CARAM Asia Press Statement

KUALA LUMPUR 1 Dec, 2007: Mandatory health testing of migrant workers and subsequent refusal of entry for work or deportation on the basis of their health or HIV status violates basic human rights and contributes to the discrimination and stigmatization of migrants and people living with HIV. CARAM Asia, a network representing migrant workers, calls on the governments of both sending and receiving countries to uphold international best practices and their own national laws on HIV and human rights by the following actions:

• Lift requirements of compulsory or mandatory health and HIV testing of migrant workers at all points of the migratory process as a condition for employment;
• Terminate policies and practices of deportation of migrants on the basis of their HIV status or for other health conditions, such as pregnancy;
• Provide ART to migrant workers and facilitate their access to appropriate health services and treatments in both sending and receiving countries.

The current reality is that mandatory testing is used by receiving countries solely as a screening mechanism to determine migrants’ eligibility for employment. As a result, there are no direct linkages to health services or treatment for those found with a health condition, most notably HIV. Any health testing, especially if it includes HIV, should be voluntary, should abide by best practices of informed consent, should provide proper counselling, and should maintain confidentiality. Health testing should be done with the intention of benefiting the health of the individual undergoing testing and should therefore be directly linked to proper health services and treatment, especially in the case of HIV and other communicable diseases.  

Migrant workers come from the poorest countries. These people make a considerable investment in order to send a family member to work abroad, often by selling land or other essential assets. The exclusionary practices that stem from mandatory testing prevent these people from being allowed to work in order to assist their families in battling poverty, leaving them and their families desperate and destitute. In many cases, even though having been rejected for work or deported, a migrant may not be informed of the health condition affecting him or her. The ramifications for those infected with HIV, their spouses and partners, are considerable.

Counter to arguments used by receiving countries’ governments, mandatory HIV testing for migrants has no proven effective role as a means for preventing the spread of HIV; it only contributes to the continued stigmatization of migrants and people living with HIV. Due to demographic changes, many developed countries are reliant on migrant workers to fill basic but undesirable jobs that keep economies going, yet these countries refuse to provide migrant workers with ART or treatments for curable conditions. The fear that the availability of antiretroviral treatment would attract an increasing number of HIV-infected migrants and thus burden public health programmes as a rationale for not providing migrants with these treatments is unfounded; it is economic opportunity that remains the driving force of migration, not the search for therapies. In light of the realities that migrant workers face and their contribution to the economies of both sending and receiving countries, CARAM Asia calls on governments to take the following actionable steps towards realizing migrant workers’ full rights to health and well-being.

Actions for governments:

• All MOUs on migration should explicitly include migrants’ right to health and remove any exclusionary conditions such as HIV as a precondition for employment.
• Make all HIV and health testing for migrants voluntary.
• Harmonize all laws and policies on HIV testing to ensure that any testing adheres to internationally accepted standards which include: informed consent, confidentiality, pre and post-test counselling, and proper referral to ARV, care and support services. 
• States should repeal laws and policies that permit mandatory testing and deportation which violates basic human rights and the right to work.
• States should provide appropriate health care, information and services for both documented and undocumented migrants with special consideration for HIV and sexual and reproductive health.
• All health services, especially counselling and prevention information, should be provided in a way that migrants understand taking into consideration their language and literacy levels.
• All HIV positive test results for migrants should be confirmed through independent confirmatory testing.
• Migrants should not be discriminated against in accessing ART, especially when ART is available to the general public under a subsidized rate. 
• Migrant workers, especially HIV positive and female migrants, should have the opportunity to be consulted in the making of policies that concern them.