19/06/2019 European Centre for Disease Prevention and Control (ECDC) - PDF document

19/06/2019 European Centre for Disease Prevention and Control (ECDC) ECDC’s mission and vision: “ECDC's mission is to identify , assess and communicate current and emerging threats to human health posed by infectious diseases .” Migration health round ‐ table: Lessons learned and moving forward • An agency of the European Union located in Stockholm, Sweden Teymur Noori, European Centre for Disease Prevention and Control (ECDC) • 39% Established in 2005; 280 employees & 27 EU nationalities male CISTM16 61% • Work with and through National Public Health Authorities in the 31 EU/EEA countries female Washington, 7 June, 2019 1 2 Putting migrant health and infectious diseases in context 512 million people living in the EU ‐ 28 in 2017 (1 st January)* Migrants are disproportionally affected by some infectious diseases:  > 40% of all HIV diagnoses in the EU in any given year  > 30% of all TB diagnoses in the EU in any given year  > 25% of hepatitis B and C diagnoses in the EU in any given year 57 million foreign ‐ born  Some sub ‐ groups of migrants have significantly lower (11.2%)* vaccination rates compared to the general population 36 million born outside the  Some sub ‐ groups of migrants & asylum seekers are over EU ‐ 28 (7.2%)* represented when it comes to multidrug ‐ resistance bacteria Infectious compared to the general population Health diseases issues * Eurostat: https://ec.europa.eu/eurostat/statistics ‐ explained/pdfscache/1275.pdf 3 4 Risk assessments Scientific advice/guidance 2015 ECDC threat assessment:  Newly arrived migrants and refugees do not represent a threat to Europe with respect to communicable diseases  The risk to refugees has increased due to overcrowding at reception facilities, resulting in poor hygiene and sanitation arrangements https://ecdc.europa.eu/en/threats ‐ and ‐ outbreaks/reports ‐ and ‐ data/risk ‐ assessments 5 6 1

19/06/2019 WHO Global Action Plan 2019 ‐ 2023: Priorities ECDC assessing its surveillance system to improve its understanding of migrant health Objective : To produce a comprehensive overview of the key infectious diseases affecting migrant populations in the EU/EEA TB RUBELLA HIV GONORRHOEA HEPATITIS B SYPHILIS  Priority 4 . Enhance the capacity to tackle the social determinants  Priority 1. Reduce mortality and morbidity among refugees of health and accelerate progress towards achieving the and migrants through short ‐ and long ‐ term health Sustainable Development Goals, including Universal Health HEPATITIS C MALARIA interventions Coverage  Priority 2. Promote continuity and quality of care , while  Priority 5. Support measures to improve communication and developing, reinforcing and implementing occupational MEASLES CHAGAS DISEASE counter xenophobia health and safety mea sures Priority 6 . Strengthen health monitoring and health information  Priority 3 . Advocate mainstreaming refugee and migrant ‐  systems sensitive health policies , legal and social protection , and gender equality Source: ECDC. Assessing the burden of key infectious diseases affecting migrant populations in the EU/EEA. Stockholm; 2014. 7 8 Migrant related variables collected through The European Migrant related variables collected through The European Surveillance System (TESSy) Surveillance System (TESSy) Chagas Chagas Variable HIV TB HBV HCV Gonorrhoea Syphilis Measles Rubella Malaria Variable HIV TB HBV HCV Gonorrhoea Syphilis Measles Rubella Malaria disease* disease* Country of Country of birth birth Country of Country of nationality nationality Probable Probable country of country of infection infection Imported Imported Region of Region of ECDC. Assessing the burden of key infectious diseases affecting migrant populations in the EU/EEA. Stockholm: ECDC; 2014. ECDC. Assessing the burden of key infectious diseases affecting migrant populations in the EU/EEA. Stockholm: ECDC; 2014. origin origin * Not under EU surveillance * Not under EU surveillance Source: ECDC. Assessing the burden of key infectious diseases affecting migrant populations in the EU/EEA. Stockholm; 2014. Source: ECDC. Assessing the burden of key infectious diseases affecting migrant populations in the EU/EEA. Stockholm; 2014. 9 10 Completeness (%) of migrant related variables collected Recommendation to the WHO and all UN agencies: Standardise through TESSy (2011 ‐ 2013) migrant health variables across existing monitoring systems  WHO, as well as multiple other UN agencies, have a whole set of Conclusions: Chagas Variable HIV TB HBV HCV Gonorrhoea Syphilis Measles Rubella Malaria disease* monitoring systems in place covering a wide range of communicable  Gaps in national data surveillance systems make it difficult to draw overall and non ‐ communicable diseases Country of conclusions on the health of migrants 62 95.6 19.1 14.4 17 26 birth   A mapping exercise needs to be undertaken to assess which migrant In ECDC’s surveillance system, which includes more than 50 infectious Country of 28 96.3 6.8 6.6 4 17 nationality diseases, it was concluded that meaningful analysis of migrant health data specific variables (if any) are currently collected in these monitoring Probable was only possible for HIV and TB systems country of 17 20.2 7.6 9 10 3 5 90.1 infection  The biggest contribution to improving our understanding of migrant health  Standardise all data collection systems by including the ‘country of birth’ Imported would be to work with European Member States to discuss how we can 39.1 40.5 82 96 98.7 variable better support them in collecting the ‘country of birth’ variable across Region of disease networks 62.5 origin * Not under EU surveillance Source: ECDC. Assessing the burden of key infectious diseases affecting migrant populations in the EU/EEA. Stockholm; 2014. 11 12 2

19/06/2019 Proposed ISTM activities in support of the WHO Proposed ISTM activities in support of the WHO Global Action Plan Global Action Plan Continue keeping the topic of migrant/refugee health high on the ISTM Priority 1 Priority agenda (your leadership is valued) 1 ‐ 6 6 Continue convening biennial migrant specific conferences (i.e. Rome 2018) 3 Priority 2 Continue promoting migrant specific research in the Journal of Travel Medicine 1 ‐ 6 Convene a global advisory group on migrant health (in partnership with key Priority 7 stakeholders) 3 Provide training to ISTM members on migrant and refugee health through Priority 3 webinars, workshops, etc. 1 ‐ 6 Develop international clinical guidance on screening for communicable and non ‐ Priority 8 communicable diseases for travel medicine physicians 1 & 2 Priority 4 Advocate for disaggregated data collection on migrant health 5 Consider developing an online Migrant Health Guide (a valuable tool for Priority 9 Priority 5 Provide clinical standards of care for migrant and refugee populations clinicians working in the area of migrant/refugee health) 1 ‐ 6 1 & 2 13 14 United Kingdom: Migrant Health Guide United Kingdom: Migrant Health Guide https://www.gov.uk/topic/health ‐ protection/migrant ‐ health ‐ guide https://www.gov.uk/topic/health ‐ protection/migrant ‐ health ‐ guide 15 16 Thank You! teymur.noori@ecdc.europa.eu 17 3