Senior government officials of the 53 Member States in the WHO European Region discussed the public health impact of large-scale migration during the 65th session of the Regional Committee for Europe in Vilnius, Lithuania. They called for continued involvement and support from WHO to respond adequately to the public health implications of large influxes of people by conducting additional assessments in countries and by providing policy advice on contingency planning, training of health personnel and delivery of supplies. It was decided that a high level WHO conference would be organized as soon as possible to agree on a common public health approach to large-scale migration in the Region.
"As refugee and migration movements escalate and the migratory routes change, more European countries face this challenge," said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. "Today more than ever, this situation calls for a regional, comprehensive and systematic public health response. As refugees and migrants move, intercountry coordination must be strengthened across the European Region, as well as with the countries of origin and transit."
In 2015 alone, over 350 000 refugees and migrants have reached European countries, adding to the almost 2 million who have taken shelter in Turkey. According to the estimates of the Office of the United Nations High Commissioner for Refugees (UNHCR), 850 000 people are expected to seek refugee status in Europe this year and next.
In spite of a common perception, there is no systematic association between migration and the importation of infectious diseases. The risk for importation of exotic and rare infectious agents, such as Ebola, Marburg and Lassa viruses or Middle East respiratory syndrome coronavirus (MERS-CoV), into Europe by refugees or migrants is exceedingly low. For example, the 15 cases of MERS-CoV infection reported in the WHO European Region since 2012 were imported by travellers or tourists, not refugees or migrants. Not a single case of Ebola was imported into Europe by refugees or migrants.
The countries from where most of the refugees and migrants originate often have higher levels of immunization and therefore a lower incidence of vaccine-preventable diseases, such as measles, compared with a number of European countries.
"Our efforts must now focus on public health measures, including immunization for vaccine-preventable diseases when needed, emergency care for injuries, access to care during pregnancy and childbirth, children's access to medical care in case of fever or childhood diseases, medication and care for those who have chronic conditions, as well as psychosocial care," added Dr Zsuzsanna Jakab.
Joint assessment missions have been conducted with ministries of health in Bulgaria, Cyprus, Greece, Italy, Malta, Portugal, Serbia and Spain using the new WHO Toolkit for assessing health-system capacity to manage large influxes of migrants in the acute phase. WHO provides policy advice on contingency planning for the health sector in Italy and Malta.
WHO also ensures that countries have adequate medical supplies when needed, through the procurement of interagency health emergency kits containing essential medicines and equipment, each catering to the medical needs of a population of 10 000 for three months.
In the former Yugoslav Republic of Macedonia, WHO will provide training in September on managing the public health aspects of migration, including standard operating procedures, to health-care workers providing medical care for people arriving at entry points into the country.
Hosting close to 2 million refugees, Turkey has welcomed the largest influx of refugees in the world, according to UNHCR. WHO established a field presence in Gaziantep in October 2013 to scale up its capacity and to respond to the public health needs of refugees. In close collaboration with the Ministry of Health of Turkey and its partners, WHO continues to assess the needs of Syrian refugees, providing support through the capacity-building of Syrian medical staff, technical and financial assistance for outbreak response and immunization campaigns, the supply of medical equipment and drugs, and the dissemination of information material to refugees.
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