 Okay, so welcome welcome colleagues Excellencies to this lunchtime side event Welcome to this event on advancing the migration health research agenda for evidence informed policy and practice Doing the IRM council. So this council is a rather special one Not only because of our new DG. This is his first council But also because of the global compact on migration the GCM Which will be formally adopted as we know next week actually 11 December in Marrakech The GCM aims to build a greater consensus on managing the world's movements of migrants and uphold the human rights of migrants and their families And we are very glad that health is integrated in half of the GCM objectives Interestingly and one of the reasons behind this lunch event is the first GCM objective which focuses on data It says that member states commit to strengthen the global evidence based on International migration by improving and investing in the collection analysis and dissemination of accurate reliable comparable data It furthermore mentioned the development of country migration profiles Which include desegregated data on all migration relevant aspects in national context including health We think that this panel with specialized IRM colleagues academia and WHO is very timely to drive the migrant health agenda further At IRM we firmly adhere to advancing an evidence-informed approach in our health interventions Speaking for a migration health division that offers health services to its beneficiaries We work with refugees and migrants rolled over and have close encounters with them This is how we learn This is how we have relevant data and this is why we want to make sure that our experiences are shared But also this is why we are strongly committed in working with our member states Partners like WHO and academic institutions in developing and maintaining knowledge platforms and research networks To advance data and research in migration and health I'm therefore proud to announce that IRM launched an open access migration and health research portal this year Decides to serves as an information platform for men's member states partners researchers media Interested in the work of in the work that IRM's on the taking so far the portal maps some 1,800 migration and health related projects IRM has implemented since 2006 covering all regions of the world We have also generated a total of some 650 technical publications on migration and health within that same period of time In addition in partnership with academics globally relaunched the Madri initiative in 2016. This is a migration health Development research initiative It's a global network bringing together researchers and practitioners to advance migration health This session will tell us more about this new partnership as well as the portal. I just mentioned of Course we can do more and we hope that the GCM will bring us an additional boost to further Interest and resources to develop high yield and analytical briefs and applied research That enable member states to make better informed decisions around migration and health on the basis of their own migration realities and capacities I'll end here. I would like to introduce our moderator Paul Simpson editor of the BMJ the British Medical Journal Paul over to you. Thank you. Thank you So it's very exciting to be here for me It's outside of the usual Health sector silo that's a medical journal editors tend to inhabit I think perhaps that's in some small way the SDGs working their magic in that It gives us a license to move outside of our our silos So I would like to introduce the panel We're planning for about 45 minutes of discussion amongst the panel members And then we're hoping to open it up to the to the floor for for questions from the floor So I will introduce from this end We have Cole Colwick Rammage who is the head of a global health research and epidemiology in the migration and health division of IOM We've got Michaela told who's from the graduate graduate Institute here in Geneva and Michaela is the executive director of the Global Health Center We have Frank Laxco who is the director of the IOM's migration data analysis center in Berlin we have Ursula Truma who is the co-founder and head of the Center for Health and Migration in Vienna, Austria and At the end we have Matteo Signol who is the team leader of research in the global TB program at the WHO so To begin with I thought it would be useful for us to to really Get a grounding for the discussion about What's data is being collected? What data is available and how is this being used to inform policy now? And and Frank I wondered if you would be I thought that you would be the best person to start that discussion So I wondered if you could give us three or four minutes on On the data that's available Okay, good afternoon everyone. I'm the odd person out on this panel because I'm not the migration and health specialists But I'm supposed to know something about migration data and statistics So let me try and frame the discussion by saying that I think across the world and Across the UN system over the years Everyone has agreed that we need better data on International migration it is a recommendation that has been made over and over again In fact if we trace back the history of this discussion We can go all the way back to 1891 in Vienna, and I have somebody from Vienna next to me And the international statistics meeting there which first called for better data on settled migrants so Despite the fact that there are some skeptics out there who say that well It's all very well to collect data on migration, but it doesn't have an impact on policy We believe that data is not an end in itself and that data is Absolutely key if you want to design an intervention or a program or a policy You need to know what is the challenge that you want to address You need to be able to then design your instruments and use data to Inform your policies and programs and then use data really to assess how well you're doing and to be able to evaluate What you're doing now despite the fact that there is this consensus In favor of improving data on migration. We've actually seen Relatively little progress in this field over the years. That's a generalization. There have been some significant improvements, but nonetheless the Former special representative to the UN secretary general Peter Sutherland when he issued his report One or two years ago One of the key messages of his report was the fact that we lack Basic information basic data on international migration Now just give you a few figures and maybe I'll stop and then come back again because I know you're gonna ask some more questions but just to give you some examples of where we are today if you take Asia and The 