Стратегия и план действий в отношении здоровья беженцев и мигрантов в Европейском регионе ВОЗ
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Д-р Piroska Ostlin, директор Д-р Santino Severoni, координатор, Отдел политики и стратегического руководства в интересах здоровья и благополучия
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Стратегия и план действий в отношении здоровья беженцев и мигрантов в Европейском регионе ВОЗ
- 1. Стратегия и план действий в отношении здоровья беженцев и мигрантов в Европейском регионе ВОЗ Д-р Piroska Ostlin, директор Д-р Santino Severoni, координатор Отдел политики и стратегического руководства в интересах здоровья и благополучия
- 2. Наращивание мер по охране здоровья в условиях миграции в Европейском регионе ВОЗ • 2013 г.: Проект "Связанные с миграцией аспекты общественного здравоохранения в Европе" (PHAME), финансирование для которого выделило Министерство здравоохранения Италии, направлен на оказание технической помощи и консультирование по стратегическим вопросам для стран, принимающих беженцев и мигрантов. • 2015 г.: Объединенная целевая группа ЕРБ ВОЗ по вопросам миграции и здоровья, призванная активизировать работу в условиях миграционного кризиса в Европе. • сентябрь 2015 г.: Министерский рабочий обед, посвященный вопросам миграции и здоровья, на РК-65. • ноябрь 2015 г.: Совещание высокого уровня по вопросам здоровья беженцев и мигрантов, на котором был принят документ "Активизация мер по защите здоровья беженцев и мигрантов". • ноябрь 2015 г.: ПКРК активно участвовал в подготовке стратегии и плана действий с проектом соответствующей резолюции, которые будут представлены на РК-66. 2
- 4. Структура рабочего документа для РК 1 Стратегия в отношении здоровья беженцев и мигрантов в Европейском регионе ВОЗ 2 План действий в отношении здоровья беженцев и мигрантов в Европейском регионе ВОЗ 3 Приложение I: определения 4 Приложение II: индикаторы С учетом положений резолюции WHA61.17 о здоровье мигрантов Будут приведены в соответствии с новой глобальной стратегией. Первое совещание по подготовке глобальной стратегии будет организовано ЕРБ ВОЗ в декабрь. 4
- 5. Введение Положение дел в сфере миграции и здоровья в Европейском регионе Немедленные действия: необходимость и возможности Сфера действия Руководящие принципы 1) Стратегия в отношении здоровья беженцев и мигрантов в Европейском регионе ВОЗ Правовая база, программные документы и опыт стран, который учитывался при подготовке обоснования для документа Обзор динамичной миграционной ситуации в Регионе и ее последствий для здоровья Профилактика болезней и преждевременных смертей, снижение уязвимости перед рисками для здоровья, повышение доступности услуг здравоохранения в контексте масштабных международных перемещений беженцев, лиц, ищущих убежища, и мигрантов Здоровье-2020, ЦУР, права человека, учет гендерной специфики и принципов равноправия, многосекторальность, общегосударственный и общесоциальный подходы, учет интересов здоровья во всех стратегиях, солидарность и гуманность, всеобщий охват услугами здравоохранения Динамика для общих действий в отношении кратко- и долгосрочных последствий миграции для здоровья 5
- 6. 2) План действий в отношении здоровья беженцев и мигрантов в Европейском регионе ВОЗ • Для каждой из 9 стратегических приоритетных областей представлены − описание ситуации − задачи − действия со стороны государств-членов − действия со стороны Регионального бюро 6
- 7. Без охраны здоровья беженцев и мигрантов не может быть полноценного общественного здравоохранения
Editor's Notes
- Ladies and gentlemen, it is my pleasure to briefly present to you the final outcome of the process of development of the first WHO Strategy and action plan for refugee and migrant health in the WHO European Region, and its accompanying resolution.
- Topic of migration and health has quickly gone up in the European agenda over the past years. As a result, the Regional Office has scaled up its work in order to respond to the increasing requests from Member States. In particular and thank to the financial support from the Ministry of Health of Italy, 2013 marked a key year for the work in this area with the start of the project ‘Public Health Aspects of Migration in Europe’. WHO/Europe was able to quickly respond since the start of the European refugee and migrant crisis in 2015, standing side by side with those countries in needed. Such need for action in the area of migration and health was widely discussed at the Regional Committee last year, and at the following High-level Meeting on Refugee and Migrant Health organized with the Ministry of Heatlh of Italy in November. The outcome document Stepping up action on refugee and migrant health adopted in Rome represented the basis for the development of the strategy, action plan and resolution that we are discussing today. Following the Rome high-level meeting, SCRC supported the development of the documents that are the main focus of our discussion today.
