 everyone around the world to this special event going world in physician week. My name is Jacqueline Nevekas, I'm the Director of Migration Health at the International Organization for Migration, IOM. And I'm here with my colleague, Cécile Rélian, who leads the Migration and Sustainable Development team here at IOM. Hi, Cécile. And Patrick Dujigan, our Health Advisor and Expert for Asia and the Pacific. Again, welcome everybody. There has been a lot of talk about COVID-19 vaccines, how effective they are, how safe they are, all very important questions of course. Another very important question, who has access? Now, we've probably all heard that vaccines are not shared equally among countries. In fact, more than 80% of vaccines have gone to high and upper income countries only. But vaccines are not only shared equally among countries, but also within countries and among people. Now, that is why today we like to talk to you about migrant inclusion in the vaccine campaign. I'd like to make two very short points. First of all, there are many migrants in the world today. The number of international migrants globally is estimated to over 200 million people, including labour migrants, international students, and many others. We can also force displaced people like refugee, there are some million in the world, and internally displaced people, some 20, I'm sorry, 49 million in the world. So we are talking about a very sizable group of people who have moved for a very great variety of reasons. Secondly, COVID-19 has shown us that we are all in this situation. Everybody can get infected. And no one is safe until everyone is safe. We hear this a lot. In other words, to solve this global crisis, we have to make sure that everyone can be protected and get vaccinated. But as we will hear, it's not that simple. Now, Petri, I'm turning to you. From your experience in the region of the pandemic, can you tell us a bit why migrants are at risk of being excluded from the vaccination campaign? What kinds of obstacles they may face in terms of accessing health services in general? Hope to you better. Thanks, Jacqueline. Well, I think it really begins right at the beginning. I mean, there are many circumstances where migrants are simply not counted to be included in countries ordering of vaccines or planning for vaccines. So right from that very beginning, particularly migrants who might be in irregular situations or undocumented situations may be invisible. And so they're simply not being counted and included. And even if they are being counted or included or there is provisions for migrants to have access to vaccines, there are many barriers in place that can pose a challenge. They may not be aware of how to get vaccines because materials aren't being provided in the right languages. They may not be included in education and outreach campaigns. They may not be able to have relevant ID cards or valid ID, which is often in many countries required, and particularly in this region, a lot of countries are requiring identification cards which many migrants may not have or they may not have valid identity documents. So that's a real challenge as well. There's also challenges sometimes in some countries, migrants are being asked to pay for vaccines, whereas national citizens are not being asked to pay. So that really starts making very big differences in terms of the challenges for access to people and the ability to be able to register for vaccines, to be able to go to their appointments, as well as there's a lot of fear amongst many migrant communities, not only fear or concerns about the vaccine itself because they haven't maybe been reached with education, but fear of some of the negative repercussions of accessing health services. Sometimes it's with stigma and discrimination from the service providers, attitudes of the population who might be saying or acting like, you know, why should these other people be getting vaccines when we should be getting them first, but also fear of repercussions from immigration or other services as well. And I think the important point is when it comes to this COVID pandemic, we really need to be reducing all of those barriers to make sure that everyone has access to them because no one is going to be safe in our communities unless everyone is safe, and including one person is excluding, you know, that person from being included. Thank you, Patrick. You made quite some important points because it's actually quite difficult to access healthcare in general, I suppose, as well as COVID-related services. For some migrants, including the vaccine course, you mentioned that migrants may actually be quite invisible because they may not be documented. You don't have papers. You mentioned actually administrative barriers as well as financial barriers. It actually also poses complicated questions around the right of every individual to access, something as basic as health services. So another big question that people may ask themselves now is why would that pose a problem for me? Why do we all need to care and worry about this access issue for migrants? Can you explain a bit more about that? I mean, it goes beyond the fact that migrants have the same right to healthcare as others. It's a human right to have access to healthcare and there is a real moral imperative to make sure they're included. But actually, from a public health point of view, migrants must be included. There cannot be pockets of people in our societies or communities in our societies that are not being included within this because the virus doesn't discriminate based on migration status, based on legal status, based on ethnicity. Everyone is being affected equally. And so, therefore, our response must also not discriminate against people based on any factors and really be looking at those who must be prioritised according to medical criteria and risk criteria first. But that includes migrants and non-migrants as well. And they must be included equally. If there are, as I said, if there are segments of the population not included, this means that all of the efforts that everyone is going forth from having to the lockdowns, from the heroic services that our health providers are doing, all of that will be in vain if we're not making sure that there is full coverage of everyone. And in particular, many migrants are in situations where they may be more vulnerable because of their living and working conditions, because of their socioeconomic conditions and their inability to access healthcare. So actually, it may be causing additional risk not only for people, but also for our communities. So it's not just a