Context

The EU Commission, which counts approximately 25 million non-nationals in the EU (just under 5.5% of its total population), estimates that there are 4.5 to 8 million undocumented migrants¹. In addition the EU recorded 222 900 new asylum applications in 2007.

In the EU, the health state of undocumented immigrants and asylum seekers is generally more precarious than that of nationals because of various reasons: psychological and physical traumas resulting from the situation fled in the country of origin, conditions of the migratory route and precarious living conditions due to uncertain administrative and social situation. And, as the WHO stresses, “it is the poorest who generally have the worst health”.

In 2007, the first report of the European Observatory of access to health care of Medecins du Monde revealed the reality faced by undocumented migrants in Europe.

Policies towards undocumented migrants and asylum seekers tend to restrict the access to health care and encourage more police controls which in turn reduce the effective use of health facilities by UDM even when they are entitled to them.

The protection of seriously ill foreigners against deportation to countries where they cannot access to effective health care is not guaranteed and assured by all the EU Member States.

Finally, the situation of undocumented migrants and asylum seekers in administrative detention centres seems to worsen, according to several reports of the European Parliament, the European committee for the Prevention of Torture and many specialised NGOs. As far as access to health care is concerned, national legislation or European legislation do not provide for clear guaranties.

The effective access to health care in detention centres remains unclear. The extension of the length of detention to 18 month as provided in the recently adopted “return directive” might involve even more opacity. The actual conditions of access to health care for foreigners in detention centres do not offer the necessary transparency that would guaranty the respect for dignity.

What is at stake?

For the HUMA network, the question of access to health care of undocumented migrants and asylum seekers is a key issue:

• In ethical terms: Considering values, humanist tradition and commitments of the EU Member States towards European and international law, and taking into account the fact that a lack of access to health care can have very serious (even fatal) consequences, it is an important ethical goal to guarantee the access to the health system for all people living in the EU.
• In terms of public health: In a world where people regularly travel between countries and continents, denying access to prevention and health care to a part of the population living in the EU represents a significant public health risk. The fight against epidemic and infectious diseases cannot be conducted without a particular attention to the fight against inequality in terms of access to health care.
• In economic terms: In order to rationalise and reduce public health costs, Member States generally emphasise prevention and the use of primary health care structure. However, undocumented immigrants and asylum seekers have no or insufficient access to prevention, early screening and primary health care, but they almost always have access to emergency health care. At this level, the diseases’ complications usually require longer and more costly treatments.

The objectives of the HUMA network project

The main objective is to contribute to the improvement of health state of undocumented migrants and asylum seekers by reducing inequalities in access to health care. In order to improve, within 3 years, asylum seekers’ and undocumented migrants’ access to health care in the EU, as well as the protection of seriously ill foreigners against deportation to countries where they cannot access health care, the network encourage the elaboration and implementation of binding norms at EU level.

The strategy of the HUMA network project

The HUMA network project creates a network of NGOs covering 19 Member States of the EU. This network leads campaigns for the recognition and adoption by the EU of:

• a right of identical access for illegal immigrants and asylum seekers as the ones enjoyed by member state nationals;
• a right to protection against deportation for seriously ill foreigners;
• access to medical care in detention centres.

The HUMA network project has 3 main components:

• To increase the commitment, knowledge, analytical and networking capacity and efficiency of European NGOs to advocate for asylum seekers’ and undocumented migrants’ access to health care in the EU

An NGO advocacy network has been established to defend asylum seekers’ and/or undocumented migrants’ access to health care. This network includes all the MdM organisations operating in 10 EU member states as well as counterparts NGOs in 9 EU member states where MdM has no presence. The network members share the same objectives and activities and will seek to establish solid, long-term collaborations;

Besides, the network realizes surveys on the legislations regarding health care and its effective access.

• To mobilise public opinion

During the project period, national and European sensitization and mobilisation campaigns will be conducted.

• To convince national and European public authorities

An advocacy officer based in Brussels will dialogue with the relevant European institutions. The HUMA network members will establish a dialogue with all the national institutions that are directly concerned by health and migration issues, in the EU member states.

¹ Global Commission on International Migration (GCIM), Migration in an Interconnected World : New Directions for Action, Report of the Global Commission on International Migration, October 2005