48 48 countries or so in Asia less than a quarter of those countries have been able to Report data on migration flows to the UN statistics division in recent years if you think about official statistics on international migration for Africa 17% of the countries in Africa have not been able to report any official statistics to the UN since 2005 If you think about censuses, which are the key source of data on international migration Many countries around the world about half of the countries around the world Do not even ask a simple question such as when did the migrant arrive in your country? And we could go on like that. So There are a number of basic challenges some of it to do with lack of data But the other challenges we face are that there is more and more data being produced today Through digital devices new technologies and we're not making the best use of this information Also, organizations like IOM are producing more and more data through our operational work and other agencies Some of this data is shared effectively some not so the challenge that we face is not simply to improve the collection of data In the future, but also to make better use of the data that is currently available to inform Policies and programs in this area. So I think I'll stop there and I'll come back again. I guess. Thank you Frank That's really that's really helpful. So we've heard about some of the challenges there of Having the data at hand, but I wonder whether I mean call perhaps you could provide us with some like a good Example of how data is being used to to inform policy in health. Thanks. Thanks, Paul I think I'd like to perhaps highlight a country case study from in this case Sri Lanka where a government Draw essentially a evidence informed migration health policy process where Data and research was the heart of that Migration health policy process and perhaps I'll I'll spend a little bit of time Talking about how that process Was initiated and catalyzed. I think that's useful for for many of the the the countries here as well So Sri Lanka has a dynamic migration flow It's considered a labor sending country with around two million migrants going to Many parts of the Gulf as migrant workers, but it's also a labor receiving country receiving Migrant labor from China and India that fuels a lot of the development projects in the country the country also went through a Protracted civil conflict and there was a dynamic of returning refugees back into the Sri Lanka But also internal mobility in terms of displacement. So it's it was a dynamic It was a dynamic migration flow in this context the government of Sri Lanka led a migration health Policy process through the conduit of the Ministry of Health and they did that through what they considered an Intersectoral approach so they had this approach where Although it was the Ministry of Health that was leading the process. They engaged Other ministries Minister of Interior Minister of Immigration for example What was I think the key point here was that they Utilized the local research community or the indigenous research institutions to drive The data because what what happened is that there was very little data existing to make Decisions around health status for example of those labor migrants that go to the Gulf States or indeed what the health Consequences to their families left behind are This process was quite long There was a national research commission under the the stewardship of the the Minister of Health It took around two to three years until the data was distilled and The data was distilled in forums where researchers got together in the same room as Policymakers and and talked about these findings in the context of of health status of different mobile population groups Out of that came a National migration health policy process Out of that came recommendations such as including a migration module in health surveys for example So really the the policy process took around six years But what came out of that was a a participatory approach An intersectoral approach to to driving data and evidence Col can I ask you a quick question which is what was the enabling Environment that that that led to that working because it's obviously quite a long process It takes some commitment. What was it that? Thanks, it's so So this was around 2009. It was the end of the civil conflict in Sri Lanka. There was a real Momentum for the peace dividend and I think there was a concerted effort amongst the government of the time to really invest In in looking at migration for development and we all hear the mantra around migration for development But the government asked a question about what was there any social and health costs to to the dependency on for example labor migrants, but there was also the practical questions about returning refugees and the different health gradients or epidemiological gradients as we call them and questions around Sri Lanka reaching malaria elimination and imported cases as being the last bastion of defense of Reactivation of malaria. So I think there was a confluence of factors that led to the government making a decision that We need to have some sort of migration health policy, but we need to do so through evidence Great. Thank you very much. I Think perhaps I could turn to Matteo now so Matteo you're working in the TB program and obviously that's a big There's a big challenge there of Around migration. I wonder if you could reflect on your experiences Yeah, thank you Of course TB is is only one of the many many health issues but it is still one of actually among the top 10 Causes mortality globally and it's the top killer from infection disease It is we are quite lucky in TB because we have a Quite solid Notification system in countries The big problem there is that for many years has been confined to ministry of health We have been talking and working Exclusive with MOH and and We know very well that Maybe 40% of our estimated TB cases globally are missing are not found not because you know, not just because we're not able to detect the disease but because We don't get the report And he may in some countries up to 20 30% of TB patients are among migrants both, you know internal migration this place population and You know cross-country migration so one of the one of the I Will say elements new elements that We want to basically put on on the agenda and is To work multi-sector area in countries and there is a movement now to ensure That not only minister of health are involved when it comes to reporting, but also all the other ministers in finance interior research and development and We think this is crucial if we really want to move forward And and try to find and treat tuberculosis as you understand very well to be