COVID-19 VACCINE IN AFRICA

By: Rebecca Walker, Nicholas Maple & Jo Vearey

Researching Migration & Coronavirus in Southern Africa (MiCoSA)
June 2021

This occasional paper is the start of a series that explores the impacts of COVID-19 and ensuing responses on migration and the wellbeing of migrant and mobile communities in Africa. This paper provides insight into how vaccine nationalism is impacting the rollout of vaccination programs, including the inclusion or exclusion of migrant groups. The paper demonstrates that

“the vast majority of international migrants, refugees, asylum seekers and IDPs are being excluded from state-based vaccine roll-out programmes either via formal policy directives or through various forms of de facto exclusion, such as barriers to access healthcare at the local and national level. These forms of exclusion are likely to have far-reaching public health implications across the continent, affecting both citizens and migrants alike.”

Page 3, “Migrants & the COVID-19 Vaccine Roll-out in Africa: Hesitancy and Exclusion”

To view the other papers in the series, see http://www.mahpsa.org/micosa

About MiCoSa

The Migration and Coronavirus in Southern Africa Coordination Group (MiCoSA) is hosted by the Migration and Health Project Southern Africa (maHp) at the African Centre for Migration & Society (ACMS), Wits University, Johannesburg. MiCoSA is an informal network of migrant-led organisations, non-governmental organisations, international organisations, civil society, activists, lawyers, researchers, government officials and policy advisors. Through an online platform and virtual meetings, MiCoSA brings together national and SADC regional partners who are concerned with the health and well-being of asylum-seekers, refugees and migrants during the current Coronavirus pandemic. To date, MiCoSA has over 150 members; to join this network, please email coronavirusmigration+join@googlegroups.com

Get involved! Reviewing publications for the iom migration health evidence portal for covid-19

The IOM Migration Health Division (MHD) Research and Epidemiology Unit is currently updating the Bibliometric Analysis of COVID-19 in the Context of Migration Health full paper and repository, harnessing relevant research publications on COVID-19 in relation to migrants, migration, and human mobility. See Migration Health Evidence Portal for COVID-19, for reference.

To efficiently do this, we are seeking the help of interested MHADRI members, specifically in screening and tagging relevant publications in which MHADRI members can participate as reviewers. The MHD Research and Epidemiology Unit will then organize and deliver a quick training for the reviewers to guide them on the step-by-step process. Rest assured too that we will acknowledge your work in the paper.

Those interested may contact the MHD Research and Epidemiology Unit at mhdrap@iom.int. Deadline for submission: 5th Feb 2021.

European Borders, COVID-19, and the Economy of Home Care

Ursula Trummer, PhD (August 25, 2020)

This article examines the impact that COVID-19 has had on the movement of migrant healthcare workers throughout Europe. Dr. Trummer specifically focuses on how the shutting of borders (with a specific case study on the border between Romania and Austria) has restricted low-income 24-hour care providers who depend on free movement in order to complete their shifts:

“For the European Union, free movement of EU citizens within EU is an important element of the very idea of a united Europe. The right to freedom of movement is guaranteed by Article 21 of the Treaty on the Functioning of the EU (TFEU). It states that “Every citizen of the Union has the right to move and reside freely within the territory of the Member States.”This should especially serve the further development of a European economy, where a European work force can fulfil labor market demands where needed across national borders.
 
The COVID-19 pandemic changed that. All of a sudden, the European Union got fragmented again into 28 national states each with their respective responses to the pandemic. National public health policies demanded the closure of national borders and overruled the freedom of movement. As health issues of EU member states are subject to national regulations, countries established different policies of border control and regulations on who is allowed to travel under which circumstances, and how matters of quarantine are handled. National borders were seen as the most important checkpoints for controlling the spread of COVID-19.
 
Ironically, this has a tremendous negative consequence especially for the health care sector in rich EU countries which depend on migrant health care workers. The closure of EU-internal borders furthermore revealed the relevance of a borderless EU for another important health issue: care for the elderly. Countries like Austria are characterized by an ageing population and consequently elder care, either in nursing homes or at home, has become a major challenge.”

Austria depends heavily on care providers from Romania, and COVID-19 has impacted their ability to travel immensely. Read the rest of the article for more detail.

Migration Health Evidence Portal for COVID-19

This evidence portal is a repository of research publications and high-yield evidence briefs on COVID-19 and its intersection with migration health.