moral thing to do and it's not just the public health thing to do. It's the smart thing to do for our communities. And if we're going to end this pandemic, we really need to make sure that everyone is included. Thank you, Patrick. I like that summary that's including migrants. It's not just the right thing to do from a moral perspective. It's also the smart thing to do from a public health point of view. Now, inclusive vaccination campaigning is not just a story about the public health effect. We are all observing that this crisis has impact and have repercussions on many factors of our society well beyond the health factor. Cecilia, can you expand a bit on this? Many thanks, Jacqueline. I think we can really say that migration and migrants in general have a huge role to play in our societies. And really that migrants are part of the solution. And let me say a few words as to why. So when really COVID-19 hits, we realize just how much we need migrants. Migrants are really the frontline workers responding to all the different challenges posed by the pandemic. They are the one looking after the elderly in the relevant centers. They are the shop attendants. They are the farmers. But they are also the engineers, the innovators in our society. And just a very clear case of that is the fact that the vaccine Pfizer BioNTech was actually developed by Turkish migrants residing in Germany. So we can really say that migrants need together the fabric of our communities. And migrants therefore have a critical role to play to fulfill the promises of what we call the sustainable development goals, which is the global agenda that was agreed upon by the international community for achieving a fairer, safer and more inclusive society by 2030. And we have only nine years left in fact to fulfill the promises of the SDGs while at the same time we can say that the pandemic has really set us back to the extent that we are now facing a lost decade of development. So this is the situation upon us. So by including migrants, by vaccinating them, by ensuring that they have access for example to legal routes to migration, that they have access to formal documentation, we allow migrants to fulfill their potential as entrepreneurs, as innovators, as workers, and actually we might have a real chance of getting back on track. Okay, those are very important points. I like what you said about migrants actually can be part of the solution. We need migrants and I also have the impression that the pandemic of course has hit the life of all of us, but it has also maybe disproportionately hit the lives of some migrants, especially vulnerable migrants. Meanwhile, we can say that's vaccinating everyone including migrants, especially those at least forgotten and the invisible that we call them, is a very important condition for all sectors of the economy to actually fully recover if I understand you well. Am I right? Absolutely right. So as long as there is a public health risk, as long as migrants aren't vaccinated and can't access the same public health services or they are afraid to do so for all the reasons that were explained before, we won't be able to fully return to normal. And this is really important because we can't really accept the current state of play with those border restrictions. These can't stay forever. If people can't move, many can't get safe and decent jobs. We can't get our food harvested or transported. We can't share innovation and skills across our borders and we can't save the lives of those who really need protection because they're leaving in unsafe places around the world. This is also important because migrants send a lot of money back home through what we call remittances. And I think previously I was more touching upon the contribution that migrants make to the host societies and I'd like to turn as well to the impact that the pandemic is having from a development perspective on the communities back home. Because indeed, migrants do send part of their income back home to support the families and their communities. And this is so important because actually with this money that those families, those communities can have access to health services that they can send the children to school, that they can have access to clean water, sanitation, all of those elements that are so critical in this health crisis that we're facing. So really what is absolutely important to realise is that the impact that the pandemic has had on remittances is absolutely huge as we are estimated that we are now facing a 40 billion US dollar drop in these remittances around the globe. So you can only imagine what that means for those communities back home. And we can say that this crisis has a cost not on young migrants but also on us all and I'd like to say also a few words on that with some 120 million people that have fallen back into extreme poverty as well as the loss of 255 million jobs, full-time jobs. So really without vaccine equity, without inclusion in accessing vaccination we will end up, all of this will end up costing us a lot more. And so the best way to ensure that we can move forward and start recovering is really to protect everyone. Thank you both. You well explained how these vaccination campaigns are of course very important from a public health, global health point of view but in fact also from a socioeconomic point of view and overall development point of view if I may say and that doing the right thing is coming actually with very difficult obstacles and barriers. Now it may be interesting actually to not only talk about problems but let's now also try to look into the solution how can we ensure that migrants are not left out of vaccination campaigns seems to really boil down to removing those multiple barriers that started mentioning earlier Patrick can you maybe tell us a bit about possible solutions that you are seeing being developed in your region or even beyond over? Thanks. Well I think we've focused on a lot of the challenges and the problems that migrants are facing and our society are facing but really this is not just about problems this is about opportunities and solutions and as very well put you know the migrants are actually part of the solution they're part of the solution of recovering from the socioeconomic and part of the solution of recovering from the health impacts of the pandemic as well. So what it boils down to is a change of mindset of not considering migrants as a problem that countries need to figure out how to solve but rather to consider migrants as part of the solution to include migrants in the planning process to make sure that they're being included on