HIV frameworks & policies: Where do migrants and mobile populations fit?

Adeeba KamarulzamanUniversity of Malaya

Kuala Lumpur, Malaysia

HIV PREVENTION AND CARE IN MIGRANT AND MOBILE POPULATIONS

• An estimated 214 million international migrants worldwide

• Sending around $414 billion remittance home to their families in 2009

• Estimated 16 million who move from rural to urban settings within their own countries

• Additional 100 million who comprise China’s “floating population”

International labour migration andHIV risk

Multilevel determinants

1. Policy2. Sociocultural3. Health and mental health4. Sexual practice

Weine SM. AIDS Behaviour 2013

• More than 60 countries restrict PLHIV from entering or remaining in a country for any purpose;

• International labour migrants may be refused entry or face deportation if they are found to be HIV-positive

• Standards for informed consent, confidentiality and counselling are not routinely applied

• Migrant workers receiving ART in the destination country may also have their treatment disrupted by deportation

• Upon returning to country of origin, often they cannot access HIV services.

International and Regional Treaties

• The UN International Convention on the Protection of the Rights of all Migrant Workers and Members of their Families– article 23: “migrant workers and members of their

families shall have the right to receive any medical care that is urgently required for the preservation of their life or the avoidance of irreparable harm to their health”.

• The UN International Covenant on Economic, Social and Cultural Rights (ICESCR),

• article 12: recognizes the right of everyone to the enjoyment of the highest attainable standard of mental and physical health, which includes prevention, treatment and control of epidemic, endemic, occupational and other diseases, as well as the creation of conditions which would ensure access to all medical service and medical attention in the event of sickness.

WHA Resolution on Migrant Health &

Global Consultation

• 2007: 60st WHA Global plan of action on workers' health • 2008:61st WHA Resolution on "the health of migrants

– Migrant-sensitive health policies and equitable access to services; – Capacity building of health service providers and professionals; – Bi- and multi-lateral cooperation, intersectoral action

• 2010: Global Consultation on Migrant Health to: – Take stock of actions by MS & Stakeholders – Reach consensus on priority areas and strategies – Initiate an operational framework to assist MS and stakeholders

Regional commitments to enhance the health of migrants

• ASEAN Declaration on the Protection & Promotion of the Rights of Migrant Workers (2007)

• ASEAN Commitments on HIV & AIDS (2007) • SAARC Regional Strategy on HIV & AIDS (2006-

2010) • SAARC Regional Strategy for TB/HIV Co-

infection (2004)

ASEAN Declaration on Protection & Promotion of Rights of Migrant Workers (2007)

OBLIGATIONS OF SENDING STATES • Enhance measures related to promotion & protection of

rights of migrant workers; • Set up policies & procedures to facilitate aspects of

migration of workers • o Recruitment • o Preparation for deployment overseas • o Protection when abroad • o Repatriation & reintegration to countries of origin; • Establish & promote legal practices to regulate

recruitment of migrant workers

Policy position

• The 2001 UNGASS Declaration of Commitment on HIV/AIDS adopted by all Member States, calls for

• “national,regional and international strategies that facilitate access to HIV/AIDS prevention programmes for migrant and mobile workers”.

Actions for governments

• Ensure that national laws recognize the right to health for international labour migrants and do not create barriers to accessing health and HIV related services.

• Include international labour migrants in national development, health and HIV-related policies, strategies and plans.

• Ensure same access as nationals to gender-, language- and culture sensitive HIV services.

• Integrate HIV services into pre-departure, post arrival, return and reintegration processes.

Actions for governments• Ensure there is no discrimination on the grounds of HIV

status in the context of entry requirements, immigration, employment or reintegration procedures

• Ensure that laws, policies and programmes respect the rights of both workers living with HIV and international labour migrants and their families.

• Enforce minimum national labour standards for both nationals and non-nationals.

• Collaborate to implement regional strategies for addressing HIV-related issues among international labour migrants.

Actions for workers’ organizations

• Promote sound HIV workplace policies.• Support the formation of associations by

international labour migrants• Support efforts to eliminate discrimination• Advocate ratification and implementation of

international conventions on migrant workers.

Actions for businesses

• Develop and implement sound workplace policies in line with the ILO Code of Practice on HIV/AIDS and the World of Work.

• Reduce financial costs for migrant workers in sending remittances to their families and communities.

Actions for civil society• Support international labour migrants to access HIV-

related services and broader appeal mechanisms, e.g. migration, labour or human rights boards.

• Establish gender-, language- and culture-sensitive HIV programmes for international labour migrants and their families.

• Conduct and disseminate research on international labour migrants and HIV risk

• Advocate for equal treatment, and challenge stigma and discrimination against migrants, including that perpetuated by the media.

Actions for international partners

• Support national AIDS programmes, civil society and other organizations, in origin, transit and destination countries, to provide health and HIV related services to international labour migrants, including those in irregular status.

• Conduct and support research on migration and HIV to inform policies and programmes.