More than 60 countries now include refugees and migrants in their national health policies, according to a new World Health Organization (WHO) report tracking progress on commitments first set out by the World Health Assembly in 2019.

The finding, drawn from a survey of 93 member states, is the first systematic count of how countries are implementing a resolution that called on governments to ensure refugees and migrants have access to health services, are included in national health planning, and are counted in health data systems.

“Many countries have begun integrating refugee and migrant health into national strategies,” said WHO Director-General Tedros Adhanom Ghebreyesus. “Yet gaps remain, particularly in collecting and using migration-related health data, ensuring participation of refugees and migrants in decision-making, and guaranteeing access to care for all, regardless of legal status.”

“Like anyone else, refugees and migrants need uninterrupted, affordable and equitable access to health services wherever they are,” Tedros said.

While WHO called the findings “encouraging,” the picture the report paints is difficult to read clearly. What “inclusion in a national health policy” actually means for care access for migrants and refugees varies widely – and the report does not name which countries fall where.

Two-thirds of the 93 surveyed countries said they include refugees and migrants in their health policies. When asked what level of access different groups receive, 16 countries said refugees can access services on a par with the host population, 14 extended that standard to documented migrant workers, and 11 to asylum seekers.

No country surveyed reported providing equal access to migrants in irregular situations – those living without legal status or formal documentation. The positive examples the report does name – from Belgium to Chile – are presented as case studies.

Only 37% of countries routinely collect and disseminate migration-related health data. Fewer than 40% train health workers in culturally responsive care. Just 30% have run campaigns to counter misinformation or discrimination, the report found. The report is the first systematic quantification of these indicators, further blurring the picture of progress, as there is no baseline to compare against.

The data is also entirely drawn from a voluntary survey completed by member states with no independent verification, meaning the results are unvetted self-assessments.

The report explicitly does not rank countries on the success, impact or implementation of their policies, and “did not assess the level of implementation or impact of any given initiative,” meaning real-world outcomes “cannot be evaluated,” it said.

The survey also contains no questions about financing, meaning a country can report including refugees in its national health policy while allocating no dedicated budget to deliver on it.

“Rather than ranking countries on their progress,” the report notes, it seeks to identify how key gaps can be addressed going forward.

The report comes as conflict, climate change and economic insecurity displace more people than ever before.

More than one billion people live as refugees or migrants worldwide, though over 800 million remain within their own borders. There are 405 million international migrants, 36.8 million refugees, 8.4 million asylum seekers and 83.4 million internally displaced people.

Dr Santino Severoni, head of WHO’s Special Initiative on Health and Migration and lead author of the report, said it was intended as a roadmap for coordinated action across governments, UN agencies, civil society, academia and migrant communities themselves.

“The health of refugees and migrants is not a marginal concern: it is a defining issue of our time,” Severoni said. “By acting now, countries can ensure that refugees and migrants are not left behind, and that health systems are stronger, fairer and more prepared for the future.”

Data ’emergency’, exclusion from emergency plans 

The new report follows a first edition published in 2022, which was a literature review of around 82,000 documents that established the scale of health disparities facing refugees and migrants worldwide. Two further progress checks are planned for 2027 and 2029, ahead of the 2030 deadline set by WHA member states for full implementation.

The 2022 report identified fragmented data collection as the central structural obstacle to effective policy. That remains unresolved. Severoni described the situation as “almost an emergency.”

“It’s not because data is not collected, but because they are collected in a very fragmented way, which makes it very, very difficult for us to have a full picture,” he said.

Just 42% of countries include refugees and migrants in emergency preparedness or disaster risk reduction plans. Irregular migrants – those without legal residency status – are entirely absent from those frameworks, even as the crises that drive displacement, from war to climate-related disasters, intensify.

“We cannot talk about refugee and migrant health without also addressing emergencies,” said Dr Chikwe Ihekweazu, WHO’s executive director for health emergencies. “Whether it’s a conflict, a climate-related crisis or an epidemic that forces movement, these crises expose the fragility of health systems and magnify the vulnerabilities of all those already at risk.”

“This is not only an equity issue — it is a global health security risk,” he added. Excluding displaced populations from health systems, he said, weakens the collective capacity to detect and respond to outbreaks and crises. “Health does not begin and end at borders.”

WHO is calling on governments to strengthen disaggregated health data collection, tailor policies to specific migrant groups including those in irregular situations, involve refugees and migrants in health governance, train health workers in culturally responsive care, and protect and expand financing.

“The phenomena of displacement is unfortunately happening more frequently in countries with fragile systems, fragile economies and limited domestic resources,” Severoni said. 

“There is almost no mention of irregular migrants in those emergency plans and response or in disease risk reductions, there is no systematic approach in assessing the system to see how their system is really functioning, how efficient and effective it is.”

“This is really a call for action to keep the promise of sharing a bit of responsibility in managing those emergencies,” he added.

Political wave washes away progress

The report highlights progress in some countries. Chile has embedded migrant community representatives in municipal health councils, with direct input into maternal and mental health priorities.

Belgium has run a national intercultural mediation programme since 1999; as of late 2024, 113 trained mediators were working across 76 hospitals and community health centres.

Yet the report’s release comes as several wealthy nations move to restrict refugee and migrant healthcare, driven by economic pressures and political campaigns questioning whether asylum seekers and refugees should be entitled to publicly funded care.

In the United States, legislation passed in 2025 changed the definition of “eligible alien” for Medicaid eligibility, cutting coverage for many lawfully present immigrants, asylees, refugees, and trafficking and domestic violence survivors.

On 1 May, its northern neighbour Canada will start requiring refugees and asylum seekers to pay out of pocket for essential health services previously covered under its Interim Federal Health Program. 

The programme “has provided basic health coverage to people fleeing war, genocide, torture, and persecution since 1957,” according to the Migrant Rights Network. Services affected include medications, dental care, mental health, vision and physiotherapy.

Across the Atlantic, Germany extended to 36 months the period in which asylum seekers are restricted to emergency-only care, doubling the previous threshold of 18 months.

In France, a similar fight is playing out over the future of its Aide Médicale de l’État programme, which provides medical care to undocumented migrants. Critics say the programme encourages migration and is an undue cost to taxpayers, though it accounts for just 0.5% of national public health spending.

International funding for refugee health has also fallen sharply. UNHCR’s 2025 budget stands at $10.6 billion, of which only 23% had been secured at mid-year. The agency has warned that up to 12.8 million displaced people could be left without life-saving health interventions this year.

“Around the world, more than one billion people are on the move, seeking safety, opportunity and dignity,” Tedros said. “Investing in refugee and migrant health is both ethically essential and strategically beneficial. Supporting their health and inclusion strengthens health systems and benefits everyone.”

Image Credits: Wikipedia Commons.