HIV PREVENTION AND CARE IN MIGRANT
AND MOBILE POPULATIONS
HIV frameworks & policies: Where do
migrants and mobile populations fit?
Adeeba Kamarulzaman
University of Malaya
Kuala Lumpur, Malaysia
• 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 and
HIV risk
Multilevel determinants
1.
2.
3.
4.
Policy
Sociocultural
Health and mental health
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 (20062010)
• SAARC Regional Strategy for TB/HIV Coinfection (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 HIVrelated 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.