The scientific literature and knowledge base on the epidemic rapidly expand daily. Tremendous efforts are being made by the global community of clinicians, researchers and journal editors to advance scientific evidence to guide policy and decision making at the field level. However, there is a need to build evidence platforms to share and distill key findings emergent from this growing body of scientific literature that is relevant to migration, health, and human mobility to ultimately assist evidence-informed decision making from a migration lens.

The portal contains:

Research Publications on COVID-19 and Migration Health

This section reflects the output of the publication mapping exercise involving the quantitative assessment of a set of published scientific articles (i.e., bibliometric analysis) on COVID-19 with reference to migrants, migration, and human mobility. Bibliometric analysis provides an important snapshot of a specific field of interest/domain. The baseline information from bibliometric analysis helps identify research gaps that future studies can investigate. The bibliometric analysis conducted by IOM and MHADRI on international migration and health is one example.

Key messages

  • As of 30 March 2020, the publications related to COVID-19 totaled 21,779 (no restriction set in terms of language and subject area). From this, a total of 43 publications were relevant to migration health and human mobility.
  • Most of the studies investigated the cases and disease transmission dynamics of COVID-19 in the context of national and international population movement, with most studies undertaken in China. The distribution of research to date indicates the role of travel and migration in the importation of the virus.
  • Research on the epidemiology of the disease among migrant groups such as migrant workers, internally displaced persons (IDPs), refugees and asylum seekers is lacking. Evidence with attribution to migrant groups within clinical datasets are seldom reported.
  • Despite multiple studies from high-income countries (HICs) using mathematical modelling to predict spread, and model social distancing, border closures and impacts on health care system capacities, there were only a few studies that model outbreak in low-to-middle-income countries (LMICs) contexts. None hitherto have focused on camps and camp-like situations.
  • There is a real need to strengthen the current knowledge base on the epidemiology and social determinants of COVID-19 and examine health-related outcomes in specific migrant groups, especially migrant workers.
  • Investigations on COVID-19 and migration health should not be limited to the role of movement/mobility in the dynamic importation of cases in a pandemic; a more inclusive research strategy that integrates the relevant interests of migrant populations should be considered.
  • Advocating for the right to health of migrants and migrant inclusion within the global, regional, national and sub-national pandemic preparedness and response plans is of critical importance.
  • The most productive authors and institutions come from Hong Kong, whose geographical proximity to and socio-economic ties with China were likely contributing factors in their early contributions to the field.

Network map of common keywords

The network map below shows an overview of the common keywords that appear in the title, abstract, and keywords of the relevant publications retrieved on the topic of COVID-19 and migration health. Network maps of keywords reveal key topics in a research area or domain as well as the relationship (co-occurrence) between common keywords. It is a relative indicator of important research areas that are drawing attention in the field. 

  • The large circles in the figure represent the most frequently occurring author keywords in the research publications (N=43) such as ‘pneumonia’ (n=26), ‘epidemic’ (n=22), ‘travel’ (n=19), ‘quarantine’ (n=18), ‘outbreak’ (n=15), and ‘disease transmission’ (n=14). 
  • The lines connecting the circles represent the co-occurring keywords. The distance between two keywords approximates how strongly the words are related based on the number of their co-occurrences (i.e., the more publications in which two keywords co-occur, the stronger the relation between them). Thus, the strongly related words appear closer together on the map. 
  • Each distinct color represents a cluster of keywords that are strongly related to each other. In the figure, ‘pneumonia’, ‘travel’, and ‘disease transmission’ are strongly related to ‘virology’, ‘animals’, ‘nonhuman’, ‘zoonosis’, ‘fever’, ‘genetics’, and ‘pandemic’ (red cluster). The keyword ‘epidemic’ is strongly related to ‘outbreak’, ‘quarantine’, ‘mass screening’, ‘air travel’, ‘travel medicine’, ‘global health’, ‘infection control’, and ‘risk assessment’ – these keywords are shown to be closer together forming the green cluster. 
  • These topics on COVID-19 and migration health can be classified into the following thematic areas: disease epidemiology (i.e., travel, disease transmission, virology, animals, nonhuman, zoonosis, genetics, pandemic); clinical management (i.e., pneumonia and fever); and public health intervention (i.e., quarantine, control, etc.).

Note: See the full paper for the Methodology and Limitations of this analysis.