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Closed borders:
migration, travel regulations
and access to treatment
Health, medicine and migrant
populations
Where do we come from, where
are we headed?
Patterns, models and strategies in the area of
migration, health, foreign policy, trade and economy.
David Haerry, EATG
• Travelling: for physical or economical
survival?
• 13 countries bar HIV+ from entering:
reasons linked to public health and
healthcare budget concerns.
• Disastrous individual consequences.
• Wave of new movement restrictions
since 1998.
• International mobility central to
globalisation of infectious and chronic
diseases.
• Ancient fear of imported diseases and
local consequences.
Border health practices, transborder flow of people and goods
• Goal International Health Regulations:
maximise health protection while
minimising interference with
international trade.
• Disease control: a foreign policy
challenge.
Shifting migration concepts
• Traditionally: unidirectional process.
• New pattern: tourists, business people
and other groups as migrant nonimmigrants move internationally for
varying periods of time.
• Refugees: 8.4 millions
• Migrants: 191 millions
undocumented: 30-40 millions
• International tourist arrivals:
806 millions
Medical migration: complex pattern
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Britain to France: wait lists
U. S. to Canada: drug prices
Norway to Spain: sunshine
To India, Mexico: cheap drugs,
generics
• To Switzerland: assisted suicide
• From Portugal & Ireland: abortion
States & medical migration
• Encouraging,
• Tolerating “laisser faire”, or
• Removing people out of territory.
Border control & diagnostic tools
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Stethoscope
X-ray
HIV-testing
Improved predictability
Genetic testing tomorrow?
• Migration must promote
increased dialogue and policy at
international level.
• “Human rights are the closest thing
we have to a shared values system for
the world. We should take every
opportunity to see them not simply as
shared goals, but as legal obligations
and policy-making tools that can
assist those charged with making
complex decisions – whether in the
areas of foreign policy, trade, security
or public health.”
Mary Robinson
Literature
• WHO Bulletin
March & May 2007