriers such as documentation must not be introduced, and financial impediments to access must be removed. Healthcare workers are not border control guards or accountants.
Fourthly, services must be acceptable to migrants. This means they should be culturally and socially appropriate.
Fifthly, they must be high quality. Wherever possible this means using evidence-based approaches to the delivery of health care, and if evidence exists on how to improve health outcomes in migrants then these should be implemented and quality assured.
Finally, states must be answerable and held to account for the observance of healthcare as a human right.
At the UCL-Lancet Commission on Migration and Health we look forward the time when all migrants have full and universal access to healthcare.