Washington D.C., USA, 22-27 July 2012 Global Overview of HIV-related Restrictions on Entry, Stay and...
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Transcript of Washington D.C., USA, 22-27 July 2012 Global Overview of HIV-related Restrictions on Entry, Stay and...
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Global Overview of HIV-related Restrictions on Entry, Stay and Residence
Susan Timberlake
Chief, Human Rights and Law Division
UNAIDS
22 July 2012
Washington D.C., USA, 22-27 July 2012www.aids2012.org
What are HIV-related restrictions on entry, stay or residence (“travel restrictions”)?
• Restrict entry, stay, work and/or residence based on HIV status only
• Single out HIV for negative consequences (making them discriminatory)
• Apply a blanket restriction against all people living with HIV (making them unreasonable)
• Can be a law, regulation, policy or practice
Washington D.C., USA, 22-27 July 2012www.aids2012.org
What are HIV-related travel restrictions?(continued)
• Not a new issue – most put in place in the 1980s, a time of fear, ignorance and prejudice about HIV
• Governments cite two reasons: To protect public health (“keep
HIV out”) To avoid costs associated with
care, support and treatment for people living with HIV
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Examples of restrictions
• Mandatory HIV testing and requirement to show HIV-negative status in order to get visa to enter or stay
• Requirement to disclose HIV status on visa application forms and/or apply for special “waivers” due to HIV status
• Sometimes applied to certain categories of people: e.g. Africans, students, entertainers
• Detention or deportation of HIV-positive non-nationals on basis of HIV status
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Examples of impact
• Company cannot post employee in certain countries
• Person subject to testing in home country or destination country without counselling, informed consent, confidentiality
• Economic loss, job loss, study loss
• Loss of dignity, emotional distress
• Detention, sometimes without treatment
• Summary deportation without due process or economic fairness
• Denial of asylum, family unification
Washington D.C., USA, 22-27 July 2012www.aids2012.org
131 countries, areas have no HIV-specific restrictions46 countries, areas have some form of restriction (see below);
Current state of restrictions
1. Andorra 17. Kuwait 33. Saudi Arabia2. Aruba 18. Lebanon 34. Singapore3. Australia 19. Lithuania 35. Slovakia4. Bahrain 20. Malaysia 36. Solomon Islands5. Belarus 21. Marshall Islands 37. Sudan6. Belize 22. Mauritius 38. Syrian Arab Republic7. Brunei Darussalam 23. Mongolia 39. Chinese Taipei8. Comoros 24. New Zealand 40. Tajikistan9. Cuba 25. Nicaragua 41. Tonga10. Cyprus 26. Oman 42. Turkmenistan
11. Democratic People’s Republic of Korea
27. Papua New Guinea 43. Turks and Caicos Islands
12. Dominican Republic 28. Paraguay 44. United Arab Emirates13. Egypt 29. Qatar 45. Uzbekistan14. Iraq 30. Republic of Korea 46. Yemen15. Israel 31. Russian Federation 16. Jordan 32. Samoa
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Travel Restrictions are irrational• Do not protect public health (can harm it); do not keep
HIV out • HIV is not contagious and people can protect themselves• The world is smaller” and movement more important • HIV treatment = long, productive lives • HIV treatment = being non-infectious• Countries can exclude based on proof of becoming undue
economic burden• Every individual should have equal access to freedom of
movement• Rational Alternative: prevention/treatment info/services
to those entering/leaving (citizens and noncitizens)
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• Global: top priority of UNAIDS (International Task Team) and global networks of people living with HIV (monitoring, advocacy); private sector (CEO sign-on initiative); aspect of migrants’ rights
• Regional: Asia, Gulf, Russia and Central Asia• National: bilateral action, civil society action
packs, national level coalitions, including people living with HIV
Action to remove them
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Towards “Zero Discrimination”: momentum to eliminate them
• WHO, UNAIDS and IOM have called for removal• World Health Assembly, UNAIDS and GF boards have
called for removal• In 2011 Resolution, Human Rights Councils • In 2011 Political Declaration on HIV, governments
committed to removing restrictions on entry, stay and residence
• At AIDS2012, global business leaders have issued a call for the elimination of restrictions
• Since 2010, 7 countries have lifted travel restrictions: Armenia, China, Fiji, Namibia, Republic of Moldova, Ukraine, and the United States of America
Washington D.C., USA, 22-27 July 2012www.aids2012.org
THANK YOU!
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Impact of HIV travel restrictions on migrant workers in
Asia and the Gulf States
Malu Marin ACHIEVE, Inc. /CARAM Asia
19th IAC, Washington D.C.
CARAM Asia
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Impact of HIV travel restrictions on migrant workers in
Asia and the Gulf States
Malu Marin ACHIEVE, Inc. /CARAM Asia
19th IAC, Washington D.C.
