INTERNATIONAL MIGRATION PAST, PRESENT, AND FUTURE (original) (raw)

OVERVIEW Opening presentations by Mark Miller of the University of Delaware and Brian Gushulak of the Canadian Immigration Department Health Branch set the context for this workshop by exploring the history and ongoing political and public health significance of human migration and mobility. Their contributions to this chapter establish a firm foundation for those that follow, providing both a wealth of detail and an overarching view of the changing picture of human migration through the ages, and particularly during the recent decades. Miller's essay reviews human migratory history, focusing on the contemporary " Age of Migration " that began around 1970. This era " has witnessed major developments in human mobility affecting all areas of the world, " Miller writes. " Understanding this still evolving global migratory context bears importantly upon comprehension of contemporary microbial threats. " Conversely, he notes the importance of health issues to the study of migration and security, particularly in recent years. Miller examines the geopolitical origins of the present Age of Migration and examines its defining features. These he characterizes as the globalization, acceleration, differentiation, politicization, feminization, and proliferation of migration in the traditional sense (the one-way movement of people from one homeland to another); the advent of formal mechanisms supporting " circular " migrations such as guestworker programs; and the growth of international tourism. Reflecting on the future of migration and development, and recognizing that " the chief threats to U.S. security since the 1970s arose from failed states and the abysmal living conditions of average people in much of the world, " Miller advocates a stronger commitment on the part of the United States to development in Africa, the Middle East, and other developing countries, including increased admissions of permanent residents from these regions. In his subsequent contribution, Gushulak, along with his colleague Douglas MacPherson, of McMaster University and Migration Health Consultants, Inc., presents a comprehensive history of migration-associated disease and disease control policies. The authors characterize " modern migration " —the mechanism that drives Miller's " Age of Migration " —in terms of its departure from traditional migratory patterns, and explore the challenges it presents for global health, and particularly for the control of infectious diseases. In order to " shift the paradigm " of disease control away from policies focused on geopolitical borders and individual infectious diseases, Gushulak and MacPherson introduce the concept of " population mobility " to replace traditional considerations of migration. " Considering mobility as a global health determinant provides a model upon which we can integrate disease management policies, processes for prevention, knowledge of disparate prevalence environments, and a rigorous health threat to risk assessment ability, " the authors write, and they suggest several approaches to the control of mobility-related disease to support this model.