1. Workshop 1.5 Title: Globalization: Trade, Population Mobility and International Security Organizers: W. Kwong, DW MacPherson Presenters: 1. DW MacPherson. Globalization: the inter- dependency of population mobility, security and trade 2. M Riestra Venegas. Migrant Labour - Mexico and the USA. 3. N Motus / J Weekers. Globalizing Public Health. 4. P Van Krieken. The relationship between health and migration.

2. Globalization: the inter- dependency of population mobility, security and trade Douglas W. MacPherson MD, MSc(CTM), FRCPC

3. International Metropolis - Vienna, September 15-19, 2003 3 What is “Globalization” ? "It is yet another Civilized Power, with its banner of the Prince of Peace in one hand and its loot-basket and its butcher-knife in the other." -- Mark Twain, in his essay, To the Person Sitting in Darkness, 1901, describing the United States playing the European-style imperialist game in the Philippines.To the Person Sitting in Darkness

4. International Metropolis - Vienna, September 15-19, 2003 4 What is “Globalization” ? "For globalism to work,...The hidden hand of the market will never work without a hidden fist -- McDonald's cannot flourish without McDonnell Douglas, the designer of the F-15. And the hidden fist that keeps the world safe... is called the United States Army, Air Force, Navy and Marine Corps." -- in "What the World Needs Now", by Thomas Friedman, New York Times, March 28,1999." -- from Backing Up Globalization with Military MightBacking Up Globalization with Military Might

5. International Metropolis - Vienna, September 15-19, 2003 5 What is “Globalization” ? Is a long-term process of global integration represented by the increasing rate of accessing international venues, driven by: –advances in trade, telecommunications, transportation –balanced by international security considerations –due to population mobility

6. International Metropolis - Vienna, September 15-19, 2003 6 “Globalization” and Mobility? Implications for Population and Public Policy  understanding the process  measuring past and current impacts  evaluation of policy consequences  looking to the future & preparing today.

7. International Metropolis - Vienna, September 15-19, 2003 7 Mobility/Migration – the process Three Considerations*: 1.The People 2.The Phases of Migration  Pre-departure  Transit  Post-arrival The Outcome Determinant Differentials (Prevalence Gaps) *MacPherson, Gushulak. Human mobility and population health. Perspect Biol Med 2001

8. International Metropolis - Vienna, September 15-19, 2003 8 The People

9. International Metropolis - Vienna, September 15-19, 2003 9 Migration Health - Context

10. International Metropolis - Vienna, September 15-19, 2003 10 Globalization and Migration Push pull factors of :  population: size, demographics and biometrics  processes of movement  prevalence gaps: source and host countries  E ducation & training  Cultural influences and beliefs  Behaviour  Language  Health

11. International Metropolis - Vienna, September 15-19, 2003 11 International Tourist Movements – Magnitudes - people WTO data. 2002* projected

12. International Metropolis - Vienna, September 15-19, 2003 12 International Tourist Movements – Magnitudes (people sources) WTO data.

13. International Metropolis - Vienna, September 15-19, 2003 13 Global Tourist Movements – Magnitudes (economics) WTO data. 2001 = US $463 Billion

14. International Metropolis - Vienna, September 15-19, 2003 14 Immigration to Canada – 1860-2001 WW IWW IIHungarian Revolt

15. International Metropolis - Vienna, September 15-19, 2003 15 Immigration to Canada – 1860-2001 Europeanization Multi-culturalization

16. International Metropolis - Vienna, September 15-19, 2003 16 Immigration to Canada

17. International Metropolis - Vienna, September 15-19, 2003 17 The Phases

18. International Metropolis - Vienna, September 15-19, 2003 18 “Pre-departure” Phase Effect may be:  negative: e.g., poverty, lower education, poorer health systems  neutral: e.g., similarity in environment, education, genetics/biology  positive: e.g., healthier behaviours

19. International Metropolis - Vienna, September 15-19, 2003 19 “Transit” Phase Advances in Transportation technology, accessibility and affordability has virtually eliminated the health risks associated with the movement phase EXCEPT:  trafficking in humans  smuggling in humans

20. International Metropolis - Vienna, September 15-19, 2003 20 “Post-arrival” Phase Effects of “pre” and “transit” phases plus: Balance of “imported” cultural, genetic, behavioural influences with host destination determinants: e.g., health care, environment BUT attainable socio-economic goals now permit reverse migration not possible in previous generations of migrants “VFR” effect: Visiting Friends and Relatives on recent migrant and 1 st generation.

