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Migration and health in Latin America during the COVID-19 pandemic and beyond

2021; Elsevier BV; Volume: 397; Issue: 10281 Linguagem: Inglês

10.1016/s0140-6736(21)00629-2

1474-547X

Ietza Bojórquez, Báltica Cabieses, Carlos Arósquipa, Juan Arroyo Laguna, Andrés Felipe Cubillos Novella, Michael Knipper, Miriam Orcutt, Ana Cristina Sedas, Karol Rojas,

Global Health Workforce Issues

COVID-19 has created a syndemic scenario that is deepening pre-existing structural inequalities for migrants in Latin American countries (LACs).1Horton R Offline: COVID-19 is not a pandemic.Lancet. 2020; 396: 874Summary Full Text Full Text PDF PubMed Scopus (642) Google Scholar, 2The LancetCOVID-19 in Latin America: a humanitarian crisis.Lancet. 2020; 3961463Summary Full Text Full Text PDF PubMed Scopus (89) Google Scholar LACs have been severely affected by COVID-19, and migrants are among the populations most impacted by the heightened humanitarian crisis across the region. Socioeconomic inequalities between migrants and local people have widened, and there are fears that progress towards the Sustainable Development Goals (SDGs) will be reversed. During the COVID-19 pandemic, food insecurity, unemployment, and reduced socioeconomic agency have led to considerable insecurity and anxiety for migrants living in LACs.3Cabieses B Obach A Urrutia C et al.Encuesta sobre COVID-19 a Poblaciones Migrantes Internacionales en Chile. Informe de Resultados Completo. Universidad del Desarrollo, Servicio Jesuita a Migrantes, Comisión de Migración y Salud, Colegio Médico de Chile, Núcleo Milenio de Resistencia Antimicrobiana MICROB-R, Red de Investigación Interdisciplinaria en enfermedades infecciosas.https://www.migracionenchile.cl/wp-content/uploads/2020/07/Reporte-FINAL-ENCUESTA-MIGRANTES-Y-COVID19-18julio2020.pdfDate: July, 2020Date accessed: March 5, 2021Google Scholar, 4Espinel Z Chaskel R Berg RC et al.Venezuelan migrants in Colombia: COVID-19 and mental health.Lancet Psychiatry. 2020; 7: 653-655Summary Full Text Full Text PDF PubMed Scopus (22) Google Scholar The region faces one of the largest mass migrations worldwide; more than 5·5 million refugees and migrants have left Venezuela, 4·6 million of whom now live in the Latin American region.5R4V Inter-Agency Coordination Platform for Refugees and Migrants from VenezuelaRMRP 2021 regional refugee and migrant response plan for refugees and migrants from Venezuela (January–December 2021).https://r4v.info/es/documents/details/82927Date: Dec 10, 2020Date accessed: March 5, 2021Google Scholar, 6R4V Inter-Agency Coordination Platform for Refugees and Migrants from VenezuelaRMRP 2020 dashboard.https://r4v.info/es/situations/platformDate accessed: March 15, 2021Google Scholar In central America, a combination of criminal and political violence, poverty, and the increasing impact of droughts on farmers forced thousands to move northwards, where many people have become trapped due to restrictive migration policies.7Kauffer E The Mexico–Guatemala border during covid-19: from open border to new assemblage?.Borders Globaliz Rev. 2020; 2: 66Crossref Google Scholar For decades, migration fuelled the economic and cultural development in the region. Today, migration has increasingly become an issue of risk and precarity. Together with the social and structural disparities that make Latin America a region with one of the highest levels of inequalities in the world,8Dávila-Cervantes CA Agudelo-Botero M Health inequalities in Latin America: persistent gaps in life expectancy.Lancet Planet Health. 2019; 3: e492-e493Summary Full Text Full Text PDF PubMed Scopus (13) Google Scholar, 9Economic Commission for Latin America and the CaribbeanSocial panorama of Latin America, 2020. LC/PUB.2021/2-P. United Nations, Santiago2021Google Scholar the worsening environment for migrants during the pandemic means their basic needs are unmet10WHOApartTogether survey: preliminary overview of refugees and migrants self-reported impact of COVID-19. World Health Organization, Geneva2020https://www.who.int/publications/i/item/9789240017924Date accessed: March 5, 2021Google Scholar and their social, economic, and cultural capabilities are not realised. In LACs, migrants face barriers in accessing regular health services due to inadequate information, the absence of culturally appropriate care, or insufficient legal provisions. Additionally, there have been challenges in the prevention of COVID-19 among migrant populations as a result of poor public health communication, reduced access to public health prevention measures, and living or working in conditions where it is difficult to isolate.11Lancet MigrationSituational and policy briefs: COVID-19 and migration.https://www.migrationandhealth.org/migration-covid19-briefsDate: 2020Date accessed: March 5, 2021Google Scholar The deteriorating determinants of migrants' health and wellbeing, revealed and increased by COVID-19, strain health systems in LACs, and governmental, regional, and international organisations' efforts to advance inclusive health policies.12Riggirozzi P Grugel J Cintra N Situational brief: perspective on migrant's right to health in Latin America during COVID-19. Protecting migrants or reversing migration? COVID-19 and the risks of a protracted crisis in Latin America.https://1bec58c3-8dcb-46b0-bb2a-fd4addf0b29a.filesusr.com/ugd/188e74_543cbb0400824084abcea99479dfa124.pdf?index=trueDate: 2020Date accessed: March 5, 2021Google Scholar COVID-19 has reduced human mobility within and across borders. Border closures and