closer to infection disease so We need to ensure that not only patients are diagnosed, but also they are kept on treatment for a quite long period of time which If if we talk about susceptible TB normal TB is six months. So it's a long period of time So we have clearly huge problems related to the capacity of minister of health to ensure that the treatment is Patients are adhering to treatment So there is clearly now much much stronger political will to work Not just with the minister of health, but with the entire sort of government and We recently had an eye-level meeting on tuberculosis where this is This statement is very clear and the issue of migrants as being is is in declaration It's very very strong there The other point is that We need to rethink our surveillance is our recording system our data system and As was previously said We lack that we don't get that information, you know, we don't get information on TB tuberculosis in migrants At the moment, but what is happening? It is that there are Multiple multi-countries TB research collaborations These are small hubs one for example in Sadek one in Western and Central Africa another one in Asia another one in Russia and Eastern Europe where researchers and MOH people minister of health people program people work together to address Research issues in that case. So migration could definitely be one of the elements and cooler of this of these research projects and That could be like a those could be platform that could help us Getting, you know more data. So this is this is the way we would like to go the research platform that you're talking about that's Cross-borders. Yes, those platforms are are are Multicountry platforms but of countries that are neighboring as I said one for example in the Sadek Another one is is is in Western and Central Africa and The beauty of those Platforms is that they are managed by the countries themselves There are inputs from of course international organizations and WHO is part of those and they are basically led by researchers and Program people at the same level So it's a platform where important research issues like for example the one that we are discussing today Could be addressed through through, you know to work together So so we've been talking about Research and Kind of cross-border collaboration I wanted to sort of move the discussion towards a conversation about universal health coverage because this is obviously a key issue and and I think Perhaps Firstly you might be able to kind of shed some light on this and one of the things that Is emerging is how the economic evidence around Providing healthcare for migrants and I wondered whether you might be able to To make some comments there. Yeah. Thank you very much When it comes to evidence on economics and Health and migration you might presume and it is very often presumed that it is more gets more expensive if you include migrants into healthcare If you open up so to speak the system then it becomes more expensive and There are stakeholders who who stress this There are several studies around this topic available already So there is some evidence and this evidence says the contrary and that is studies that we have showed that Timely access to healthcare is indeed not Not costing more but is cost saving so on the contrary if the success is not given This will at least double economic costs of treatments and it will multiply Especially when you think of infectious diseases like TB And when you think of multimorbidities So To make a very long story short There is evidence that there is a cost saving potential in giving universal access to health care And I can give you some numbers on this. It's it's arranging around 50% to up to 99% for specific Interventions that can be saved if you Allow early access to treatments to give you one example high blood pressure An important issue if you treat a blood high blood pressure in primary care This will save up to 90% of the costs of an operation that becomes necessary as a Result of no treatment. So you see the cost saving potential if you look into this in detail is really great a second example Diabetes diabetes type 2 Very important As numbers of people affected by diabetes are growing and people are in very early age and young age are Are affected An economic study showed here that the cost saving potential of primary care treatment of diabetes is 74% Compared to hospitalization that becomes necessary without such a treatment. So again, you see With this example that cause the cost saving potential of providing universal access to health care is great and The good thing is that there is increasing evidence on that another aspect just Very briefly to tackle is when we talk about Economics and if we take a broader aspect on that we also have to think about Productivity and loss of productivity loss of income. So these are economic considerations that really do not only tackle or Approach to the health care systems But also to societies in general and just to remind us I mean health and being in good health is The number one determinant of mastering process of integration I think for a first answer Okay, great. Thank you very much So I quite like to turn to Makayla at this point and because it does sound like that there are challenges in Bringing together data There's good sort of case studies of sort of data being used to inform policy, but but I was a recent health research Symposium and some of the kind of same Issues are coming up which was about how do we connect research to policy? And I wonder whether you might be able to Reflect on that Thanks a lot Paul and thanks also for I am inviting me to this panel. So I think it's great to have such a lunch event so I think data and evidence is important It is very important, but let me also be a little bit devil Yeah, if you permit I think data and evidence cannot be seen in isolation either So in some ways we also need to we need to also Challenge sometimes the evidence and the data we get because yes, and we have heard from Frank You know, we need to have there's lack of data We need more data or we made better use of data But we also have misuse of data and we also have distortion of data And that's the moment when we actually need to look into a political context when we cannot isolate Data from the political context in which we use the data in which Actually the data is embedded and I think that's where I'm challenging it So in some ways, you know at the time of fake news, that's our political environment We need to be aware of that and we have to talk about that So we have to challenge evidence sometimes and we have to challenge data And so we have to challenge the figures, but also sometimes even you know Even more so I think sometimes