MAPHM supports the Marseille Statement put forward by EUPHA and we empower the Maltese Government:
- Leave no one behind, by ensuring that migrants are not left behind in policies on health and their needs are fully addressed in health systems; and
- Translating knowledge, by promoting evidence-informed health policies, taking into consideration cultural and language differences.
We look forward to collaborate with the relevant authorities to support relevant initiatives and projects.
The Marseille Statement: Building bridges for solidarity in public health
November 2019
The European Public Health Association, the Société Française de Santé Publique – French Public Health Society – and the undersigned, meeting at the European Public Health Conference in Marseille in November 2019, urge all governments to honour the commitments undertaken in pursuit of the Sustainable Development Goals, and specifically the pledge of ensuring healthy lives and promoting well-being for all (related to goal 3, but also many of the other goals)[1]. This year at our conference in Marseille, we focus on building bridges for solidarity in public health. Marseille as a harbour city in the South of France, located at the Mediterranean Sea, symbolises not only the border but also the bridge between Europe and other countries bordering the Mediterranean Sea. In the last decade, the Mediterranean Sea has emerged as a very dangerous border for those trying to cross in unseaworthy vessels to reach Europe. This humanitarian crisis calls for reinforcement of intersectoral collaboration to promote health and wellbeing globally, nationally and locally.
We, gathered here in Marseille, therefore call upon national and international decision-makers to intensify efforts to build bridges for solidarity in public health. Particular attention should be given to:
- Leaving no one behind, by ensuring that migrants are not left behind in policies on health and their needs are fully addressed in health systems; and
- Translating knowledge, by promoting evidence-informed health policies, taking into consideration cultural and language differences.
Leaving no one behind
The ‘health for all’ frameworks (such as the International Covenant on Economic, Social and Cultural Rights (UNHCHR 1976)), undersigned by all countries in the European region, identify access to healthcare as a basic human right for everyone. Governments that have made these commitments must be held accountable for providing healthcare to asylum seekers and undocumented migrants. Following from the ‘health for all’ principle and considering the ‘health in all policies’ principle, health should also be included in migration policies. More concretely, no one seeking asylum or without appropriate documentation should die or be put in danger by limited or no access to healthcare.
Translating knowledge
On a policy level, the emergence of the anti-science movement and anti-immigration sentiment risk undermining our health policies. Science is increasingly criticised and ignored by parts of society. The anti-science movement is negatively impacting achievements made in health (e.g. false information about vaccination is lowering vaccination rates) and creates confusion about health-related issues (e.g. the discussion about the use and misuse of electronic cigarettes). This undermining of science needs to be combatted. Scientific evidence alone may not be enough when facing a strong anti-science voice. Deliberate strategies to oppose false information are also needed. At the same time some contemporary societies are exposed to an anti-immigration sentiment. These two developments could lead to politically coloured health policies that increase health inequities for migrants. When translating health research and knowledge to policy and advocacy, a public health narrative needs to be created that supports our vision of more health equity.
At the individual level, the multiple diverse cultural backgrounds and languages in our societies must be taken into account. It is important to develop a public health narrative that tells a story to which people can relate in a language they can understand and in a context they know. Health literacy considerations need to be made to avoid health inequities in migrants. Going further on this issue of language as a true issue for public health effectiveness and recognition is a true ‘bridging’ issue and requires more work in the future.
Continued commitment by the public health community
The public health community reiterates its commitment to the values and principles of the Alma Ata Declaration[2], adopted in 1978; the Ottawa Charter[3], adopted in 1986; the Tallinn Charter[4], adopted in 2008; and the Vienna Declaration[5], adopted in 2016.
The public health community:
- takes its responsibility for supporting migration policies;
- is determined to the value of solidarity through the health for all policies approach;
- and calls for action to combat inequities in health.
[1] Health in the SDG Era. WHO, 2015. http://www.who.int/topics/sustainable-development-goals/sdg-banner.jpg?ua=1 (accessed 19 June 2019).
[2] Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. (2004). Development, 47(2), pp.159-161. Available at https://www.who.int/publications/almaata_declaration_en.pdf, last accessed 9 August 2019.
[3] Ottawa Charter for Health Promotion. (1986). Health Promotion International, 1(4), pp.405-405. Available at http://www.who.int/healthpromotion/conferences/previous/ottawa/en/, last accessed 16 July 2018.
[4] Tallinn Charter: Health Systems for Health and Wealth. Copenhagen: WHO Regional Office for Europe; 2008. Available at http://www.euro.who.int/__data/assets/pdf_file/0008/88613/E91438.pdf, last accessed 9 August 2019).
[5] McKee M, Stuckler D, Zeegers Paget D, Dorner T. The Vienna Declaration on Public Health. Eur J Public Health 2016; 26: 897–98. Available at https://ephconference.eu/repository/publications/Vienna_Declaration_final_version.pdf, last accessed 16 July 2019.