21. International Metropolis - Vienna, September 15-19, 2003 21 Prevalence Gaps

22. International Metropolis - Vienna, September 15-19, 2003 22 Refugees & Asylum Seekers by year Worldwide Persons in need of Protection, UNHCR. * est.

23. International Metropolis - Vienna, September 15-19, 2003 23 Refugees & Asylum Seekers by Host Region, 1999

24. International Metropolis - Vienna, September 15-19, 2003 24 Globalization and Migration 140 million people live outside of their country of birth (1/40 persons) migrants represent > 15% of the population in over 50 countries worldwide OECD, Canada, USA –migrants represent ~ 2/3 of population growth 45 million migrants from developing nations will enter the workforce globally to 2015

25. International Metropolis - Vienna, September 15-19, 2003 25 Security, Trade & Health Is there a relationship between events distant from health in: time and place – Temporally/geographically distant political balance - trade and security vs. health

26. International Metropolis - Vienna, September 15-19, 2003 26 Security - Man-made Disasters Malfeasant –September 11, 2002 –Anthrax in USA –War on Terror –CBRN Programs –Nuclear Weapon Programs

27. International Metropolis - Vienna, September 15-19, 2003 27 Security – Man-Made Terrorism: –Bombings USS Cole, US Embassies Kenya/Tanzania World Trade Center Bali Israel/Palestine Civil disputes –violent Balkans – Serbia, Kosovo Rwanda/Burundi East Timor Moscow theatre

28. International Metropolis - Vienna, September 15-19, 2003 28 Security – Man-Made Accidental Bohpol / Union Carbide Three-Mile Island / Nuclear Uruguay Gold Mines / mercury poisoning The Kursk Nuclear Sub- marine

29. International Metropolis - Vienna, September 15-19, 2003 29 Security – Natural Disasters Environmental –Severe Weather Floods Drought Storms – hurricanes, tornadoes, Fires

30. International Metropolis - Vienna, September 15-19, 2003 30 Security – Man-made/Natural Disasters Man-made / Environmental –MDR – everything –Walkerton, Cincinnati –VHF – Ebola, Hanta –SARS –BSE –Heat deaths: Chicago, Europe

31. International Metropolis - Vienna, September 15-19, 2003 31 Security Security involves more than intelligence, police or military services:. Environmental security Social security: language, culture, health, employment...

32. International Metropolis - Vienna, September 15-19, 2003 32 Trade, Security, and Health Post-911 World “Security trumps trade Health trumps security” US Senate Appropriations – USD 40 Billion for security: international, border, homeland

33. International Metropolis - Vienna, September 15-19, 2003 33 Unlinked Costs Cholera in Peru, South America< 1 Billion USD Plague in India 3 – 5 Billion USD BSE in UK/Europe25 Billion USD SARS30 Billion USD. War in... Balkans, Priceless Great Lakes/Africa, Balkans, Kosovo, on Terror...

34. International Metropolis - Vienna, September 15-19, 2003 34 Travellers shy away from international travel War, pneumonia outbreak, North Korea blamed for decline in Air NZ bookings on key international routes Travellers shy away from international travel War, pneumonia outbreak, North Korea blamed for decline in Air NZ bookings on key international routes Air New Zealand 21 March 2003 http://home.nzcity.co.nz/news/default.asp?id=29857&cat=976

35. International Metropolis - Vienna, September 15-19, 2003 35 Migration Measuring Past and Current Impacts  Links: health, security and trade  Integrated (horizontal, vertical, longitudinal) decision- making mitigates impacts in the other two sectors... = Paradigm shift in local-international public health, economic/trade and security management.

36. International Metropolis - Vienna, September 15-19, 2003 36 Migration Measuring Past and Current Impacts  The West are nations built on migration  The West will grow and compete based on migration  The West is changing demographically and biometrically, including health determinants, directly related to migration

37. International Metropolis - Vienna, September 15-19, 2003 37 Migration Measuring Past and Current Impacts  The Developing Nations are source countries for migration  The Developing Nations will grow and compete partly due to migration  Are the Developing Nations benefiting; (public health, trade, security) related to migration - see WTO, Cancun September 2003?

38. International Metropolis - Vienna, September 15-19, 2003 38 Migration Evaluation of Policy Consequences  foreign policy - trade  immigration policy  international security policy  health policy

39. International Metropolis - Vienna, September 15-19, 2003 39 Migration Looking to the future & preparing today  Challenge to academics & researchers, social scientists, program administrators, and governmental policy makers; and front-line service delivery workers  Evidence-based decision-making.

40. International Metropolis - Vienna, September 15-19, 2003 40