advising how to reach those populations really understanding what challenges they're facing in terms of registering or documentation required for vaccines and including them in that process to remove those barriers. We've seen some good examples of countries including migrant workers in vaccination campaigns particularly if there's being concentrated COVID cases in that area and we've seen good examples of enrolling migrants themselves to become vaccine educators and community outreach workers to give education and information to other migrants as well. We've also seen some countries remove the requirements for identification or having reduced identification requirements so providing any form of name and address or other forms of registration so that for the second dose migrants are able to have the same dose and the same information required but they're not being required to present those challenges and passports and these complicated documents as well. So really I think important to how do we address these challenges really I think we need to change the mindset that migrants aren't a problem to be solved they are part of the solution and without including them we're going to be unable to solve this global challenge. We really need global responses that includes everyone and that means asking migrants what their issues are encouraging them to be part of the solution and going that extra mile to reach out to them and having their views and inputs as part of the vaccination planning itself. Okay brilliant. I think your stories show us how clearly important this for everybody to include migrants in the vaccination efforts and this is a story about policies across sectors. It's not only about the health sector. It's also about addressing the ID card issue or registration card issue. This barrier is not going to be resolved by a health provider by the health sector. It's a very good example of how different sectors in society are part of this important task. We also heard about operational challenges and solutions information messages to be shared in the right language to reach a hard-to-reach community of why migrants I want to underline the importance of engaging migrants that you actually both mentioned as well. Engaging migrants themselves to build trust for example to combat vaccine hesitancy and misinformation. I think we may also like to highlight an important role that migrants play in the COVID-19 immunization role out itself as co-developers and providers of migrant and people-centered health services in countries of their origin and of destination. Actually I would like to try to move to questions from the audience who may have been listening to us and of course welcoming the audience to write on their questions in the common boxes. Okay, so give me a second time reading some of them to try to summarize. Okay, got it. There are already not enough vaccine doses for citizens. So how can you expect governments to cover or prioritize people who are not even citizens? That is a very common question I think. Pat, do you want to answer that question? Sure. I think there's two points to make on that. Firstly, I don't think we're saying that non-citizens should be prioritized over citizens. It's not saying that migrants are somehow special and because they've crossed a border unnecessarily more at risk and not be prioritized for COVID. Really, what we're saying is they must be equally prioritized because if the priority of the government is protect the health of citizens of that country, that cannot be done until everyone within that country has access to vaccines as well. So if only citizens are being covered with vaccines, COVID is not going to go away, the impacts are not going to go away, the impact on the health system, impact on the economy is not going to go away because COVID will still exist within that community. So it's not about whether governments should be prioritizing one group over another or can only cover a segment of the population. The pure simple reality of it is unless everyone is safe no one is safe. So we must include everyone. This is not an option. It's not a request, it's just a reality. If there are people who are not being included well, the immunity is not going to work well and COVID will continue within our community. So it's not really an option, it's really a reality that everyone needs to face. Consider everybody equally and evidently there are not enough vaccines in the world today and all migrants in all countries are prioritizing different groups, different age groups for instance and then it doesn't, it's not about vaccinating all the migrants at once, it's then also of course prioritizing the migrants as they are prioritizing the citizens. That's a very good point. I see there is another question that is also a question that I've been hearing quite a lot about what can regular people, I like that term regular people what can people do to help immigrants and refugees having access to vaccines? That's an interesting question. I have some thoughts about it myself to see it over to you first. If I can comment over. So I think we all have a role to play and indeed it's interesting to hear the terminology of regular people. We are definitely all members of the same society and we need to see and understand which role we each individually of us play in that mix. First of all, of course by being very much recognizing the when you are for example in front of a shop attendant who is a migrant or who is your care worker and so on to really show I would say recognition and embracing the fact that they are bringing a lot of benefits for our societies. So I think as individuals in the way of dealing with migrants and from a human to human somehow relationship, I think each of us we have a role to play to provide that recognition and embrace the benefits that we are getting from having those individuals in our society and playing very active an important role in the pandemic. From the perspective more from I would say from the policy makers what is really important is also to fully embrace this reality and to alleviate all of the barriers that can really help migrants to contribute to our society. So it really means looking at what is it that currently we have in our legislation in our ways we are providing access to basic services that could actually be preventing those particular groups, migrants and their families to have access to them. So I think there is also a very important role definitely from the policy makers themselves to really map and screen what is it that right now is an impediment that needs to be overcome. If indeed all of us we