Migration and health, a defining issue of our times, has increasingly gained importance in Europe. The COVID-19 pandemic and war in Ukraine have further highlighted the need for a strong community of researchers and health professionals to focus their efforts on documenting the inequities, needs and aspirations of migrants and to explore solutions to these.1,2 The Lancet Migration European Regional Hub has emerged as a catalyst for collaboration to harness cross-country synergies and drive evidence-based policy.
The Hub's objectives are fourfold: (i) to facilitate evidence generation across the European region through intercountry collaboration; (ii) to disseminate evidence and promote best practices to stakeholders in migration and health; (iii) to act as a nexus of expertise supporting research, practice, and policy dialogue within the region; and (iv) to enable the next generation of migration and health researchers in their learning and career pathways.
Since the Hub's inception in January 2021,3 it was time in July 2022 to convene a strategic workshop in Geneva, with sixteen regional migration health experts to discuss the Hub's progress to date, and to determine key priorities for research collaboration in the European Region. During this workshop, challenges facing migrant health professionals and researchers were discussed, as well as possible strategies to address them. Multiple gaps in evidence and research methods were further uncovered. The group will have three working groups for the next two years: (i) Universal Health Coverage (UHC); (ii) Vaccination coverage with a special focus on COVID-19; (iii) and Border Security, detention and health (Table 1).
Table 1.
Current thematic priorities for the Lancet Migration European Regional Hub.
| Theme | Key priority areas | Cross-cutting priorities |
|---|---|---|
| Universal Health Coverage and migration |
|
|
| Vaccination coverage with a special focus on COVID-19 |
|
|
| Border security, detention, and health |
|
Achievement of UHC is dependent on cross-sectoral collaborations.4,5 Workshop participants raised concerns about undocumented migrants being excluded from basic health service provision, especially in areas with border or detention zones that often lack public health interventions and primary healthcare facilities. In particular, chronic diseases require more attention, across the life course. Health service delivery needs to be migrant-inclusive and culturally sensitive, especially for mental health. Urgent action is needed to support the World Health Organization's (WHO) Special Initiative for Mental Health, which is in line with UHC.6
Undocumented migrants continue to be excluded or not caught-up in immunization programmes across Europe.7 This is due not only to restrictive policies, but a multitude of factors including healthcare provider awareness, public communication, and health literacy.
A significant barrier to studying and improving the health of migrants in European countries has been the difficulty in collecting and accessing data in detainment settings particularly due to restrictions on people's movements and access to care. The mainstream narrative surrounding migration to and within Europe has often been fuelled by politics and has stigmatized migrants as a threat,8,9 although evidence demonstrates the contrary.1,2,7 Amidst a new era of policies such as the New Pact on Migration and Asylum proposed by the European Commission,10 and concerns over recent plans by the United Kingdom to deport asylum applicants abroad, it is critical to generate cross-border evidence that documents the consequences of such policies health and wellbeing.
There is a need to ensure basic data on migrants is included in routine national data collection, and to disaggregate data by migrant status and other demographic indicators, to identify inequities between groups. The European region has over twenty official languages. Translation and sharing of best practices and tools will help to create cross-border synergies. Migrants need to be placed at the centre of health services and health research through participatory approaches. Current narratives, misconceptions, and stereotypes towards all types of migrants need to be addressed, through evidence-based dialogue.
The Hub's network of experts will support countries to address the above issues. Country focal points and special advisors for migration and health research will be identified, and collaborations with other networks within and outside Europe will be established. Over time, the Hub will aim to serve as a trusted ‘Think Tank’ for migration and health research in the European region.
In 2023, a series focusing on ‘Migration and Health Inequities’ will be published in collaboration with The Lancet Regional Health - Europe. This series aims to build on the 2018 UCL-Lancet Commission on Migration and Health recommendations and provide the European regional perspective five years after the publication of the Commission report.11 Specifically, the series will address overarching thematic issues as well as update some key areas of interest regarding migrant health with the latest research developments. Lessons learned, particularly surrounding equity and migrant-inclusive health systems, including the wider determinants of health, will be showcased. Evidence from different countries and disciplines will be synthesised to inform policy. There will be a range of articles co-authored by some of the best experts in the region.
To read more about the Lancet Migration European Regional Hub, visit migrationhealth.org/regional-hubs/europe.
Contributors
BK and KB conceptualised the piece. RJ and KB drafted the initial comment. KB, BK, and RJ provided revisions.
Declaration of interests
There are no conflicts of interests to declare.
Acknowledgements
The two-day workshop was supported by the Geneva Centre of Humanitarian Studies. The meeting was hosted by the non-profit Fondation Brocher in Hermance. We thank the workshop participants: Benedetta Armocida, Abdelkrim Boukachabia, Elżbieta Czapka, Esperanza Diaz, Sophie Durieux-Paillard, Seyed-Moeen Hosseinalipour, Yves-Laurent Jackson, Pooja Jha, Aoife Kirk, Michael Knipper, Reem Mussa, Eszter Szocs, and Apostolos Veizis.
References
- 1.Kumar B.N., Hargreaves S., Agyemang C., James R.A., Blanchet K., Gruer L. Reducing the impact of the coronavirus on disadvantaged migrants and ethnic minorities. Eur J Publ Health. 2021 Nov;31(Supplement_4):iv9–iv13. doi: 10.1093/eurpub/ckab151. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Kumar B.N., James R., Hargreaves S., et al. Meeting the health needs of displaced people fleeing Ukraine: drawing on existing technical guidance and evidence. Lancet Reg Health Eur. 2022;17 doi: 10.1016/j.lanepe.2022.100403. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.James R., Blanchet K., Orcutt M., Kumar B. Migration health research in the European region: sustainable synergies to bridge the research, policy and practice gap. Lancet Reg Health Eur. 2021;5 doi: 10.1016/j.lanepe.2021.100124. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Mosca DT, Vearey J, Orcutt M, Zwi AB. Universal Health Coverage: ensuring migrants and migration are included. Global Social Policy.
- 5.World Health Organization. Regional Office for Europe . World Health Organization. Regional Office for Europe; 2017. . Migration and health: fact sheet on Sustainable Development Goals (SDGs): health targets. [Google Scholar]
- 6.World Health Organization . World Health Organization; 2019. The WHO special initiative for mental health (2019-2023): universal health coverage for mental health. [Google Scholar]
- 7.Crawshaw A.F., Farah Y., Deal A., et al. Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review. Lancet Infect Dis. 2022;22(9):E254–E266. doi: 10.1016/S1473-3099(22)00066-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Blanchet K. Time to reconcile migration and health in Europe. Lancet Reg Health Eur. 2022;21 doi: 10.1016/j.lanepe.2022.100500. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.The Lancet Global Health Refugees and migrants: overexposed yet unseen. Lancet Global Health. 2022;10(9) doi: 10.1016/S2214-109X(22)00329-1. [DOI] [PubMed] [Google Scholar]
- 10.Trummer U. The European Union needs a policy and strategy to secure access to healthcare for undocumented migrants. BMJ. 2022;376 [Google Scholar]
- 11.Abubakar I., Aldridge R.W., Devakumar D., et al. The UCL–Lancet Commission on Migration and Health: the health of a world on the move. Lancet. 2018;392(10164):2606–2654. doi: 10.1016/S0140-6736(18)32114-7. [DOI] [PMC free article] [PubMed] [Google Scholar]