Enhancing global health security through the inclusion of migrants and animals in policies and responses
This post is based on the findings and recommendations shared in two technical and policy briefs drafted by Praxis Labs and IOM, recently published by the IOM Migration Health Division (MHD).
Climate change, migration and zoonotic diseases are interconnected, posing some of the most pressing existential challenges of our time. Climate change affects the environmental factors that can promote or inhibit the survival, reproduction, abundance, and spread of diseases, vectors, and hosts, as well as the modes of disease transmission and the frequency of outbreaks.[i]
According to the Intergovernmental Panel on Climate Change (IPCC), human-induced climate change will increasingly affect weather and climate extremes[ii], and droughts and floods have significantly increased over the past decades.[iii] Up to 1.2 billion people could become displaced as a result of climate change globally by 2050[iv], reflected by an unprecedented 89.3 million forced migrants in 2021, of which the majority internally displaced people (IDP) were displaced as a result of disasters.[v] Population movement as a result of climate change and environmental degradation impacts cross-species viral transmission risk[vi], with the resulting changes in land use considered the largest driver of zoonotic infectious disease emergence.[vii]
Zoonotic diseases in turn represent a growing threat to public health, with an estimated 75 percent of newly emerging human pathogens originating in animal species.[viii] Vulnerabilities to zoonoses, not only depend on the prevalence of pathogens, but importantly on social determinants of health, such as poverty, living and working conditions. One group particularly at risk therefore are labour migrants, many of whom are employed in precarious jobs in the livestock production industry, a sector often considered undesirable by local workers. Zoonoses therefore exert significant pressure on the agri-food industry. Numerous reports highlighted the disproportionate burden of COVID-19 to workers in the meat-processing industries across Europe and the United States as a result of sub-standard and unsanitary working and living conditions.[ix]
These challenges are described and addressed in two new briefs published by MHD, which provide key recommendations to policy makers and responders in migration contexts, to enhance protection for humans and animals.
The briefs cover two connected but separate areas: labour migrants in Southeast Asia, and climate related disasters in the Horn of Africa, while the focus of both briefs is the need for adopting systems thinking through a One Health approach. One Health aims to enhance interdisciplinary collaboration between those working in public health, veterinary medicine, environmental protection and other fields. It is defined as 'an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems, recognizing that the health of humans, domestic and wild animals, plants, and the wider environment are closely linked and interdependent'.[x] The One Health framework can provide a more comprehensive approach to zoonotic disease risk among migrants, as it allows for the inclusion of social determinants of health, such as poverty and marginalization, which particularly affect the most vulnerable migrant populations.
Zoonotic disease risks and vulnerabilities are amplified or reduced along the spatiotemporal scale of migration. Population movement is associated with increased mixing of displaced, mobile and host human and animal populations, including through increased contact between domestic animals, wildlife, and humans, which in turn may lead to increased disease transmission between species. When animals and humans move into new environments, they may face new pathogens and vectors prevalent among local populations. Furthermore, crowded and unsanitary living conditions in relief and refugee camps increase vulnerability to infectious disease, which is also linked to malnutrition and long-term stress as a result of movement. Health services and staff may be affected during disaster and displacement, hampering an organized health response, the availability of quarantine and vaccinations, in turn exacerbating the risk of zoonotic disease outbreaks.[xi]
In the case of labour migrants, they often lack access to primary healthcare facilities[xii] and health insurance[xiii], while migrant and mobile population groups are largely excluded from regional and national infectious disease preparedness and response plans.[xiv] As a result, migrants are affected most severely by health threats, as well as gaps in public health responses.
The global response to COVID-19 and continuing re-emergence of zoonoses such as Ebola, highlight the need for improved action and focus on the protection of humans, animals, and the environment in the context of climate change, migration, and health. Projected increases in human and animal mobility and connectivity underline the need to address these threats simultaneously. Increasing evidence is available on the linkages between climate change and migration and climate change and zoonotic disease risks, including as a result of changing pathogen and vector environments, although the nexus of migration, climate change and zoonoses is not comprehensively understood and/ or addressed.
To further improve the health and wellbeing of communities most affected by climate change-related migration, the importance of the presence of domestic animals, and trade-offs between access to animals, human health and livelihoods need to be better understood. The role of domestic animals in climate change related mobility and displacement, the impact on host communities, and the potential benefits of maintaining displaced communities’ access to animals in terms of livelihoods and health, need to be actively researched to better inform policies and programmes.
[i] Wu et al, 2016. Impact of climate change on human infectious diseases: Empirical evidence and human adaptation. Environment International, 86, 14-23.
[ii] IPCC, 2021, Sixth Assessment Report, Climate Change 2021: The Physical Science Basis
[iii] UNCCD and FAO, 2020. Land degradation neutrality for water security and combatting drought, Bonn.
[iv] Institute for Economics and Peace, Over one billion people at threat of being displaced by 2050 due to environmental change, conflict and civil unrest
[v] IDMC, 2022. Global Report on Internal Displacement
[vi] Carlson et al, 2022. Climate change increases cross-species viral transmission risk, Nature
[vii] Bernstein et al, 2022. The costs and benefits of primary prevention of zoonotic pandemics, Science Advances
[viii] Jones et al, 2008. Global trends in emerging infectious diseases. Nature 451:990-94
[ix] Finci et al, 2022. Risk factors associated with an outbreak of COVID-19 in a meat processing plant in southern Germany, April to June 2020, Eurosurveillance 27 (13); Herstein et al, 2021, Characteristics of SARS-CoV-2 Transmission among Meat Processing Workers in Nebraska, USA, and Effectiveness of Risk Mitigation Measures, Emerging Infectious Diseases 27 (4); Pokora et al, 2021, Investigation of superspreading COVID-19 outbreak events in meat and poultry processing plants in Germany: A cross-sectional study, PLOS ONE 16 (6)
[x] WHO, 2021. Tripartite and UNEP support OHHLEP's definition of "One Health"
[xi] Braam et al, 2021. Identifying the research gap of zoonotic disease in displacement: a systematic review, Global Health Research and Policy
[xii] World Bank, 2020. Potential Responses to the COVID-19 Outbreak in Support of Migrant Workers
[xiii] Legido Quigley et al, 2019. Healthcare is not universal if undocumented migrants are excluded, BMJ
[xiv] Wickramage et al, 2018. Missing: Where Are the Migrants in Pandemic Influenza Preparedness Plans? Health and Human Rights 20 (1)
All blog posts are authored by members of the Praxis Labs collective. All opinions expressed are the author's own. All rights remain with the author.