even the research in itself because it brings us a lot of data But it gives us a delay in using in being able to use the data by the time We are able to have the full data collection done Yeah, well evidence The policy debate is over So what do you do? So there's a challenge there, but then it's also sometimes the challenge around what do you what approach you take? And I think that brings me right back in what you have said in terms of the disconnection the connection of you know Data and evidence and realities political realities, and that's really what I want to talk here Because it is true Yeah data collection can have an impact and should inform policy But decisions are made not necessarily on the basis of data So I'm not on the basis of evidence so decisions are made governance decisions are made Within a political view and so what we have here we operate and so what we also have is that disconnection and we work in silos We have clearly a fragmentation Where we work different systems we have a health system we have a migration system we have a development system We have a humanitarian system now sometimes these systems overlap But sometimes also they operate in their own little bubble and if you look at the governance level Where do they interface if you come here to the IOM council? I would be really interested to to to look at the composition of the delegates here at the council and Compare that composition with the composition of the delegates of the World Health Assembly Now clearly it might not be the same Sometimes it might overlap, but sometimes it might not be the same now there you have already a disconnect So policy-making at that governance level actually doesn't match You need to bring them together You have to have a ministry of health representative in this room to talk about migration and of course We know we need to have that we need to talk health as a political agenda As we have to talk migration as a health agenda But we don't do that sufficiently and of course it's very nice that we are here and have lunch event So but I would ask we have this event. We have a panel right after a high-level panel We have a film festival at the Graduate Institute tonight What happens tomorrow? We will still talk about health What happens the day after? Will we have still talk about health or is that just a punctual intervention very fought for and Needed I don't say that But you know, how can we actually bring it into their mindset in terms of you know, it's an approach which needs to change So thank you very much Micaela I think we've got a few minutes where I think it would be good to have some reflections on what we've heard so far Frank You said that you would like to say something anybody else on the panel keen to reflect Yeah, and Mateo, so yeah, okay, so yes, I agree with everything that was said by the last speaker. I think To some extent the global compact on migration and its section dealing with data Recognizes that if you want to improve data You also have to have a communication strategy and you need to communicate data more effectively and there's some Brief reference to public opinion In that section of the compact it's probably not enough but I think the more important point is that the compact describes 11 actions which should be taken To improve data on migration But it poses the whole discussion or sets the discussion I think essentially within a sort of technical framework, so The argument that's put is you know, if only we had more surveys or more questions in censuses on Migration etc. Etc. Or if we spent more on capacity building then we'd have more data and we'd begin to solve our problems Well clearly we wouldn't because there are many Sensitivities around data data is a highly political issue Countries may decide to collect certain forms of data and they may decide that they don't want to share that information Either internally or with other countries So one of the things that we have been talking about I think in IOM is the importance of what I would call in inverted commas Data dialogue, I mean you have to recognize that there are many different ministry stakeholders within a country Collecting data on different aspects of migration, and they don't always come together and share the information Or do they don't come together and think about well, what's our national strategy? What evidence do we really need on migration? IOM over a number of years has promoted the idea that countries should develop country migration profiles and Those profiles are prepared in consultation with governments the set set up into ministerial working groups where ministries like the Ministry of Health Is often represented, but it's but it's been slow. We've made slow progress, and I think we need to do much more in that area The other thing that we need to do is to encourage countries to share data and to work together To identify You know common areas where they all have an interest in having some data perhaps at the sub regional or regional level or even across continents Because migration always involves more than one country unless we're talking about IDPs and internal movements so When we're thinking about action steps, and this isn't really fully addressed I think specifically in the compact under data, but the compact does stress the importance of International cooperation in order to be able to manage migration effectively Then I think that's an important Element of this debate. So that's where I think the WHO and the IOM Connection and the connection with the different ministries and stakeholders come in Just one last point 20 years ago. I was in a room near here I organized a meeting with government officials about research and policy And how do you bring the two communities together? And we had slides up on the screen The researchers have a set of stereotypes about policymakers. They they don't know anything about research They're very impatient the policymakers have stereotypes about the researchers. They're so slow. They're always talking about theory They don't have they don't deal with practical problems. So how do you bring these two communities together is? Something that we've been talking about for a long time It's not easy to get everyone in the same room together and to bridge that gap And I welcome people's thoughts on how to really make progress in this area because There have been met. I think many initiatives over the years Trying to tackle this issue Thanks a lot Frank Colt can I just check you were you waving because you wanted to say something because let me let me go to Mateo first He had his hand up and then I'll have him back. Yeah. Thank you. My comment builds on what you have just said You know, of course my experience is