OMigrant as Global health challenge - ICAR 2019

Migrant as Global health challenge
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Disclosure

          I have no conflict of interest to declare in relation with this presentation

Name       : Nicoara Corina
Association : NPS Italia ONLUS - sez. Sicilia

Everyone has the RIGHT…… medical care and necessary social services
                                     UNIVERSAL DECLARATION OF HUMAN RIGHTS

                                                       (ART 21- 25)

IN 2016 ABOUT 258 MILLION PEOPLE LEFT THEIR COUNTRY OF
ORIGIN WITH AN INCREASE OF 49% COMPARED TO 2000, WHEN THEY
WERE 173 MILLION AND 18% COMPARED 2010 WHEN THEY
CONSIDERED
220MILLION
                                                 UN REPORT 2017

HIV SITUATION IN THE WORLD

IN 2017 36,9 MILLIONS INFECTIONS HIV/AIDS IN THE WORLD

IN 2017 1,8 MILLIONS OF NEW HIV INFECTIONS

THE IMPACT OF HIV IS LOWERED BY 0,40% FOR 1000           PERSONS NON
INFECTED IN 2005 TO 0,26 FOR 1000 IN 2016

AFRICA, IS THE MOST AFFECTTED BY HIV WITH 1,24% FOR 1000 PERSONS
NON INFECTED IN 2016

MORE OR LESS 1 MILLION PEOPLE DEATH FOR HIV RELATED DISEASES , OF
WICH 120 000 CHILDREN OF AGE LESS THAN 15 YEARS

The New Diagnosis
•   AFRICA SUD-ORIENTALE: 800.000 (-30% between 2010 and 2017)
•   ASIA E PACIFICO: 280.000 (-14% between 2010 and 2017)
•   AFRICA CENTRO-OCCIDENTALE: 370.000 (-8% between 2010 and 2017)
•   AMERICA LATINA: 100.000 (-1% between 2010 and 2017)
•   CARAIBI: 15.000 (-18% between 2010 and 2017)
•   MEDIO ORIENTE E NORD AFRICA: 18.000 (+100% between 1997 and 2017)
•   EUROPA DELL’EST E ASIA CENTRALE: 130.000 (+100% between 1997 and 2017)
•   EUROPA OCCIDENTALE E NORD AMERICA: 70.000 (-8% between 2010 and 2017).

INCIDENZZA DEL HIV NEI PAESI DI PROVENIENZ A
DEI MIGRANTI PRESENTI SUL TERRITORIO ITALIANO

HOSPITALITY    accessibility                AUTONOMY

        Late Presentation to Care
          Mortality

              Increased healthcare costs

                      Risk of further transmission

MsM

  DRUG                 WOMAN
  USERS

             KEY
          POPULATION

  SEX
WORKERS                MIGRANTS

          PRISONERS

HIV in Europe

  The risk of importation of HIV by migrants
to Europe is LOW
Refugees and migrants are constituted 40% of the new
HIV diagnoses in the EU, of which 92% were occurring in
Western Europe
The most common work-related health conditions reported by labour
migrants in Europe include musculoskeletal, respiratory and mental
health.

….E IN ITALIA?
                          5 MILIONI MIGRANTI

52,4% proviene dall‟Europa (di cui 1,5 milioni da Paesi UE)
20,5% dall'Africa                                             IRREGOLARI NON STIMABILE
19,3% dall‟Asia
7,7% dall‟America
+ IMMIGRATI REGOLARI ISCRITTI 400 000

The Republic safeguards health as a fundamental right of the individual and as a collective
interest, and guarantees free medical care to the indigent. No one may be obliged to
undergo any given health treatment except under the provisions of the law[…]
                                                                 Art 32 Costituzione della Repubblica Italiana

In the population groups at risk the new HIV diagnoses are 4
times larger among the foreigners, compared to the Italians.
> 60% acquire the infection with heterosexual relationships and of these 2/3 are women.
  25.8% the diagnosis of HIV infection was placed at an advanced stage of illness
 The violence suffered in the migratory path, the living conditions and the risky post-migration rights
Italian data attest to the post-migration

Sex work is considered one of the high risk factors for the spread of HIV, because is not
formally considered a job, which limits them from obtaining residence and work permits.
In Italy 70.000 sw are estimated!

Regolare , o Irregolare ?
Lettera SIMM
•   1 DICEMBRE 2018 N° 132 è entrato in vigore il DECRETO SICUREZA , CHE
    ABOLISCE IL PERMESSO DI SOGGIORNO PER MOTIVI PROTEZIONE
    UMANITARI (legge Turco-Napolitano 286/1998)
GRAVE SITUAZIONE DI IRREGOLARITA’ E DI CONSEGUENZA NON
ACCESSO ALLE STRUTTURE SANITARIE E ALLE CURE MEDICHE
 LE SOCIETA’ SCENTIFICHE (SIMM,SIMIT,SIMET,SIPSA,AIPA, SOCIETA’
ITALIANA DI PSICOLOGIA DI COMUNITA’, Sitl, SOCIETA ITALIANA
PEDIATRIA) HANNO MANDATO UNA SEGNALAZIONE DI CRITICITA’ PER
LA TUTELA DELLA SALUTE INDIVIDUALE DI MIGRANTI E DELLE SALUTE
COLETTIVA ALLA MINISTRA DELLA SALUTE , On.le Dott.ssa Giulia Grillo

Segnalazione criticità applicazione L. 132/2018 su
possibilità di tutela della salute individuale di
migranti e della salute collettiva
                                         •   PNAIDS ratificato ott. 2018 conf.
                                             Stato.-Regioni

Criticality of access to care of migrants in Italy :
Unawareness of the rights of healthcare professionals and beneficiaries

 Health care organization

Limits of competence of health personnel

     Language and cultural barriers

Poverty

Proposals :
1.      Immunization programs

2.     Increase surveillance to identify new HIV cases through rapid tests

3.     Strengthen information campaigns on the treatment and prevention of diseases

4.     Building bridges between public institutions, NGOs and host communities, offering
     immigrants decent living conditions, appropriate care and integration pathways
5.      To train social workers and cultural mediators

NPS Italia e le sue Sezioni in AZIONE

IL 28/05/2019 L’Assessorato della Salute , Regione Sicilia ha comunicato la
«Ricostruzione Commissione Regionale AIDS» , di cui anche NPS Italia sez
Sicilia ONLUS farà parte con un rappresentante

Il 26 /06/2019 è prevista la Convocazione del Tavolo Misto dell’Istituto Nazionale per
le Malattie Infettive « L. Spallanzani « dove si unirano le Organizzazioni di
Volontariato e le Associazioni di pazienti, e di cui NPS Italia ONLUS sarà parte
componente

MONITORAGGIO MIGRANTI E HIV

L’APE della Prevenzione

                          Grazie per l’attenzione