CARAM Asia
RESPONSE TO HIV/AIDS IN KOREA
international context
XIX IAC, July 2012 Lee Dukhyoung, Korea CDC
14
CONTENTS
Timeline Challenges Opportunities
Timeline
Timeline 1
17
1981~1985 Fear and stigma imported before real in-
fection; during the incubation period, fear and
stigma grown by reluctant medical society and fear mongering media.
“You never have second chance to change
first impression”
Timeline 2
20
1985. First HIV infection of a foreign res-ident reported in Korea
1987 Nov. AIDS Prevention Act (AIDS law) 1988 Jun. Seafarers subject to HIV testing
by Enforcement Decree of the law
Timeline 3
1988 Dec. Testing for specific group of for-eigner newly stipulated (the law amended)
1989 Dec. HIV testing requirement for long-term stay(>90 days) foreigner at en-tertainment, sports by amended Enforce-ment Decree
1993 Jul. Mandatory testing for seafarers abolished by amended Enforcement De-cree
21
Timeline 4
2010 Jan. Removed restrictions of reentry/stay because of HIV-positive status by amending the Directive of the Entry of HIV Infected Foreigners (internal guideline of the Ministry of Justice)
2010 Aug. HIV testing requirement of in-coming and before placement health exam on foreign worker removed in the labor-re-lated Regulation
2010 Nov. HIV-related restrictions abol-ished in the Immigration Control Act
Timeline 5
2012 Jul.
24
Challenges
25
“We against they” proposition
Blood HIV screening tool directly applied to person as “risk population group”
26
Over-reliance on HIV testing
1986. 3 persons with HIV confirmed out of sex workers (in US military base ar-eas)
> from 1987, all of them to be tested once a year
1987. HIV testing partly applied on sea-farers
> early 1989, seafarers included in mandatory testing target
1988-89. HIV testing requirement on for-eigner of specific group
27
Biased by numerator analysis
Proportion of sex worker (in US military base areas) to total cumulative number of persons with HIV by year
Year 1987 1988.6 1996 2010
Sex worker(A
)
8 11 15 ?
Total(B) 14 26 570 7,656
A/B(%) (57) (43) (3) ( <1) ?
1988 Seoul Olympic Games
29
Opportunities
30
Change of the disease paradigm
1996-97
31
Civil Societies Global opportunities International NGOs, esp. International AIDS Soci-
ety
32
UN Advocacy
WHO UNAIDS since 1994 Global Fund for AIDS 2011 UN High-level Meeting on HIV/AIDS
KCDC at Osong( 五松 , 5 pine trees)
KOREA CENTERS FOR DISEASE CONTROL& PREVENTION
33
KCDC at Osong( 五松 , 5 pine trees)
Impact of HIV travel restrictions
on migrant workers in Asia and the Gulf States
Malu Marin ACHIEVE, Inc. /CARAM Asia
19th IAC, Washington D.C.
CARAM Asia
Some migration figures
Temporary labor migration towards the Middle East and, in particular, the Arab States, represents the dominant flow.
The stock of migrants in the Middle East in 2011 stands at an estimated 28.5 million migrants.
There are 13.2 million migrants in South East Asia and East Asia.
1.2 million are working in Malaysia alone.
The Philippines has an estimated 3.8 million contract workers abroad and majority of these work in Asia and the Gulf States.
In the Philippines, domestic workers and household workers make up the single largest group of female newly-hired overseas contract workers at any given year.
Almost 80 percent of all Indonesian migrant workers are women and 88 percent work in the informal sector.
In Sri Lanka 42% of all overseas workers in 2010 were female domestic workers, deployed mostly in Middle East countries.
CARAM Asia
Health Testing
Mandatory requirement for work permit
Pre-departure, post-arrival and upon renewal of work contract
Migrant workers are being screened for up to 22 diseases and conditions including pregnancy and HIV.
Administered without regard for universal standards (counseling, consent and confidentiality)
HIV+ diagnosis Quarantine (in the Gulf States)
Immediate deportation (Asia)
Inhumane treatment
No access to treatment or referrals abroad
Fall out of the health system when they get home
Absence of counseling results to psychological trauma, stress and internalized stigma
Immediate loss of income
Categorized as “permanently unfit ” and blocked from ever legally entering a GCC country to work again
Migrants’ results are fed into a database that is shared with all other Gulf Cooperation Council Approved Medical Centres Association (GAMCA) centres.
Migrants end up stigmatized and discriminated, e.g. blamed as vectors of diseases in both origin and destination countries.
Impact
Policy Implications
Health of migrant workers must go beyond work examinations for Fit/Unfit status
Compulsory health testing of migrant workers has become a money making tool for recruitment agents and testing facilities
Mandatory Testing is discriminatory and contradicts national laws on HIV testing
Not a public health approach- no prevention, treatment/ referral service
Mandatory testing skews HIV data in both countries of origin and destination, especially if the bulk of cases are coming from migrant workers.
