Securing Borders: The Danger of Blurring Global Migration Governance and Health Security Agendas in Southern Africa

This paper explores the potential risks associated with the blurring of global migration governance and health security agendas in Southern Africa, a region associated with high levels of population mobility as well as communicable and, increasingly, non-communicable diseases. The current development of the Global Compact on Safe, Orderly and Regular Migration and the Global Compact on Refugees – agreements that aim to guide global practice – has a securitisation agenda at its core. This framing responds to the global moral panics associated with the movement of people across national borders. These increasingly nationalistic and racist panics are dangerous for multiple reasons, and the securitisation agendas of the global compacts risk negatively affecting health in Southern Africa in two ways. Firstly, increased securitisation may undermine much-needed efforts to develop migration-aware and mobility competent cross-border, regional health system responses. Concerns include the ways in which an increasingly securitised migration management system will likely result in a growing population of irregular migrants who, owing to fear of arrest, detention and deportation, will avoid (and evade) public healthcare services, with negative consequences for all. Secondly, the development of (im)migration interventions centred around a securitisation approach may provide opportunities for co-opting components of the global health security movement – itself a problematic and contested terrain – by using health status (or perceived health risk) as an additional securitisation measure through which to further restrict movement across national borders and/or to justify deportation of non-nationals. This could be achieved through compulsory health screening, risk assessments and health-related restrictions on movement across borders. Collectively, these processes risk producing challenges that will further stall progress towards global health goals by undermining attempts to develop coordinated, cross-border, migration-aware and mobility-competent health programmes. In addition, they risk deterring irregular cross-border migrants from accessing prevention and treatment programmes for both communicable and non-communicable diseases. If these concerns are not addressed proactively, the consequences could be devastating for both Southern Africa and the global community.