Forced Migration and Global Responsibility for Health; Comment on “Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis”

Document Type : Commentary


1 Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany

2 Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany


Forced migration has become a world-wide phenomenon in the past century, affecting increasing numbers of countries and people. It entails important challenges from a global health perspective. Leppold et al have critically discussed the Japanese interpretation of global responsibility for health in the context of forced migration. This commentary complements their analysis by outlining three priority areas of global health responsibility for European Union (EU) countries. We highlight important stages of the migration phases related to forced migration and propose three arguments. First, the chronic neglect of the large number of internally displaced persons (IDPs) in the discourses on the “refugee crisis” needs to be corrected in order to develop sustainable solutions with a framework of the Sustainable Development Goals (SDGs). Second, protection gaps in the global system of protection need to be effectively closed to resolve conflicts with border management and normative global health frameworks. Third, effective policies need to be developed and implemented to meet the health and humanitarian needs of forced migrants; at the same time, the solidarity crisis within the EU needs to be overcome. These stakes are high. EU countries, being committed to global health, should urgently address these areas.


Main Subjects


    1. Perruchoud R, Redpath-Cross J, eds. Glossary on Migration. Geneva: International Organization of Migration; 2011. International Migration Law Series No. 25.
    2. United Nations High Commissioner for Refugees (UNHCR). Global Trends: Forced Displacement in 2015. Geneva, UNHCR; 2016.
    3. Leppold C, Ozaki A, Shimada Y, Morita T, Tanimoto T. Defining and acting on global health: the case of Japan and the refugee crisis. Int J Health Policy Manag. 2016;5(8):457-60. doi:10.15171/ijhpm.2016.68
    4. The Lancet. Refugee and migrant crisis: the deficient global response. Lancet 2016;388(13345):633. doi:10.1016/S0140-6736(16)31342-3
    5. Razum O, Bozorgmehr K. Disgrace at EU's external borders. Int J Public Health. 2015;60:515-516. doi:10.1007/s00038-015-0689-4
    6. International Organization for Migration (IOM). Summary Report on the MIPEX Health Strand & Country Reports. Brussels: IOM, Regional Office Brussels, Migration Health Division (MHD); 2016.
    7. Bozorgmehr K, Bruchhausen W, Hein W, et al. The global health concept of the German government: strengths, weaknesses, and opportunities. Glob Health Action. 2014;7:23445. doi:10.3402/gha.v7.23445
    8. Bozorgmehr K. Rethinking the 'global' in global health: a dialectic approach. Global Health. 2010;6:19. doi:10.1186/1744-8603-6-19
    9. IOM Counts Latest Mediterranean Arrivals in 2016. IOM website. Accessed October 31, 2016.
    10. Bilak A, Caterina M, Charron G, et al. Global Overview 2015: People Internally Displaced by Conflict and Violence. Geneva: Internal Displacement Monitoring Centre, Norwegian Refugee Council; 2015.
    11. Heudtlass P, Speybroeck N, Guha-Sapir D. Excess mortality in refugees, internally displaced persons and resident populations in complex humanitarian emergencies (1998-2012): insights from operational data. Confl Health. 2016;10:15. doi:10.1186/s13031-016-0082-9
    12. Toole MJ, Waldman RJ. The public health aspects of complex emergencies and refugee situations. Annu Rev Public Health. 1997;18:283-312.
    13. IASC. IASC framework on durable solutions for internally displaced persons. Washington, DC: The Brookings Institution - University of Bern; 2016.
    14. Hollings J, Samuilova M, Petrova-Benedict R. Health, migration and border management: analysis and capacity-building at Europe’s borders. Int J Public Health 2012;57:363-369. doi:10.1007/s00038-011-0319-8
    15. Carrera S. The EU border management strategy. FRONTEX and the Challenges of Irregular Immigration in the Canary Islands Working document; 2007.
    16. Léonard S. EU border security and migration into the European Union: FRONTEX and securitisation through practices. European Security. 2010;19(2):231-254. doi:10.1080/09662839.2010.526937
    17. Bialasiewicz L. Off-shoring and Out-sourcing the Borders of Europe: Libya and EU Border Work in the Mediterranean. Geopolitics. 2012;17(4):843-866. doi:10.1080/14650045.2012.660579
    18. 18.   Smith J, Daynes L. Borders and migration: an issue of global health importance. Lancet Glob Health. 2016;4(2):e85-e86. doi:10.1016/s2214-109x(15)00243-0
    19. Fazel M, Karunakara U, Newnham EA. Detention, denial, and death: migration hazards for refugee children. Lancet Glob Health. 2016;2:e313-e314. doi:10.1016/s2214-109x(14)70225-6
    20. Ottersen OP, Dasgupta J, Blouin C, et al. The political origins of health inequity: prospects for change. Lancet 2014;383(9917):630-667. doi:10.1016/s0140-6736(13)62407-1
    21. Zetter R. Protection in Crisis: Forced Migration and Protection in a Global Era. Washingtin, DC: Migration Policy Institute; 2015.
    22. Weinzierl R, Lisson U. Border Management and Human Rights: A study of EU Law and the Law of the Sea. Zimmerstr: German Institute for Human Rights 2007.
    23. Razum O, Kaasch A, Bozorgmehr K. From the primacy of safe passage for refugees to a global social policy. Int J Public Health. 2016;61(5):523-524. doi:10.1007/s00038-016-0817-9
    24. Bozorgmehr K, Razum O. EU's external borders: what is the role for global health law? Lancet. 2015;385(9983):2147. doi:10.1016/s0140-6736(15)61015-7
    25. Roberts B, Murphy A, McKee M. Europe’s collective failure to address the refugee crisis. Public Health Rev. 2016;37:1. doi:10.1186/s40985-016-0015-6
    26. Bozorgmehr K, Szecsenyi J, Stock C, Razum O. Europe's response to the refugee crisis: why relocation quotas will fail to achieve 'fairness' from a health perspective. Eur J Pub Health. 2016;26:5-6. doi:10.1093/eurpub/ckv246
    27. Reimann A. Flüchtlinge in der EU: 160.000 angekündigt - 4741 umgesiedelt. Spiegel Online. 2016.
    28. Trilling D. What to do with the people who do make it across? At Europe's Borders. London Review of Books. 2015;37:9-12.
    29. Cometto G, Ooms G, Starrs A, Zeitz P. A global fund for the health MDGs? The Lancet 2009;373(9674):1500-1502. doi:10.1016/s0140-6736(09)60835-7
    30. Basu S, Stuckler D, McKee M. An alternative mechanism for international health aid: evaluating a Global Social Protection Fund. Health Policy Plann. 2014;29(1):127-136. doi:10.1093/heapol/czs141
    31. Gostin LO, Monahan JT, DeBartolo MC, Horton R. Law's power to safeguard global health: a Lancet--O'Neill Institute, Georgetown University Commission on Global Health and the Law. Lancet. 2015;385(9978):1603-1604. doi:10.1016/s0140-6736(15)60756-5
  • Receive Date: 16 September 2016
  • Revise Date: 31 October 2016
  • Accept Date: 01 November 2016
  • First Publish Date: 01 July 2017