Health is for all: addressing migrants and refugees during COVID-19 pandemic is mandatory

The COVID-19 pandemic is spreading worldwide and it is mandatory to include in the global response to the virus also migrants, refugees, asylum seekers, and internally displaced people. This people are among the most vulnerable to the disease: they have a higher risk of discrimination and stigmatization during the epidemics. In addition they might have higher health-related risks and lower access to health services, due to barriers such as language difficulties and legal, administrative and financial troubles. Finally, many refugee camps are overcrowded and lack basic services such as food and clean water access. Caring for this people is not only mandatory as health is a universal human right, but also it will also ensure safety to all citizens by controlling the spread of the disease.

In the WHO European Region, international migrants represent approximately 10% of the population; among these 7% are refugees. WHO has recently released an interim guidance for refugee and migrant health in relation to COVID-19 in the WHO European Region, that will be updated as the epidemiological situation evolves. The main endorsement to the Member States is to ensure that health related messages reach everyone in the community, so strategic communication should be develop to reach all refugee and migrants that may have difficulties in receiving and understanding the information. Secondly it is important to assure that these people do not become scapegoats and be discriminated even more during the pandemic. It is responsibility of the Member States to ensure that all people have the same access to prevention, diagnostic and infection control measures, should include refugees and migrants in national strategies and plans during outbreaks. 

Language and means of communications should be widely disseminated and understandable for all. For this reason WHO advise to translate all the information in several languages, and involve in the communication strategy also ethnic/religious media, since for some community they are the most trustable source of information. It could also be important to use different kinds of communication tools: flyers and direct contacts can be useful, but also social media key messages. For this reason it could be important that government ensure that displaced people have no restriction to internet connection.
 
One of the main important point in the WHO recommendations is the importance to ensure that migrants and refugees do not avoid to seek health care fearing registration. Irregular immigrants should not be forgotten, as they face risk for themselves and could contribute to the spread of the virus. An example all Countries should follow is the strategy adopted by the Portuguese government, who decided to legalize all migrants with visa and pending asylum request. The measure is temporary, as it will last until the 1st of July, although the term could be extended if necessary. Regularization guarantee the rights of vulnerable people in this uncertain times.
 
If we want an effective response to the COVID-19 pandemic the strategy must be inclusive, and must reach all vulnerable people.
 
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