about to be close. It's very very limited but there we we we have an opportunity The the TV research networks that I mentioned they are exactly that they are they are led by researchers and Program people in countries they set up their own agenda and They don't work just in their own countries, but they they work with the neighbors in most cases That's I think a perfect platform to You know really start moving this and have projects in the ground to make make You know what we are discussing more in reality and you know What I've seen for other research issues When you have researchers and Program persons in the same room you Maybe the process is bit slow sometimes But you have both the political will and the means to make things moving so That will be my suggestion to really start from more local and sub you know sub regional and work To to try to to really move forward with this agenda Great, thank you. Um, okay, so we're gonna go to col. I'm gonna get this left And then we're gonna go back to Mikaela and then we'll move into the next phase. Thanks paul You just agree with that point exactly. I think What we see happening at the sub regional level and the sub national level around migration health governance is is quite amazing, there are Countries that are meeting for economic purposes economic cooperation mechanisms free movement of people and grafting migration health As a gender items on that a good example of that is the colombo process Where it's a meeting of member states that are Labor sending countries recognizing the importance of Looking at research evidence about Say cause of death mortality Of migrant workers abroad I think these Increasingly are becoming important for regional corporation processes in in in migration governance But I just I mean doctors like to prescribe things and when you're dealing with a patient That's the country people don't like to be prescribed things, but I think A very general compass is identifying a focal point at a country level To drive this agenda as frank said through an intersectoral process is important Doing a lot of mapping of domestic legal frameworks to to look at to what extent is the right to health enshrined for For the non-citizens for example Mapping actors. I mean a lot of this stuff could be done as as the first step in in in Um identifying what capacity gaps exist at a country level before embarking on any sort of policy formulary So I think and this doesn't require a lot of money. It requires a lot of will and a sort of a technical expertise to do this, but I think Taking stock of existing dynamics is important Thank you, col. Um, let's say you had an intervention Yeah, I just wanted to refer to a third stakeholder when it comes to to data Uh, production also data protection and that that is uh, these are the angios Especially when it comes to vulnerable migrant groups like for example irregular migrants most data concerning health status, but also access to healthcare will be produced by Uh angios who provide services So there is some data from their side But the question is how can this be properly connected to researchers or also to to Policy and political actors. That's an open question. I don't have an answer And the second thing I wanted to mention I find is very interesting what you said about this Uh, conference you made on how to how to bring together researchers and and political actors Because right now, I guess next year in february that will start a european Network of scholars who are addressing exactly this issue. How can research address properly Political stakeholders, how can this gap between research on one hand and policy making on the other side be closed? It's within the horizon 2020 program. They will work on that for four years. So maybe it would be worthwhile to exchange results So we'll know in four years Um Michaela, you wanted to make a comment before we move into the next phase. Yeah, I can actually just um reply And I would say speak a different language Speak the same language get into a coherent language. We speak different We are also in different language silos. We speak a very different language in health We talk all the time about evidence. It's really lovely, but it doesn't resonate With anybody who is a diplomat. I mean it is useful at that moment when they want to use it because it makes the argument stronger But it doesn't resonate otherwise So speak a different language speak the language which resonates sometimes. It's a question. It's it's a it's an emotional language It's about emotions. It is about values and human beings, but it's about the human being next to us Sitting next to me. So speak a different language with everybody in the room can understand and connect to But it also means that we need to get out of the framing So, I mean, I think it's really interesting frank because you mentioned, you know, the global compact has been within this technical framework And so I would say yes And so what the problem is we face in europe and of course my own country is part of that Restoring from the global compact So it's about the political framing. Well, yes, it's nice to have the technical framing But ultimately you need the political framing in which you act Because otherwise, well, you you have to dropouts and so then what is the value? How can you still work of it? Of course, they will work with you, but of course it has its value. I don't challenge that but I'm just, you know Making the argument here and I think It is also it for me. It also means, you know, do we need to learn better from the past from experience From the research we have So how far actually we are able to learn Are we able to learn and adapt ourselves? We know what's going to happen We know we have experienced it so many times that but do we ever learn? Can we please use the data and the evidence we have and build on that for the future Thanks, Micaela Um, I would like to move us on just because I've got an eye on the clock and it would be good if there was Questions from the floor that we get the opportunity to hear them. Um, so, um, I'm going to ask each panel member perhaps Moving from right to left or my right to left. Um, just to sum up, you know, they're kind of concluding thoughts comments in Sort of three minutes no more because we're now we're tight but um Just what is your take home messages? No, we've got the the compact on the on the horizon It's going to be the kind of compass for us moving forward. So What's your message? Cole, would you like to start? You know, that's that's a challenging one. Um, I'd say mainstreaming migration health within Within health discourses migration And health seems to be sidelined and within migration governance discourses Health seems to be sidelined. So I