Across the
globe, 31 countries have policies of deporting HIV-positive citizens of
other countries, the Eighteenth International Conference in Vienna was told on Tuesday. Moreover,
speakers from three European countries explained that while their countries do
not deport individuals because of HIV, the deportation of refused asylum
seekers and undocumented migrants does occur, even when it is doubtful that the
individual will be able to obtain essential medicines in the country they are
sent to.
Peter
Wiessner presented an analysis of data in The Global Database on HIV-Related
Travel Restrictions, which identified 31 countries whose law, policy or practice allows for the
deportation of foreign nationals because they have HIV. In many but not all
cases, this primarily affects long-term residents.
Seven
countries in the Gulf (a region reliant on migrant labour) and four others in
the Middle East have such policies. Egypt says it
deported all 722 foreigners (90% of them African) who were diagnosed with HIV
in the country between 1986 and 2006.
Numerous
Asian countries, including India,
Malaysia, Singapore and Taiwan, are also ready to deport. In
recent years, South Korea
has deported 521 of 546 HIV-positive foreigners it identified.
In Europe, Russia, Moldova
and Armenia
deport foreigners who have HIV. Hungary,
which is a member of the European Union, may expel foreigners who do not take
treatment.
Other
speakers compared the situation of migrants in Austria,
France and the United Kingdom.
Each
referred to the European Court of Human Rights ruling in the case of N, a landmark
case which determined that it would not be “inhumane or degrading treatment”
for a state to deport a person to their home country even if antiretroviral
treatment were not always accessible there. Although the N case concerned a
Ugandan woman and the government of the United
Kingdom, it has had legal implications for countries across
Europe and has allowed to states to reject
many applications from migrants with HIV.
Franck
Amort, presenting on behalf of Maritta Teufl, noted that Austrian government
policy has become increasingly restrictive in recent years. An analysis of
court transcripts and rulings had identified that the examination of evidence
about treatment and healthcare facilities in a migrant’s country of origin tended
to be inadequate. Claims that treatments are available were taken on face
value, and the likelihood of the individual in question being able to actually
obtain treatment was not seriously considered.
The British
and French speakers presented quite different approaches to supporting migrants
threatened with deportation.
Taking
quite a pragmatic approach, Sarah Radcliffe of NAT described how, in the UK, an advocacy
organisation and group of HIV clinicians had worked to improve the access to
healthcare for asylum seekers who are being held by the government in a
detention centre (often a preliminary step before removal from the country).
Key aims were that access to antiretrovirals would be uninterrupted, there
would be continuity in healthcare (for example, attendance at clinic) and that
a person being deported would be adequately prepared (for example, with
sufficient drug supplies and links to care at their destination). To these ends,
a guidance document has been developed in co-operation with healthcare staff at
detention centres and this has been previously described on aidsmap.
Radcliffe
said that she was aware of the document being used by community organisations
to advocate for detainee’s rights to access HIV care, and in some cases to
prevent or delay deportation.
The aims of
Caroline Izambert from Act-Up Paris were more ambitious. She suggested that the
case law of N could still be challenged.
She also
pointed out that this court decision referred only to a minimum standard and
did not in any way prevent a state from offering more protection to a migrant
with a health problem.
In fact, France has since 1998 had a law allowing a person to be given a residence permit on medical
grounds. The person must require essential treatment that is not accessible in
their country of origin, but that is available in France. Although the implementation
of this law has tended to be restrictive in recent years, the law was upheld a
few months ago by the Conseil d’Etat, a high ranking judicial body.
Moreover,
this judicial decision clarified that for a treatment to be considered 'accessible' it had to be genuinely accessible to the individual concerned.
Although a drug may be available in a country, in practice treatments may only
be available in certain locations, to certain social groups, with interruptions
in supply, in limited quantities, or at a price that is unaffordable for the
person concerned.
Izambert
recommended that activists in other countries should fight for the
implementation of similar legislation.