Deportation of HIV positive migrants Impact on health and human rights

1. Deportation of HIV positive migrants Impact on health and human rights A Chinese medical worker hands out leaflets on AIDS to migrant workers at a train station in Guangzhou, China. Peter Wiessner XVIII International Aids Conference, July 20, 2010, Vienna

2. Our expertise on the topic Community driven research since 1999 2 surveys: Embassies around the world Data on deportation of HIV+ Distribution of information: Quick Reference 9 editions, 10 languages www.hivrestrictions.org Printed edition available at Deutsche AIDS-Hilfe booth in Global village

3. International collaboration DAH, EATG, IAS, GNP+, ILGA & others UNAIDS Task Team “Travel Restrictions” 2008 Counselling & advocacy Report “returned to risk” (HRW, AHPN, EATG, DAH) Our expertise on the topic

4. A personal testimony… “The company I was employed moved to XY in 2005. It was decided that I should work there. I applied for a work permit. Without further thoughts I attended the necessary health checks, a formality to get the visa…. Two days later I got a phone call. Another blood test had to be done. Again, some days later the doctor called me to come over immediately. He was in uniform, decorated with stripes and metals. His first question was, if I ever had sex in my life (he knew that I am not married). He told me that I am HIV+ and that I would have 3 days time to leave the country. I was shocked and had many questions. He did not give any answers and kept on repeating that I had to leave the country. I informed my company, which was a good decision because two days later they did get all information from the health authorities. The company got threatened, that the office would be closed, in case they continue to keep me employed. I lost my job and went back to Germany. The disclosure of my HIV status caused me many problems to find another position. It took me 2 years to deal with the situation and to find another job in the same sector”. (Anonymous, German, known to the author)

5. Why this example? Problem for long term visa applicants, migrant workers & students ... Not only people from the developing world are affected People from developed countries are privileged, example Jordan: “Europeans who are able to afford medication will very likely not face deportation if HIV is detected”

6. Migrant workers from developing countries higher burden Differences in terms of behaviour/handling Detention Deportation Differences in terms of access to health care and social services Welfare system? Employment options? Access to medication and care? Level of stigmatisation?

7. Devastating impact • Violation of rights & professional standards • VCT: confidentiality & counselling, • Information about HIV, treatment options, transmission • Doctor patient relationship • Personal level • Forced disclosure (Loss of control/personal information) • Insecurity about career perspectives • Disepowerment • (Life) threatening consequences • For the person involved • The family he/she supports

8. Scope of the problem? 31 countries force HIV+ migrants to leave based on HIV status Many more countries may deport HIV+ migrants Deutsche AIDS-Hilfe: Quick Reference, Berlin 2010

9. Deportations from 31 countries 11 countries from Middle East/Gulf States 9 countries from Asian/Indian region 5 countries from European region (WHO Europe 53)

10. Deportation … • Bangladesh • … is likely if authorities get knowledge about HIV status ... • Hungary • … can take place if advised by the public health authorities ... • Jordan • … recordedcases of expelled HIV+ Africans ... • North Korea • … on “well-meant” grounds: “no treatment available” ...

11. Deportation … • Kuwait • … with no exception for any HIV+ person! • Malaysia • … designated by law, applies to migrant workers ... Qatar • … immediate after detection of HIV-infection, even tourists affected Applies to migrant receiving and migrant sending countries

12. Some figures … • Egypt • 1986 to 2006: 722 HIV+ foreigners detected • All 722 have been deported (90 % Africans)source: National AIDS Program, IOM, 2008 • South Korea • 521 of 546 HIV+ foreigners forced to leave source: Korea Centre for Disease Control; Korea Times, 03.03.2008 • Russian Federation • 2008: 1,579 legal migrants tested HIV+ • 198 deported source: Federal Hygiene and Epidemiology Centre of Rospotrebnadzor

13. Some figures... Saudi Arabia & United Arab Emirates High Number of (Asian) migrant workers Mandatory HIV-testing Detention in jail like “Hospital”- cells Imprisonment up to one year without treatment Many HIV+ die while waiting for deportation 2008: 1518 people with HIV, Hep B & TB deported (UAE) South Africa No specific HIV related restrictions 6 Mio non citizens in the country (2008) Deportation of HIV+ migrant workers to Zimbabwe: inability to continue treatment = death sentence

14. The principle of Non-Refoulement Prohibition of deportation if a person is in danger of being subject to torture, or another cruel, inhuman, or degrading treatment or punishment Andrea Mortlock case 1979: from Jamaica to NY 1987: convicted for selling cocaine (1 year prison) 1995: Ordered deported in absentia HIV Status with complicated regimen not available in Jamaica Lawyers argued: Deportation = death sentence Severe discrimination faced in receiving country

15. Impact of HIV Status on immigration proceedings? Petition/findings of the Inter-American Commission on Human Rights Availability of medical care in receiving country Availability of social services + support (close relatives) European Court of Human Rights (case law) Current medical condition must be considered (“advanced” or “terminal” stage of illness) Availability of friends or family support in country of origin Availability of medical care in country of origin Challenges/Problems Narrow interpretations (ECtHR) “in principle” – “terminal” Is treatment for the individual deportee available + accessible? (long term basis, rural + urban areas, or does availability only exist “in principle”?) Independent source of information?

16. Recommendationsfor national governments Provide equivalent medical care to detainees Publish information on number of deportations, grounds for removal countries to which removed Create programs to improve lives of migrants Ensure that national laws meet “non-refoulement” obligations Reexamine deportation to countries where treatment and social support is inadequate

17. Recommendations for national governments Secure access to treatment and care for migrant workers Establish pre-deportation service enrolment and temporary medication supply Create cross border treatment and standards of care Make sure medical records are kept confidential Place the issue of deportation on the research agenda Recommendations for intergovernmental Organizations Publish all data and share your case studies Develop a policy brief on HIV testing among migrants

18. Community response • Address • Deportations as illegitimate limitations of rights • Point out • Exclusionary policies violate GIPA principles • Deportations based on HIV fuel stigma of PLHIV • Include • Put the migrant and mobile populations needs on your agenda • Define what “universal access” means within your borders • Make sure • Conferences and meetings don’t take place where the rights of PLHIV are not respected • Support • Data base: send any important information to www.hivrestrictions.org

19. Acknowledgement • Karl Lemmen, Deutsche AIDS-Hilfe • David Haerry, European AIDS Treatment Group • Rhon Reynolds, African HIV Policy Network • Katherine Todrys, Human Rights Watch • Joseph Amon, Human Rights Watch • Thanksforyourattention! • Contact: peter-wiessner@t-online.de • More Information: www.hivrestrictions.org