Challenges
Migration and HIV and AIDS, separately and jointly, are politically- contentious subjects
Negotiations, whether bilateral or multi-lateral, tread on issues of migrants’ rights, citizenship, public health and national sovereignty.
Efforts High Level Multi-Stakeholder
Dialogue on HIV Prevention, Treatment, Care and Support in the ASEAN Region, February 2009. Convened by JUNIMA*, ASEAN Secretariat and CARAM Asia.
Regional Dialogue on the Health Challenges for Asian Labour Migrants, July 2010. Convened by JUNIMA and IOM, with ASEAN, SAARC, GCC.
*Joint United Nations Initiative on Mobility and HIV/AIDS in SEA
Efforts Migration Roundtable between
Malaysia and Indonesia: Improving migrant workers’ access to HIV-related prevention and healthcare services, March 2011. Convened by UNDP.
High Level Multi-stakeholder Dialogue on Migrant Workers’ Health and Access to HIV services in the ASEAN Region, November 2011. Convened by JUNIMA, ASEAN and UNDP.
Removing HIV Travel Restrictions in Ukraine
Latest Developments
Marina Zelenska, Ministry of Health of Ukraine
XIX INTERNATIONAL AIDS CONFERENCE
46
Ukraine and HIV
Ukraine is the second largest country in Europe, after the Russian Federation, with an area of 603,700 sq km. The territory from North to South is 893 km, from West to East is 1316 km. The population of Ukraine is 46.6 ml people.
•The HIV epidemic was first recognized in Ukraine in 1987. Since then, Ukraine has maintained and developed a standardized system for passive surveillance based on confidential name-based reporting of HIV cases.
47
HIV/AIDS legislation – one of the state priorities
Ukraine was the first post-Soviet state to adopt the AIDS Law (1991).
August 24, 1991 is the birthday of independent Ukraine (creation of an independent state)
December 12, 1991 – adoption of the Law “On AIDS prevention and social protection of the population”. One of the first regulatory documents passed by the Parliament of independent Ukraine.
48
Adaptation of Ukrainian legislation to international law
12.12.1991 – adoption of the Law “On AIDS prevention and social protection of the population”.
12.23.2010 – new version of the law. New version title: “On stemming the spread of diseases caused by HIV as well as legal and social protection of people living with HIV” Priority in the new version of the Law – respect for human rights and freedoms in accordance with best international practices.
03.03.1998 – new version of the Law in accordance to ratification of the Convention for the Protection of Human Rights (1950) of 07.17..97 (cancellation of HIV mandatory testing for prisoners, PLHIV rights codified)11.15.2001, 04.14.2009 – amendment to the Law.
49
Amendments to the Law are based on:
International law acts relating to HIV/AIDS
Methodological materials of international organizations working in the area of HIV/AIDS prevention
Results of a detailed expert review of the provisions contained in the 1st version of the law, conducted by a UNAIDS panel of experts (Geneva), and their recommendations
50
Key international instruments used to develop amendments
Political Declaration on HIV/AIDS, 2006 Taking Action against HIV – Handbook for Parliamentarians
UNAIDS/Inter-Parliamentary Union/UNDP), 2007 International Guidelines on HIV/AIDS and Human Right,
UNAIDS/ Office of the United Nations High Commissioner for Human Rights (consolidated version 2006)
UNAIDS recommendations on terminology, 2007 UNAIDS/WHO Policy Statement on HIV Testing, June 2004 • Criminal Law, Public Health and HIV Transmission: A Policy
Options Paper. – UNAIDS/02.15R, Geneva, Switzerland, 2002, 52.
“Criminalization of HIV Transmission. Policy Brief, UNAIDS), August 2008.
51
Principles and innovations of the Law
Legal protection of people living with HIV and their families
Preventing discrimination against PLHIV and most at-risk populations
Ensuring the right to access HIV prevention, treatment, care and support:
• Expanding access to free HIV testing• Introducing a harm reduction strategy to prevent the spread of HIV• Ensuring free access to post-exposure prevention services• Ensuing participation of organizations of different types of ownership in
the provision of charity, health and social services to PLHIV• Doctor’s right to take additional measures to prevent HIV transmission;• Procedure for notifying HIV status
Cance
led
HIV Travel Restrictions
Previous version of the Law (1991):
Article 11. Diplomatic missions and consulates of Ukraine shall issue entry visas to foreigners and persons without citizenship, who stay in Ukraine for more than three months, provided that they have produced a document confirming their HIV-negative status, unless otherwise is stipulated in international treaties Ukraine is a party to.
Ukraine is quickly adapting to best international standards that ensure PLHIV’s human rights and freedoms.
At present, Ukraine has a favorable regulatory environment in place to ensure that PLHIV can exercise their rights.
New challenge facing Ukraine is to create a system to ensure that all entities (government bodies, NGOs, public officials and citizens) strictly comply with the Law.
UKRAINE: further steps
54
Thank you for attention!