think mainstreaming is very important. Um, and And to do that, um, the I mean, I'd like to push back a little bit about what micaela just mentioned We've we've done some analysis about existing data and we've found on the heat map of of data and who's producing data in migration health There's entire vacuums from the global south Um, we don't have enough research and evidence from these regions. So even with the existing data set, it's very much a labor receiving or indeed Migration receiving Perspective. So I think we really need to improve research capacities in order to do to even mainstream migration Yeah, so, um, I think my message would be, um, Ultimately what I also mentioned earlier, I think is also to change the approach in research And that approach to be and maybe challenge their research We do as that fundamental research but move into applied research really But also move into a research, which is much more of a hybrid format Where you actually bring people together where you actually on the one hand have your policy dialogues where you interact constantly And at the same time also to your data collection and bring in your data collection as you also dialogue and bring different Stakeholders together and it's not just governments and as Osula rightly said also NGOs and many other stakeholders Need to come in Yeah into that debate private sector. Do we talk to the private sector in migration? I think it's to to provide a different approach in research and provide a different form of platform and outreach Thanks very much Um frank, would you like to okay? Yeah very briefly on the private sector? I think that's increasingly important given the amount of data that's being generated by the private sector Just give one example Mobile phone data has been used to track the movement of malaria infected populations between Sanzibar and Tanzania There's probably lots of data that is being produced by the private sector Not being fully utilized by different stakeholders Stakeholders and policymakers today So we're going to need much more public private interaction in the future I think the key messages will be um, we need to develop comprehensive data strategies working with countries and regions according to their priorities and Start by making the best use of what already exists and giving helping policymakers and others to Use what data already exists and And then I agree with coal that the emphasis really needs to be on building data capacities in the global south Because that's really where we most lack Information at the moment. I don't have time to list a whole bunch of things that iOM is doing Or planning to do in response to the gcm data agenda. Thanks Yeah, thank you I may repeat myself But I think that we do need more evidence on economics of health and migration What we know so far is that exclusive exclusion is expensive What we don't know so far yet who's really paying the price Maybe the taxpayer, maybe humanity So I think we need to get better evidence on this. I also think that we need to To encourage researchers and policymakers to get into dialogue we I think we agreed that somehow Our researchers do not have the impact with their data and with their knowledge and the evidence that they could have and should have And I think to develop maybe a common knowledge And the common language would be one important Step to better link evidence to relevance because this link is missing so far And I think a third thing for me concerning capacity building is one very important thing is and this is bringing researchers Globally together and there is one wonderful network that has just been Starting to do that and this is madri and maybe you did see these folders somewhere outside You're very welcome to take them with you and share them with you share them with People, you know madri is a unique network that brings together researchers from all over the world and we know that especially in concerning research health and migration The global south is not that much integrated also in research processes that it should be And this should change and I think that madri as a network will be part of this change Wonderful. Thank you. Mateo Yes, uh, universal health coverage is clearly at the center of The work of of who and the the new administration has really put UHC at the core of our work And we should clearly Ensure that migrants are part of that sort of movement Um My uh, I have two Points basically many related to the work. I think tuberculosis could be um A good way a good a good starting point to Um, uh, to to to to basically create Um Ownership in countries on on data Uh, uh migration I think there is high political Momentum for tuberculosis control Migration is clearly a major problem Uh, and you know and the networks that I mentioned earlier Are already existing and could be um a platform where where uh work can really uh can really start um from From the who side particular from my side. There is full commitment To support as much as possible this work on migration Wonderful. Thank you all. Um, we've done very well and we're we're back on track by uh, so It's a good discipline from the panel I wondered whether we had some questions from the floor um We've got 10 or 15 minutes that where we could take questions if if there's any burning uh Questions that we want, um If there's we've got one at the back and I hope that your microphone works Yes, it's not Palau, but my name is My name is Florian first. I'm the from IOM. I'm the head of immigration and border management And I have a question specifically related to the migration health research agenda I understand there's a lot lot of lack of research, especially in the south on uh migration and health And what kind of primary data would you need from From from the first Contacts at the borders, you know, is there something where you feel is it an appropriate Moment in space anyhow in the first place and if so, what kind of data would you need from those? civil servants interacting as a first Person on the line with arriving migrants. What is data that then would help you to further research? Uh in this area. Thank you. Great. Thank you very much It's a another question. We could take a number at once so we can start with this one Who on the panel would like to to tackle that question? I'm sort of looking at you Cole So the question relates to um, what sort of data or research could be done? um at the border points of entry and exit so As you know the international health regulations and global health security is a critical aspect of of global health What we find is that In iom's work within the realm of global health security The point at which people cross Could be through airports seaports and land crossings and what's