changes to migration policy across Latin America interrupted migrants' movement, leaving thousands stranded across the region. Others were forced to return to the same danger, social exclusion, inadequate health care, and poverty they had fled. Migrants who were trapped in transit, or who were living with undocumented or irregular status, became even more vulnerable to family separation, trafficking, or exploitation.13International Organization for MigrationUN MigrationCOVID-19 analytical snapshot #26: stranded migrants.https://www.iom.int/sites/default/files/documents/covid-19_analytical_snapshot_26_-_stranded_migrants_0.pdfDate: 2020Date accessed: March 5, 2021Google Scholar In the pandemic migrants have had reduced access to asylum processes and resettlement schemes have been suspended,14International Organization for MigrationIOM, UNHCR announce temporary suspension of resettlement travel for refugees.https://www.iom.int/news/iom-unhcr-announce-temporary-suspension-resettlement-travel-refugeesDate: 2020Date accessed: March 5, 2021Google Scholar with many asylum seekers and refugees subsequently facing a protection crisis. This diverse region has proven its capacity to cooperate and exchange knowledge and practice in public health,15Pan American Health OrganizationAnnual report of the Director of the Pan American Sanitary Bureau 2020. Saving lives and improving health and well-being. Pan American Health Organization, Washington, DC2020https://iris.paho.org/handle/10665.2/52852Date accessed: March 5, 2021Google Scholar, 16Vasquez EE Perez-Brumer A Parker RG Social inequities and contemporary struggles for collective health in Latin America. Routledge, London and New York2020Crossref Google Scholar and has a strong tradition of social medicine and community health, which is evident in the multiple community-based initiatives that have emerged to combat COVID-19.17Melo Maciel FB Pereira Campos dos Santos HL Araújo da Silva Carneiro R et al.Community health workers: reflections on the health work process in Covid-19 pandemic times.Cien Saude Colet. 2020; 25: 4185-4195PubMed Google Scholar, 18Terán-Puente C Aráuz V Terán G et al.Manual operativo del sistema comunitario de vigilancia epidemiológica Covid-19. Sociedad Ecuatoriana de Salud Pública, GAD Sucre, Universidad Estatal de Milagro UNEMI, Quito, Ecuador2021Google Scholar However, the detrimental impacts of COVID-19 on migrants and failure of inclusive health policies and systems have revealed the vulnerability of migrants to the consequences of politics designed without considering migration and human mobility in government agendas. These failures underline the importance of compliance with international standards, such as the Global Compact for Safe, Orderly and Regular Migration19WHOProposed Health Component in the Global Compact for Safe, Orderly and Regular Migration. World Health Organization, Geneva2020https://www.who.int/migrants/about/gcm-health-component/en/Date accessed: March 5, 2021Google Scholar and the WHO global action plan to promote the health of refugees and migrants.20WHOPromoting the health of refugees and migrants: draft global action plan, 2019–2023. Report by the Director-General. World Health Organization, Geneva2019https://www.who.int/publications/i/item/promoting-the-health-of-refugees-and-migrants-draft-global-action-plan-2019-2023Date: May 23, 2019Date accessed: March 5, 2021Google Scholar Explicit commitment from governments to include migrants in all phases of the evolving public health response to COVID-19 is needed. This response must include ensuring access to vaccination and social protection programmes without discrimination and addressing the broader socioeconomic inequalities that affect migrants' health.21Orcutt M Patel P Burns R et al.Global call to action for inclusion of migrants and refugees in the COVID-19 response.Lancet. 2020; 395: 1482-1483Summary Full Text Full Text PDF PubMed Scopus (113) Google Scholar The forthcoming Ibero-American Summit on April 21, 2021, presents an opportunity for heads of states and governments across the region to make explicit commitment to ensure all migrants, refugees, and asylum seekers, irrespective of age, gender, or migration status, have universal and equitable access to health care and pandemic prevention and response. Sustainable and inclusive approaches to migrant health should go beyond humanitarian response and meet the needs of local and mobile populations alike, in line with the SDG agenda. Yet the regions, countries, and municipalities most affected by COVID-19 also need solidarity and global support in responding to the current global public health crisis and future global health challenges. This online publication has been corrected. The corrected version first appeared at thelancet.com on April 15, 2021 This online publication has been corrected. The corrected version first appeared at thelancet.com on April 15, 2021 IB, BC, CA, JA, AC-N, and KR are Lancet Migration Latin American Regional Hub board members; MO is Executive Director of Lancet Migration; BC and MK are co-Leads of Lancet Migration Regional Hub, Latin America; ACS is Lancet Migration Regional Research Fellow, Latin America. We declare no other competing interests. Department of ErrorBojorquez I, Cabieses B, Arósquipa C, et al. Migration and health in Latin America during the COVID-19 pandemic and beyond. Lancet 2021; 397: 1243–45—In this Comment, the date of the Ibero-American Summit has been corrected to April 21, 2021. This correction has been made to the online version as of April 15, 2021. Full-Text PDF