The protection of the right to health for refugees in Africa requires urgent attention, especially when evidence shows that new variants of the Covid-19 virus are spreading. In the wake of World Refugee Day on 20 June 2021, and against the backdrop of the UNHCR’s theme: “Together we heal, learn and shine”, it is pertinent that we interrogate how African countries are ensuring that the right to health of refugees is guaranteed. This is particularly important with the development of Covid-19 vaccines worldwide, and in the administration of these vaccines in Africa.  

Existing research underlines the need for heightening refugees’ access to health facilities. Research further shows that refugees in Africa have been particularly hard hit by the Covid-19 pandemic. This situation is further compounded by the fact that many refugees live in overpopulated camps or reception centres, where they lack adequate access to health services, clean water and sanitation. This makes them even more vulnerable to contracting Covid-19.

Prior to the pandemic, xenophobia in health facilities and lack of legal status were revealed as the most significant barriers to refugees accessing healthcare in South Africa. These barriers have been exacerbated by the pandemic, thus heightening the risk of poor health among refugees. Refugees, particularly women, are still faced with the challenge of accessing healthcare services such as Covid-19 testing. This has led to the fear of approaching hospitals for testing and has affected their emotional wellbeing and mental health.  

President Cyril Ramaphosa delivered a speech on 1 February 2021 where he assured that the vaccine roll-out plan would include migrants. Prior to this, the Minister of Health had, in several speeches on the vaccine roll-out, only made reference to South African citizens.

To date, the Department of Health has failed to provide any direction about vaccination arrangements for non-citizens. This has led to various responses from civil society organisations demanding that the department provides clarifications.  

In Kenya and Uganda, studies show that many refugees do not have access to tailored, trustworthy information about Covid-19. This has led to constant exposure to rumours, harmful and incorrect information which can have severe effects on the continued spread of the virus. The impact of the first wave of the pandemic had a devastating effect on the lives of refugees in Uganda. Since the lockdown in March 2020, refugees in Uganda have struggled to access healthcare services, which has led to the loss of lives. This situation continues. The complaints of refugees in Uganda over accessing basic information about the vaccine shows a backlog on the part of the government in addressing this.      

In Mali, the most distressing Sexual and Reproductive Health (SRH) care challenges women face are in the areas of accessing family planning, pre- and postnatal care, and assistance for victims of gender-based violence (GBV). The Covid-19 pandemic contributes to these challenges. For example, the fear of contracting Covid-19 has caused a low turnout of women in hospitals. The pandemic has also caused a decline in accessing healthcare since public health advisers have become limited. Moreover, most funding is targeted at the Covid-19 response measures and many experts are unable to operate at an optimum as a result of travel bans.

Refugees in Democratic Republic of the Congo still struggle with accessing quality healthcare services as many of them reside in communities that lack health facilities, or with ill-equipped and under-staffed health centres that face frequent shortages of drugs.

In Libya, refugees who are ambushed while crossing the Mediterranean Sea and eventually taken to detention centres are not guaranteed access to healthcare services. These refugees are supported by humanitarian organisations, but these organisations have a limited presence in Libya.   

The African Charter on Human and Peoples’ Rights sets out in article 16 that “every individual shall have the right to enjoy the best attainable state of physical and mental health”.    

The African Commission, in its 449 Resolution on Human and Peoples’ Rights as a central pillar of a successful response to Covid-19 and recovery from its socio-political impacts, urges states to “observe the principle of non-discrimination in accordance with article 2 of the African Charter by ensuring that protection is extended to refugees”.

The African Commission also condemns “all violations of rights to which asylum seekers, refugees and migrants have been directly or indirectly subjected in the context of the management of the Covid-19 pandemic in states parties to the African Charter and its Protocols”.  

Since the outbreak of Covid-19, the World Health Organization and United Nations have adopted guidelines and checklists for the protection of human rights. This includes access to healthcare during the enforcement of Covid-19 measures and addressing inequality in vaccine roll-outs.   

UN Secretary-General António Guterres has tweeted that “vaccine inequity is not only unjust it’s also self-defeating.”

In this regard, governments should incorporate the vaccination of refugees in their national policies and Covid-19 mass vaccination programmes. This should include every person notwithstanding their citizenship status. Inclusion should go beyond just speaking and preparing for Covid-19 vaccines and should be seen in practice.  

Governments can also ensure fairness in the distribution of the vaccine by preventing healthcare authorities from distributing the personal information of refugees to immigration officers. This will protect the refugees from the risk of deportation, therefore creating trust in the system, encouraging refugees to turn up for vaccination.   

And to allay the fear of refugees and encourage them to seek healthcare services, correct information about the spread of Covid-19 should be circulated and safety measures must be ensured in health facilities. DM

Information pertaining to Covid-19, vaccines, how to control the spread of the virus and potential treatments is ever-changing. Under the South African Disaster Management Act Regulation 11(5)(c), it is prohibited to publish information through any medium with the intention to deceive people on government measures to address Covid-19. We are, therefore, disabling the comment section on this article in order to protect both the commenting member and ourselves from potential liability. Should you have additional information we should know about, please email [email protected]