WHO global action plan on promoting the health of refugees and migrants, 2019–2023*

Many refugees and migrants lack access to health care services, including mental health services, disease prevention, treatment and care, as well as financial protection. 

Nationality should never be a basis for determining access to health care; legal status often determines the level of access within national insurance schemes and health systems, without revoking the principle of universal health coverage as set in international agreements. Refugees and migrants may, in some circumstances, fear detection, detention or deportation and may be subject to trafficking or slavery. Unaccompanied children are particularly vulnerable and need specific provisions. 

Barriers to accessing health care services differ from country to country. They may include language and cultural differences, high costs, discrimination, administrative hurdles, adverse living conditions, and lack of information about health entitlements. All these conditions make seeking care difficult. Additionally, these experiences can precipitate negative mental health outcomes. 

Refugees and migrants may come from areas where communicable diseases are endemic. This does not, however, necessarily imply that they are an infectious risk to host and transit populations. On the other hand, they may be the ones to be at risk of contracting communicable diseases, including foodborne and waterborne diseases, as a result of the perils of travelling and factors in the host country associated with poor living and working conditions, together with lack of access to essential health care services. Access to vaccination and continuity of care is more difficult for people on the move. Poor access to medicines and poor management of treatment may facilitate the development of antimicrobial resistance. Specific vulnerabilities to HIV infection and tuberculosis require specific integrated health care services for refugees and migrants. In addition, if they have existing chronic conditions and hereditary diseases, they may experience interruption in their care, and may lack the medicines they need or health records documenting their treatment when they move to a different country.

The goal of this proposed global action plan is to assert health as an essential component of refugee assistance and good migration governance. The aim of the plan is to improve global health by addressing the health and well-being of refugees and migrants in an inclusive, comprehensive manner.