been quite weak is the kind of Research done at the the nexus between populations that are crossing Landborders, if you look at the Ebola outbreak that happened in 2014 Capacities about Mapping human mobility and superimposing those maps on epidemiological mapping. So this is where Points of entry research are really critical. So you can have some sort of real time Um analyses around how people are moving what typologies of people What is the direction of flows and iom's developed? Some pretty good tools in that realm that Could be portable or exportable to different contexts. So that's that's one but but he also you I think there's um As frank mentioned there there are methods around using technologies around Mobile phone use for example to map People how they move through borders And also from a very applied research aspect iom has been doing a research study During the Ebola outbreak where we we looked at People that are screened at airports at points of entry. So we partnered with the immigration authorities and the health authorities and we looked at Those scanning machines temperature scanning machines the the infrared scanners whether or not that was effective in picking up Cases of suspected people with Syndromeic based case detection. So I think there are different research strategies that one can imply at the points of entry. Thanks Thanks col I think I Yeah concerned the question which kind of data I would have a long long wish list Can share with you But I think most important would be Data on the health status, of course On the health needs that people have when they come but also on expectations that they bring With them and that guide maybe a future behavior and I learned that iom for example did develop So-called ephr a personal health record that was designed to collect that kind of data In first line assessments. I don't know whether you're familiar with that, but this would be The first things in my wish list Thank you Jacqueline you would like to make a comment. Yeah, actually I have two comments Well, I'm glad to see that in fact we are practicing what we preach aren't we by having a health related discussion in a migration platform. So I think that's that's good Because it's about all of the panelists somehow we're saying we have to mix the different sectors I think we're doing that. Sorry. I have to put on my glasses The other thing I wanted to want to say is that the trigger your question trigger that is And it was mentioned earlier we Use of data very important. We should not miss use data. I want to mention something in this contact because We can of course prove a lot of theories with with data, but we have to be very balanced and One thing is we have to be cautious about is we don't want to stigmatize Migrants which is happening a lot and will only fuel the already negative narrative We don't want to stigmatize migrants as disease carriers. The whole message should be how can we better prepare? health systems, how can we prepare? For integration by knowing what the health status is of migrants who who may be coming to a community That's one. The other thing also is that We should also be very cautious of of looking into health status of people by with with questionnaires We search questions if we do not Attach with that the access to health services It doesn't do any justice to people if they are researched about certain Needs that they may have and then there is no response that follows And this is something that was very very much underlined in a very recent Meeting that was organized by the government of of belgium as well as an iom on A big program of the iom at p departure health assessments and Yes, very important Pre-departure health assessments had a moment that we encounter people What can we ask but also what can we deliver? How can we respond to the needs that we discover that these populations have? Thank you very much. Um, mikaela, you you want to make a comment just a quick thought and that goes in line What i've said earlier, but i think just as a different flavor here I think what an immigration you do that quite a bit But in health you don't do that much, but you need to also collect political intelligence So basically you need to have also A sense of history in the country and in the two countries you have to have a sense of the political system You have a sense of the policies and the legal framework So there is a lot of other data than the just the strong and Very, you know data We're talking about here So I think there is a lot of intelligence around it which we need because that Influences ultimately also in which ways can you actually implement policies or advance or change policies or push for policies? Mateo, I wonder whether you you might comment on it from a tb perspective because one of the challenges of tb is Is is that people have a long Period of time when they have the disease if they're in treatment but keeping people in treatment after they've moved through a border Yeah, I think I think The questions Could be also seen from the perspective of control programs Not just from the perspective of Of the migrants But also from the perspective of control programs who Have the duty to monitor what's happening in their own countries and You know, there are clearly questions particularly when it comes to infection disease transmissible disease that Menicio had I think would like to have I'm not sure if the border, you know, it's a right, you know place to to collect the information but My sense is that we probably don't Don't often go back to to the control programs in countries to ask Which are the questions? that You will need which are the type of data that you will need to You know to to monitor and to control the disease in your country And I'm pretty sure that this is for tb. There are lots of questions that that Program managers have all the time and particularly You know the issue of you know You know unique identifiers for patients how you ensure that patients Can be recognized the issue of Being able to transfer, you know information from one country to another It's sensitive information, but it has to be transferred and And then the issue of ensuring that The patients first of all finish the treatment, but the results are also reported back so that Whoever is in charge of the of the program in this case a tb control program Has an understanding of of a full understanding of what's happening basically in the country Great. Thank you very much Mateo. Was there any other questions from the floor? We've got time for one if that you um, I might be a bit controversial here just to keep the audience lively And and it's mainly directed you frank and building what Mateo has just said that In a health perspective. Sorry. I'm