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  1. 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 Borland International Organization for Migration

  2. 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

  3. Which migrants?

  4. 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)

  5. 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

  6. Global Statistics Source: UNDP;ILO;UNHCR;UNDESA;British council; US State Dep

  7. National AIDS Policy • Migrant • Mobile Population • Illegal Migrant • Internally Displaced Person • Foreign Businessmen • Trafficked Person • Seasonal Migrant • Roma • LabourMigrant • Returnee 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

  8. 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)

  9. Migration as a Process • Migrant health profile: • Disease prevalence • Living, working conditions • Access / barriers to health services • Violence, exploitation • Mobility factors (separation from partner) • Actions, attitudes • throughout the cycle

  10. Migration as a Social Determinant of Health Positive or negative impact on migrant’s health depending on the conditions throughout the process

  11. Structural Environmental Individual Responses • 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

  12. 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)

  13. 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

  14. www.iom.int rborland@iom.int