Author
No differences between the situation of asylum seekers and beneficiaries of international protection for what concerns access to health care were reported. See the section on Reception Conditions: Health Care.
In May 2022, CEAR and the Fundación Sanitas signed an agreement to provide comprehensive health assistance to refugees. Concretely, more than 75 refugees will be provided with mental healthcare, dental assistance and support for their emotional well-being.[1] The project continued to be implemented during 2024 and was renewed for 2025. Since the project launch in 2022, 270 refugees received support.[2]
In May 2024, the Government adopted the law proposal establishing the universality of the National Health System, which if approved will reintroduce the access to the health system to any person residing in Spain, independently of their residence status.[3] The universality of the Spanish National Health System existed until 2012, when it was limited by law. While welcoming the law proposal which incorporates significant improvements that respond to long-standing demands from the third sector, the Third Sector Platform (Plataforma del Tercer Sector) suggested specific proposals to reinforce the principle of universality and guarantee effective access to healthcare for all, without distinctions or administrative obstacles. According to the Platform, effective residence and administrative simplification are key to guaranteeing universal access to healthcare. Thus, it called for the right to healthcare to be recognised for all persons who are effectively resident in Spain. To prove such residence, it proposed that registration with the local council (the so-called ‘empadronamiento’) be used as the main method, but that other alternative means such as sworn statements, social services reports or accreditations issued by third sector entities also be accepted. This flexibility would guarantee access to the healthcare system without discrimination and with greater legal certainty. The Platform also considered it essential to address administrative simplification by establishing a clear, simple and uniform legal framework that avoids differing interpretations between autonomous communities and guarantees access without delays or bureaucratic obstacles.[4] In March 2026, the Council of Ministers approved the royal decree regulating the procedure for recognising the right to health protection and healthcare at public expenses for foreign nationals who are in Spain without legal residence. To reduce bureaucracy in the process, entitlement will be recognised with a sworn statement. In this document, the applicant declares that they do not have health coverage through any other means, that they cannot export their entitlement from another country and that there is no third party obliged to pay for their care. In addition, the royal decree facilitates the accreditation of habitual residence in Spain. Although registration with the local council (‘empadronamiento’) is the preferred document, other forms of proof will be accepted in its absence, such as certificates of enrolment or registration at public schools, social services reports or certificates of visit registration, electricity, gas, water, telephone or Internet bills in the applicant’s name, registration certificates or consular registration documents.[5]
In January 2025, the Autonomous Community of Andalucía launched the Red Isir, a network of health professionals aiming at improving their knowledge and tools in the assistance to migrants.[6]
In November 2025, the organisation ‘Médicos del Mundo’ reported that 28,000 persons have been excluded from access to health in Spain from January 2022 and August 2024, including many vulnerable persons such as asylum seekers.[7]
Inclusion measures
In March 2023, the municipal public transport entity ‘ETM’ of Valencia launched, together with the NGO ‘CEAR’ the initiative ‘ETM Refugio’, consisting in the provision of free passes for public transports to asylum seekers and refugees, with the aim of improving their social and labour inclusion.[8] In April 2024, the validity of the initiative was extended until April 2025.[9] No information on further extensions of this initiative was available at the time of writing.
In 2025, UNHCR continued to support initiatives aimed at advancing the inclusion of refugees through employment, social engagement, higher education, participation, sports and language learning, while ensuring access to these initiatives for the broader refugee community.
In relation to the initiatives facilitating refugees’ access to sports as a powerful tool for inclusion, UNHCR collaborated to initiatives such as the UEFA Unity Cup, Special Olympics and the Women’s Race.[10]
In addition, UNHCR continued its ‘Contigo’ mentoring project in partnership with the NGO Diaconía, targeting refugee children and youth aged 15 to 30. The initiative supported 104 participants through community engagement and awareness-raising activities, with the involvement of 123 volunteer mentors residing in Madrid, Málaga and Cádiz. The project strengthened beneficiaries’ prospects for integration while promoting the role of civil society and local communities, as well as supporting access to the labour market. Building on the progress made in 2024, the project continued throughout 2025 and successfully facilitated the labour integration of 17 beneficiaries into 14 private companies operating in Spain.[11]
In April 2025, CEAR launched the CEAR CF Football Team to foster the inclusion of refugees through sport.[12]
In December 2025, the political party PSOE submitted a law proposal at the Congress urging the Government to promote sports programmes to integrate migrants and asylum seekers.[13]
The lottery ticket of the 15 December was dedicated to the UNHCR and its work, with 5 million the tickets for sale.[14]
In 2025, UNHCR provided two small grants to women refugee‑led organisations creating safe spaces for 172 refugee women, mostly survivors of gender-based violence, and strengthening their autonomy, resilience, well‑being, inclusion and community networks. UNHCR also promoted a stronger interaction between women refugee-led organisations and organisations working in the asylum reception system.[15
As underlined by UNHCR, increasing arrivals in 2024 put a focus on the need to support longer-term integration. Building on the positive response related to the arrival in large numbers of Ukrainians in the past years and on the results of the Spain with Refugees Forum, more opportunities arose especially for private sector engagement, and many initiatives started to consolidate, providing more meaningful opportunities for refugee integration and inclusion through employment, education, sports and refugee participation. A Memorandum of Understanding with the Spanish Federation of Municipalities and Provinces (FEMP) was signed to promote local refugee inclusion.[16]
Following a proposal made by the Minister of Inclusion, Social Security and Migration, in July 2023 the Council of Ministers approved the funding of EUR 1.5 million until 2026 to the Spanish Olympic Committee with the aim of promoting sports within the reception systems for migrants and refugees.[17]
In 2026, the NGO CEAR, in partnership with the LaLiga Foundation and with the support of “JD Sports”, launched a series of training clinics in various cities across Spain, which are addressed to refugees who are members of CEAR CF teams, with the aim of enhancing their sporting development, technical training and the values of football.[18]
Refugee participation
UNHCR strengthened two‑way communication and collaboration among more than 70 refugee and community‑led organizations through the Red‑refugiadas network, sharing over 60 initiatives and facilitating three meetings to enhance exchange, mutual support and capacity‑building.
