The manner in which international organizations (IOs) deal with vulnerable groups (VGs) has implications for the study of International Organization. Vulnerability provides an uncommon, but useful, vantage point from which to examine some of the strengths and shortcomings, as well as the relevance and challenges, of IOs. For IOs, the questions of “who is (considered to be) vulnerable” and “who does what, when, and how to address vulnerability?” need to be answered from both an empirical and a normative perspective. In this respect, it is important to highlight the different definitions, disciplinary perspectives, and evolving paradigms on vulnerability. Addressing the plight of VGs, specific IOs help people at risk or in need, especially when states are either unwilling or unable to do so. Yet VGs have usually struggled to make their voices heard, while structural causes of vulnerability have been hard to address. When aid arrives, it often is late, inadequate, or has unexpected side effects. Implementation of IO policies to support VGs usually lags behind norm development. Still, IOs have carried out considerable work to support VGs.
Dennis Dijkzeul and Carolin Funke
Valeria Marina Valle, Caroline Irene Deschak, and Vanessa Sandoval-Romero
International migration flows have long been a defining feature of the Americas and have evolved alongside political and phenomenological shifts between 2009 and 2018, creating new patterns in how, when, and why people move. Migration is a determinant of health, and for the nations involved, regional changes create new challenges to defend the universal right to health for migrants. This right is repeatedly guaranteed within the global agenda, such as in the 1948 Universal Declaration of Human Rights by the United Nations; the 1966 International Covenant on Economic, Social, and Cultural Rights; and the 2015 United Nations Sustainable Development Goals (SDGs), especially SDG 3 regarding health and well-being, and SDG 10, which aims to reduce inequalities within and among countries. The 2018 Global Compact for Safe, Orderly and Regular Migration confirms a worldwide partnership highlighting protection of migrants’ right to health and services. The literature reviewed on migration and health in the Americas between 2009 and 2018 identifies two distinct publication periods with different characteristics in the Central and North American subregions: 2009 to 2014, and 2015 to 2018. The first period is characterized by an influx of young adult migrants from Central America to the United States who generally traveled alone. During the second period, the migration flow includes other major groups, such as unaccompanied minors, pregnant women, disabled people, people from the LGBTIQ+ community, and whole families; some Central Americans drew international attention for migrating in large groups known as “caravans.” In South America, the 2010–2015 period shows three defining tendencies: intensification of intra-regional cross-border migration (with an 11% increase in South American migrants from 2010 to 2015 and approximately 70% of intra-subregional migration), diversification of countries of origin and extra-regional destination, and the persistence of extra-continental emigration. Social determinants of health have a foundational relevance to health and well-being for migrants, such as age, housing, health access, education, and policy environment. Guiding theories on migration and health include Push-and-Pull Theory, Globalization Theory, Transnationalism, Relational Cultural Theory, and Theory of Assimilation. Migration and health was analyzed through the lens of five disciplines (Management, Social Work, Communication, Education, Information Science & Library Science, Law): clinical medicine, social sciences, health (general), professional fields, and psychology. There is an overrepresentation of literature in clinical medicine, demonstrating a strong bias towards production in the United States. Another gap perceived in the literature is the minimal knowledge production in South America and the Caribbean, and a clear bias towards publication in the North American continent. At the regional level, the Pan American Health Organization (PAHO)’s agenda serves to highlight areas of success and opportunities for future research, particularly in two areas: strengthening partnerships, networks, and multi-country frameworks; and adopting policies, programs, and legal frameworks to promote and protect the health of migrants. As these strategic lines of action aim to provide the basis for decisions regarding migrant health in the region, they should be considered two important avenues for further academic exploration.