- During the past months, EURO has organized a detailed and inclusive process of consultation in order to discuss the draft documents with the variety of stakeholders involved in this area, which you may see in detail on the screen. This consultation process involved the different technical units at the European Office, WHO Regions and Headquarters, Member States, UN Agencies and other international organizations working in the area of migration and health. The process was overseen by the newly created SCRC subgroup on migration and health, chaired by Italy.
- The working document contains both a strategy and an action plan, the two parts being highly interlinked but clearly separated. In addition, two annexes have been included as per request of Member States: one on key definitions relevant to the document; and the second one on 5 identified indicators to measure progress on the implementation of the action plan. Such measurement will be done through a simple questionnaire, which will be circulated every two years. The strategy, action plan and resolution are all informed by the 2008 WHA61.17 resolution on the health of migrants, and they will be aligned to the new global strategy on migration and health when this will be developed. In this regard, I am happy to inform you that EURO will be hosting the first meeting with HQ and all WHO Regions for the preparation of this global strategy.
- Quick overview of the content of the strategy part: Introduction: acknowledges the legal and policy framework that have served as a basis for the development of this document – such as the European policy Health 2020, the 2030 Agenda for Sustainable Development and the 2008 WHA resolution on the health of migrants –, the Outcome document of the Rome High-level Meeting as well as the past related policy dialogues including the 2010 WHO-IOM Global Consultation in Madrid. Status of migration and health in Europe: provides a short summary of the available evidence in this area. It acknowledges the heterogeneous nature of the different categories of migrants, and states the two different types of phenomena in which the document focuses: structural long-term migration patterns owing to global inequalities, and large-scale arrivals consequence of war, conflict and natural disasters. The third section recognizes the current momentum, which represents both a need but also an opportunity to act on the short- and the long-term public health implications related to migration. Scope of the document: prevent disease and premature death, responding to the health needs associated with the migration process in transit and host environments, and addressing vulnerability to health risks, while acknowledging countries’ specific circumstances and legal frameworks. Overall guiding principles that inform the actions recommended in the document, including: a human rights-based approach, gender-responsive and equity-driven focus, as well as the whole-of-society, whole-of-government and health-in-all-policies approaches enshrined in Health 2020, and which are a must to act in a multisectoral environment such as migration health.
- Each of the 9 priority areas that make up the action plan contain a background, objective and identified actions by Member States and the Regional Office. The 9 of them are represented in the icons on the screen. Area 1 (establishing a framework for collaborative action) aims at strengthening the collaboration within and among UN agencies and bodies, the European Union and Eurasian Economic Union, IOM and other institutions and organizations in the area of migration health. Area 2 (advocating for the right to health of refugees, asylum seekers and migrants) focuses on the need to provide the public with accurate and truthful information, to reduce discrimination and stigmatization, and to offer the conditions to enjoy healthy lives for all. Area 3 addresses the social determinants of health, through the establishment of effective policy dialogues on migration health across all relevant sectors and actors. Area 4 (achieving public health preparedness and ensuring an effective response) aims at including the health needs of these mobile groups and the public health implications of migration in the planning and development of public health capacities and services. Задача заключается в том, чтобы определить базовый потенциал систем здравоохранения для немедленного, а также в более долгосрочной перспективе, обеспечения потребностей беженцев и мигрантов в отношении здоровья, с особым вниманием к уязвимым группам. Задача заключается в том, чтобы создать достаточный потенциал для реагирования на инфекционные болезни и любые другие угрозы здоровью, а также обеспечить эффективную охрану здоровья в странах транзита и назначения. The goal of area 7 is to prevent and reduce the risks posed by noncommunicable diseases by ensuring that the needs of these mobile groups form part of the national strategies in place. Area 8 aims at ensuring ethical and effective health screening and assessment, which should be risk-specific and evidence-based. It is recognized that further comprehensive guidance on this issue is needed, without breaching confidentiality and in coordination with key stakeholders. Finally, area 9 aims at improving health information and communication, by ensuring the adequacy, standarization and comparability of records which should be made available to these groups to facilitate access to health information and essential care.
- In short, this strategy and action plan, as well as its accompanying resolution, have been developed under the overall belief that migration health is a key component of population health; and therefore, public health cannot exist without the health of these mobile populations. Now we have the tools and increasing knowledge to succeed in this endeavour.