UNHCR also conducted participatory assessments, including a focus group with 13 Syrian women contributing to a regional study on return, and nine discussions with 146 unaccompanied asylum‑seeking children to better understand their experiences and protection needs in both the child protection system in the Canary Islands and in the asylum reception system in the mainland.
Refugee participation was further reinforced through the “Pass the Mic” programme, which helped to build communication and advocacy skills of 16 refugees, and through three small grants awarded to three refugee‑led organizations to implement empowerment and mental health and psychosocial support ‑related projects through arts and entrepreneurship that reached 230 people.
In addition, UNHCR created opportunities for refugee‑led organisations to expand their visibility and engagement with authorities and key partners, including participation in UNHCR’s regional consultations, the European Youth Parliament summit (where five young refugees participated), cultural events and UNHCR’s seventy‑fifth anniversary celebrations. These spaces helped position refugees and their organisations as essential protection actors with direct insight into community needs.[19]
[1] Seguros News, ‘Fundación Sanitas y Ayuda al Refugiado acuerdan cuidar de la salud de los refugiados’, 23 May 2022, available here.
[2] Sanitas, ‘Fundación CEAR’, 3 February 2025, available here.
[3] Diario de León, ‘El Consejo de Ministros aprueba el proyecto de Ley de Universalidad del Sistema Nacional de Salud’, 14 May 2024, available here; Diario la Ley, ‘Universalidad del Sistema Nacional de Salud’, 28 May 2024, available here.
[4] Plataforma del tercer Sector, ‘La Plataforma del Tercer Sector reclama en el Congreso que se garantice el derecho a la atención sanitaria a todas las personas con residencia efectiva en España’, 22 October 2025, available here.
[5] Ministerio de Sanidad, ‘El Consejo de Ministros aprueba el real decreto que refuerza la universalidad en el acceso a la asistencia sanitaria pública’, 10 March 2026, available here.
[6] Junta de Andalucía, ‘Salud impulsa la mejora de la atención sanitaria a la población migrante a través de su Red Isir’, 3 January 2025, available here.
[7] La Vanguardia, ‘Médicos del Mundo documenta 70.000 exclusiones sanitarias en España entre enero de 2022 y agosto de 2024’, 18 November 2025, available here; Cadena Ser, ‘La falta de empadronamiento deja fuera de la sanidad a quienes viven en caravanas o alquileres clandestinos’, 21 November 2025, available here.
[8] El Periodic, ‘La EMT lanza “EMT Refugio”, un nuevo bono gratuito para refugiados o solicitantes de asilo’, 13 March 2023, available at: https://tinyurl.com/2m3bz67k.
[9] Valencia Plaza, ‘La vigencia del bono EMT Refugi se amplía hasta abril de 2025’, 26 April 2024, available here.
[10] Information provided by UNHCR in March 2026.
[11] Information provided by UNHCR in March 2026.
[12] CEAR, ‘Presentado el CEAR CF, un equipo que golea por el refugio y la inclusión de las personas refugiadas’, 1 April 2025, available here; Cadena Ser, ‘El CEAR CF, un gol para la inclusión de los refugiados’, 13 May 2025, available here; CEAR, ‘CEAR club de futbol’, available here.
[13] Europa Press, ‘PSOE insta al Gobierno en el Congreso a impulsar programas deportivos para integrar a migrantes y solicitantes de asilo’, 7 December 2025, available here.
[14] ONCE, ‘El cupón de la ONCE difunde la labor de ACNUR, la Agencia de la ONU para los Refugiados’, 12 december 2025, available here.
[15] Information provided by UNHCR in March 2026.
[16] Information provided by UNHCR in March 2025.
[17] Europa Press, ‘Aprobada una subvención al COE de 1,5 millones para favorecer el deporte en los centros de acogida’, 4 July 2023, available at: https://tinyurl.com/yc3truz2.
[18] Diario Siglo XXI, ‘La CEAR y LaLiga ponen en marcha una serie de clínics formativas para personas refugiadas del CEAR CF’, 26 March 2026, available here.
[19] Information provided by UNHCR in March 2026.