A/HRC/23/41 I. Introduction 1. Contemporary international labour migration is propelled by globalization and neoliberal economic policies that promote deregulation of labour markets, including the flow of cheap, low-skilled labour.1 An estimated 105 million individuals currently work outside their country of birth.2 Remittances from migrant workers, which exceed Official Development Assistance to developing countries,3 contribute significantly to growth in household economies and improve the underlying determinants of health such as housing and education. The impact of the migration process on a migrant worker‟s health can be significant, and where poorly managed, may outweigh any economic and social benefits. 2. This report addresses the enjoyment of the right to health of individuals who migrate from one country (sending State) to another country (receiving State) for paid employment and who work in low-skilled or semi-skilled industries in receiving States. The scope of the report is restricted to migrant workers because certain issues, like those related to recruitment agencies, compulsory testing and occupational health, give rise to serious violations of the right to health and therefore warrant a separate inquiry. Nonetheless, concerns such as access to health care in receiving States are faced similarly by other migrants, such as refugees, and the analysis can indeed be extended to all groups of migrants. Some individuals migrate through official channels, others through informal ones, while others ebb in and out of both. The term “irregular” has been used to cover migrant workers who live or work in the receiving State without authorization, whereas “regular” refers to migrant workers with authorization to live and work in the receiving State. The report pays particular attention to work in construction, domestic work, sex work and agriculture, as examples of dirty, dangerous and degrading jobs (3D jobs) that these migrant workers frequently fill. 3. Migrant workers often commence the migration process as relatively healthy individuals.4 However, the complexity and diversity of circumstances throughout the various dimensions of the migration cycle may render them highly vulnerable to poor physical and mental health outcomes, compromising the enjoyment of other rights.5 For instance, irregular migrant workers may face extreme health risks during transit owing to hazardous conditions such as being cramped or hidden in boats or trucks.6 They may also face physical and sexual violence during transit. 7 Limited or no health care during transit and in transit countries may further increase the burden of disease, including untreated non- 1 2 3 4 5 6 7 Mode 4 of the General Agreement on Trade in Services, for example, aims to free up borders for services without requiring States to guarantee protections for migrant workers. See Tomer Broude, “The WTO/GATS Mode 4, International Labour Migration Regimes and Global Justice,” Research paper No. 7-07 (May 2007), p. 28. International Organization for Migration (IOM), Labour Migration web page, available from http://www.iom.int/cms/en/sites/iom/home/what-we-do/labour-migration.html. World Bank (WB), Migration and Development Brief 19 (2012), p. 1. A/HRC/14/30, para. 23. IOM, Migrant Health for the Benefit of All (2004), document MC/INF/275. IOM, “Migration: A social determinant of the health of migrants,” Background paper (2006), p. 8, available from http://www.migrant-health-europe.org/files/FINAL%20DRAFT%20%20IOM%20SDH.pdf.. IOM, Migrants’ needs and vulnerabilities in the Limpopo Province, Republic of South Africa, Report on Phase Two, February-March 2009 (2009).. 3