can have access to the relevant services so we can all be safe for all the good reasons that Patrick was mentioning earlier. Thank you Cecile. I guess we all have a very important role to play migrant or not migrant in avoiding discriminations xenophobia and to nurture a positive narrative around migration and stop the myths about migrants and refugees and really look at the facts that you have so well described throughout this conversation. That would already be a leap forward. Now there is another relevant question coming in. How can governments reach all migrants? Even people who are not registered and don't have documents and are in fact hiding. That's a very good point and Patrick I remember you were the one mentioning I think that many migrants are invisible and some even want to remain visible because they are so worried about being caught by the police and maybe deported. How can governments reach out to all migrants and maybe this is a particular organisation like IOM maybe in touch with migrant communities. Patrick do you have a concrete example of that from your work in the region? I think this really goes to the nuts and bolts of working with migrants and it really goes back to that issue of listening and understanding migrants and their perspectives and hearing from them what the services are. It's simply not good enough to sit back and wait for migrants to come to services. Services need to be provided in a way that migrants can understand linguistically or the language that they can understand in a cultural way that they can understand in the locations that they are at and in ways that don't provide extra challenges like financial costs or having to travel or being afraid of migration. There's been some good examples within this region, particularly in Thailand where the government has been including migrant workers in vaccination campaigns, particularly in the locations where there have been recent COVID cases or recent clusters of outbreaks. The government has taken a proactive approach including working with IOM to make sure that information from the government migrants from surrounding countries to work with migrant health workers to reach communities and do a lot of that networking and encouraging people to come forward for providing free of cost care not only for the vaccine but also healthcare in terms of COVID testing and follow up and making sure that not just vaccines are provided but in case there is extra lockdown measures provided or quarantine measures that are provided for the other food, water and sanitation and other medical needs of being taken care of as well. So that's been a really good proactive approach of going to where migrants are reaching them in a way that they need to be reached in a way that they can understand that doesn't cause negative impacts to their migration status or to their other socioeconomic status. Very good example. Thank you. Do you think it's also information that migrants can be able, can get vaccinated? How can we inform them? I think you just gave a very good illustration of that Patrick that indeed it is true information and very different channels of information that migrants can get the right information and in the right language. Anything to add there from your end, Cecile or Patrick? Maybe if I might... Oh sorry, Cecile, after you. I just wanted to say that you touched a critical point just now by talking about having access to information in the native language of the migrants. That's absolutely key. And I think again if we have to turn to positive examples as we see them we can say that some mayors city leaders have taken some extremely innovative approaches that have really been very impactful. So really understanding that one needs to be efficient and therefore reaching out in the local language is one critical point but very much in the native language of the migrants and sales but also it is about and I think Patrick already spoke a little bit about that getting to the places where migrants are and it's very clear that there are pockets of cities where those populations may be actually marginalised. So really having mobile teams in cities reaching out to them and doing something that is all so important which is winning trust of migrants. So really working through community leaders, religious leaders and therefore making sure that the official information is well understood and well accepted and really also this couple potentially with accessing other type of services of cash based intervention. So there's a whole array let's say of tools and ways of working that we have seen being tested in different parts of the world and again very much particularly in city context which is so important because we know that the immense majority of cases of COVID-19 are actually happening in cities so that's why I want to really embrace and salute here how much city leaders have shown the way in this process. Very good also nice to know linked with the role of cities and mayors in fact just something to think about and also to think of another example outside of Asia imagine I'm an urban refugee very very big town in easily the region in Nairobi where many Somali and Ethiopian migrants are living there are quite some challenges in accessing vaccines here it's actually a comment that came from somebody I think this is a very good summary indeed of a situation a very big city refugees, urban refugees, migrants labor migrants probably undocumented many are living there and try to access vaccines I think the examples you gave are excellent in showing there are ways of reaching also these people but we have to really think of it as a whole society approach and not just think of so it means the health sector no it will go through many different channels and sectors I think we are already talking for more than half an hour it's amazing I think we have to wrap up I will not try to summarize this conversation I want to thank you Cecilia and thank you Patrick and thank you to all the audience for your actual questions and listening to this special event on migrant inclusion and vaccination campaigns and of course we are always available to answer questions so do not have a difficult conversation with the public as I said hard to summarize this discussion but I can safely say that this conversation today showed that there is only one way out of this crisis and that's together so let's continue to discuss and find ways to jointly recover better, stronger and faster have a great best of the day everybody around the world and hopefully see you soon again and leave no one behind thank you very much everybody thank you bye bye