TOPSHOT - A picture taken on December 10, 2018 shows silhouettes of migrants, part of an art installation, at the grounds of the International conference on Global Compact for Migration in the Moroccan city of Marrakech. - Politicians from around the globe gathered in Morocco for a major conference to endorse a United Nations migration pact, despite a string of withdrawals driven by anti-immigrant populism. The Global Compact for Safe, Orderly and Regular Migration was finalised at the UN in July after 18 months of talks and is due to be formally adopted with the bang of a gavel at the start of the two-day conference in Marrakesh. (Photo by FADEL SENNA / AFP)FADEL SENNA/AFP/Getty Images
Silhouettes of migrants at the Global Compact for Migration conference in Marrakech © AFP

Despite popular perceptions, migrants moving to high-income countries cause neither a rise in healthcare costs nor infections. They are younger and healthier and have fewer babies.

These are some of the findings from the UCL-Lancet Commission on Migration and Health, whose new report coincided with the adoption of the world's first Global Compact on migration in Morocco this week.

Migrants are more likely to bolster services. In the UK, more than a third of doctors received their medical qualification in another country while the Brexit-related slowdown in new EU migrant workers is causing severe staff shortages in the NHS.

Migrants do however experience many problems accessing services themselves. Undocumented migrants fare even worse.

The Global Compact is just a start, but as the president of Médecins Sans Frontières comments, the declaration does at least establish that “saving lives of migrants is not a crime, and migrants are not criminals”.

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Three questions

Helga Fogstad, executive director of the WHO’s Partnership for Maternal, Newborn and Child Health, which this week brought together participants from 85 countries in New Delhi to measure progress.

What was the most significant announcement at the meeting?

The partners pledged to strengthen and expand health systems, improve multisectoral collaborations, align partnerships around national health strategies, and scale-up innovations to improve efficiency, impact, and reach. Important commitments included Indian Prime Minister Narendra Modi’s announcement of a $100bn investment in health services by 2025.

How worried are you about the US “global gag rule” and its restrictions on US aid for abortion and family planning services?

While the full consequences of President Trump’s expanded version of the global gag rule are still unfolding, it is clear that access to essential reproductive health services is being impacted. Organisations like IPPF and Marie Stopes International that were implementing programmes with funding from the US government have had to reduce or eliminate family planning and other services, especially in sub-Saharan Africa . . . The rule is likely leading to an increase in unintended pregnancies and unsafe abortions.

What can richer countries learn from the partnership?

The Sustainable Development Goals and the UN global strategy for women’s, children’s and adolescents’ health are relevant for all countries. Improving health and wellbeing is one of the greatest investments that contribute not just to social development but also to economic growth. Stakeholders still operate in silos, which act as the biggest barrier to scaling up. More multisectoral collaborations will address health challenges in a comprehensive and integrated manner.


The dirtiest country on earth The FT mapped satellite data of fine particulate matter (PM2.5) — a measure of air quality — against population data to see how many people were affected by this type of dangerous pollution. The problem is most acute in India but it is not alone. See also: Climate change and the threat to global health.

News round-up

Congo crisis deepens Ebola cases in the Democratic Republic of Congo passed the 500 mark, with Unicef expressing deep concern about the number of children infected. The worsening crisis in the conflict-stricken country leaves the UN Security Council with few options. (Cidrap, The Conversation)

Infant mortality Nearly 30m babies each year are born too soon, too small or become sick and need specialised care to survive. Investing an extra $0.20 per capita could prevent two out of every three neonatal deaths by 2030. (WHO/Unicef)

Aids agency in turmoil UNAids, which heads the global fight against Aids and HIV, has been embroiled in a row over its “dysfunctional leadership”. Sweden, its second-biggest donor after the US, said it would withhold funding until Michel Sidibé, the agency's director, resigned. Mr Sidibé said on Thursday he would leave in June. Here's UNAids' own report. (Guardian, Al Jazeera)

Tracking health spending In 2016, the world spent $7.5tn on health, almost 10% of GDP. The average per capita was $1,000, but half of the world’s countries spent less than $350 per person, according to a new report and database. External aid makes up less than 1 per cent of the total, but its share of health spending in poorer countries is increasing. More than half of all external funding for health in low and middle-income countries is devoted to just three diseases: HIV/Aids, TB and malaria. (WHO)

WHO funding The World Health Organization explained plans to raise $14bn to meet its five-year goals. One of its new initiatives aims to help poorer countries better respond to emergencies. (Devex) 

Drug deals What began as an antitrust lawsuit over two drugs has morphed into an investigation of alleged price-fixing involving at least 16 companies and 300 medicines. (Washington Post)

Mental health matters What does the rise of the “self-care” industry — encompassing anything from eating healthily to getting a manicure — tell us about provision of care for mental ill-health? (Vice)

New for old A look inside the lab at the California Institute of Biomedical Research where scientists are busy examining a huge collection of drug compounds to find new uses for existing drugs. (Stat video, 3m)

McDonald's meat move The world's biggest fast-food chain said it would reduce the use of antibiotics in its beef, fuelling hopes that other restaurants would follow suit. There has been growing concern that overuse in farm animals is helping drive antimicrobial resistance in humans. (NPR)

Best from the journals

Human rights and health A look at how the human right to health has been interpreted since the second world war, from the birth of the WHO in 1946 to cold war tensions, international action against Aids and the new drive for universal health coverage. (The Lancet)

Road traffic accidents More than 1.3m people die from road traffic incidents each year, a number that has barely moved in the last ten years. Here's a neat visualisation of the latest data. (The Lancet, WHO)

Epidemic preparedness Developing suitable and timely diagnostics has been an expensive barrier to controlling and preventing disease. More should be done to accelerate tests, improve data sharing and smooth regulatory obstacles. (The Lancet)

Health inequalities New data showing a slowdown in life expectancy growth in England has prompted debate about its causes. Unwelcome trends include widening inequalities between rich and poor areas and a growing number of young adults dying from the likes of suicide and drug overdoses. (BMJ blog)

Sexuality and depression Depressive symptoms in adolescence increase at a higher rate for lesbian, gay and bisexual youth, who are four times more likely to self-harm than their heterosexual peers. (Lancet Child and Adolescent Health)

Food fears Does fast food have an unfair reputation for expanding our waistlines? An international study showed 95 per cent of restaurant meals — but only 72 per cent of fast food meals — contained 600 calories or more. Another report suggests a link between overeating males and the lifespans of their future grandsons. This video explains how calories are counted. (BMJ, Nature Communications)

Podcast of the week

War on obesity The tale of how Oklahoma — the city described as having the worst eating habits in the US — declared war on fat and became a laboratory for healthy living. (Mosaic, 22m)

Your thoughts on 2018 and beyond

What were your highlights and low points for global health this year? And what do you think will be the big themes for 2019? Email or tweet us @fthealth and we will feature the best responses in our year-end issue.

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Final thought

The trouble with girls Bias against female advancement in medicine and science manifests itself in many ways, from access to advanced education to invitations to speak at elite meetings. (BMJ)

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