CARAM Asia’s Open Letter to Governments in Asia:
18 May, 2008: Migrant workers’ vulnerability to sexual violence, lack of access to affordable health care services and HIV prevention programmes are causes of HIV infections that can be mitigated. Therefore, CARAM Asia urged you to address these vulnerabilities through HIV prevention, treatment and care programmes targeting migrant communities.
In conjunction with the Global AIDS Week of Action from 18-24 May 2008, CARAM Asia joined activists around the world calling for governments to honour your commitment to fight AIDS made at the United National General Assembly Special Session on AIDS (UNGASS) in 2001. Two weeks from now, there will be a high level meeting at the UN to discuss the progress made by each government in the fight against AIDS as set out in the UNGASS meeting.
We thank you for your bold promises on universal access to anti-retroviral treatment by the year 2010. In 2005, United Nations Member States endorsed this goal, committing to: “developing and implementing a package for HIV prevention, treatment and care with the aim of coming as close as possible to the goal of universal access to treatment by 2010.”
Achieving this target means putting many more people on treatment than the 4.9 million currently in need in Asia. In 2007, the United Nations Joint Programme on HIV/AIDS (UNAIDS) and World Health Organisation (WHO) estimated 4.9 million people in Asia were living with HIV. Approximately 300,000 people died from AIDS-related illnesses in this region in the same year. You can reverse the spread of this epidemic.
However, your approach will not be comprehensive without addressing the proven migrant workers’ vulnerabilities to HIV. There are currently about 54 million migrant workers across Asia (Source: Asian Development Bank) but data on the exact number of them contracting HIV while abroad is not known as they would be deported back to their origin country once found to be HIV positive. Some are even sent back without knowledge of their HIV status, counselling and treatment in destination countries. Such move is like sweeping the problem under the carpet. Uninformed migrant workers risk dying from HIV related illnesses.
For the destination country governments, it is worth noting that being a migrant is not a risk factor to HIV, it is the stresses and vulnerabilities of the migration process that are the risk factors. Contrary to addressing these environmental vulnerabilities, destination countries are responding to the epidemic with mandatory HIV testing and deportation policies. These policies are not a public health approach. Health testing should be done with the intention of benefiting the health of the individual undergoing testing. It should be complimented with proper health services and treatment.
Thus, we call upon you to:
1) Include HIV education in pre-departure and orientation programmes for migrant workers
2) Put in place reintegration programme and referral systems for returnee migrants to access treatment, care and support services
3) Provide affordable access to appropriate health services and treatments in both sending and receiving countries for migrant communities
4) Lift requirements of mandatory health and HIV testing of migrant workers at all points of the migratory process as a condition for employment. Many people living with HIV are still productive and can contribute effectively to economies. The solution for them should not be deportation but adequate treatment.
5) Terminate policies and practices of deportation of migrants on the basis of their HIV status
6) Ensure meaningful involvement of migrants living with HIV throughout the entire programme planning and implementation processes. This is important for programmes to be tailored to the needs of affected communities.
Governments should step up its effort to mount life saving efforts addressing the vulnerabilities of migrant workers with costed budgets. It is only two years to reach the target of universal access to treatment by 2010, you must ensure migrants are not marginalised.
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