577 Health on the move, governance in pieces: mapping the fragmented global architecture and ecosystem of actors, instruments and norms shaping migration health

Abstract OP 6: Health Policy 2, B308 (FCSH), September 3, 2025, 15:45 - 16:45 Background Migration is increasingly recognized as a key determinant of health(1). However, governance for migration and health remain fragmented globally and continue to evolve in siloes(2-6). Aim This paper aims to map the global governance architecture around migration and health by conceptualizing two interrelated domains: Global Migration Health Governance (GMHG) and Global Governance for Migration Health (GG4MH)(7, 8). Methods Using a systematic approach with keyword combinations of governance, migration and health, we conducted a multi-step search process. First, we used web search to retrieve relevant policy documents. Second, we used AI-assisted search to extract references from the retrieved documents to additional actors and instruments. Thirdly, site-specific searches were done within the websites of the identified actors, and finally, during charting of the retrieved instruments, we continuously iteratively updated instruments and actors until no new actor or instrument reference surfaced. We mapped and analysed 40 policy instruments, and classified 39 global actors, identifying governance frameworks and normative framings influencing global health and migration discourse, highlighting critical gaps and opportunities for coordinated global responses. Results 15% of mapped instruments fell within GMHG domain while only eight of the 40 instruments were binding. Normative framings ranged from rights-based and equity lenses to security-focused, risk-averse narratives(9-12). Among the 39 actors, mandates varied widely, with notable power asymmetries, collaboration densities, mandate overlaps and blind-spots, ambivalent normative positions and weak intersectoral coordination. Conclusion This study reveals a large, interconnected but unstructured and uncoordinated global ecosystem of actors and instruments shaping migration health. It also provides a foundational lens for diagnosing governance blind spots and guiding future efforts for migration health diplomacy (for GEMMS) and rights-based resilience planning(1, 13-15). References Select references include Kapilashrami & John (2023), Mac-Seing et al. (2023), Kickbusch et al. (2014), and Zimmerman et al. (2011). Full list in the main paper.