from iom Thank you From a health perspective, we would say you would not screen unless you intended to treat And if I look at the research Aren't we in trouble here that researchers collecting data without any intention to change policy? So shouldn't it be the policymakers who are actually engaging with the researchers to determine what are those questions they need answered? I I think that's more a question for the mhd department No comment. All right. Um, I don't know whether anybody else feels like a comment on that. She leave it hanging there guys It would be lovely if policymakers would actually engage in research The question is whether they would do it and therefore, you know, they are clear roles as well and different mandates And I think that we need to respect as well But that's why also I think a hybrid approach towards research is so important because that's precisely when you bring them together And you know, not just have a finalized research project done and then present data That's the train is gone by the time. Yeah, probably But actually engage on the way throughout You know, and I think that's where you actually keep a certain level of relevance So the policy maker may not be the the person who is able to engage But he can also inform your research just as much as you as a researcher can inform Policymaking and of course we would want to have this mutual relationship But that again is a different way of looking at things that you have actually a partnership set up here in terms of a dialogue Which is not just, you know, where you work in silos once again But where you actually come together and talk to each other and what it what it does require Is and of course we as the the graded institute we do that quite a bit is working on global health diplomacy It's precisely, you know trying to To merge those views but also to build those little relationships to build trust And I think these are elements which are just outside of the purely technical realm in a sense because on that basis In fact, you can move on and move together Thanks, okay that I think Cole give me a signal and then Mateo I think thanks for the question Well, I look I think it's it's quite important That that research is done Even on the same research question In different contexts. I'll give a very practical example of this When we did research studies in Philippines and in Sri Lanka and in Bangladesh about the mental health and the nutritional status Of children that were quote-unquote left behind by migrant workers The effects on child mental health and and child nutrition in the Sri Lankan child Was pathological like it was the scales were pathological whereas in the in the Filipino left behind child They were thriving. They in fact when we looked at the data They were they were Nutritionally better off than a that a non migrant child comparatively It's so important that research is done And imagine the the policy consequence of of that data. So I think it's it's really important to do Applied research research that's contextualized But different results can happen in different countries and we and just from that point There's a difference in communal raring of children. For example in Philippines and a host a host of factors where People governments they enable migration in in different ways And I think there's a lot to say about the importance of research for policy making and I think I hope that example also highlights the need to invest in applied research genders And Jacqueline, I think you wanted to just add a brief comment Yeah, that was a great comment Paul and I think The Sri Lanka example was actually a good example of the participatory approach and really mixing the policy And and the research wills but we have to also bear in mind when we talk about participatory approaches And they have to be not only at the very end but throughout the entire process We should definitely not forget the migrants because let's be real the migrants are not vulnerable poor people Only I mean migrants are very innovative people and maybe the strongest and the smartest So when we talk about participatory approaches Also, and it's about research matters. They may actually be Very good Participants in when are we talking about developing of research or how to interpret research and what is it that also they need because They have to also They have a lot to say as well and we should see them as full participants as well Thank you. That was exactly my comment But there is a there is a fourth group. I think in addition to the civil society to the migrants Which is important. I think it's it's the funders And we often forget about them. But in my experience is that when you have the table The you know the the programs or the public health people the researchers The civil society and the funders is that that is where you have the right mix to move a research agenda forward in my experience, you know, of course research is free and It's a beauty of research is to explore and see and look for opportunities. This has to be has to remain but my experience when The country the you know the program identifies research question clear research questions at least in my area of tuberculosis when they Are able to identify those questions they get funded because funders they they see the relevance Of of of a question, which is for the benefit of public health in the country So that is a player that I think we should not we should really include in our at our table Thank you very much Matteo. So I'm trying to keep closely to time. So I think I think I'll use my privilege just to highlight something that the british medical journal is Is is doing with the iom? spearheaded by coal and with the madri network So clearly this is a topic that's Very important to the journal. So we'll be embarking on publishing a special series On migration and health Looking at the research agenda for migration and health The first of those papers will will probably publish early next year and they're going to start on governance uhc and othering Um, but one of the things I think that the british medical journal Really does well as it mixes academic rigor with Sort of journalistic flair. So not only are we going to have some Fairly weighty academic pieces, but we're going to also be publishing Features written by journalists and we will also be publishing multimedia infographics and podcasts as well Um, so do look out for that next year. Um, and probably If you're not already following madri on on twitter, then that would be a good place to to keep up to date Okay, so um, we are on time and and I think that all I'm left to do is to thank you for listening and to thank the panel Because I think it's been really interesting. So thanks all