Tip of the iceberg
Entry restrictions generally affect people who want to stay in a country
for a long period of time. Depending on the duration of the stay, a
negative HIV test result must be presented to authorities for approval
of the stay. HIV-positive test results generally lead to refusal of
entry or to being forced to leave if one is already in the country. Such
regulations limit PLHIV in the selection of educational opportunities
and places of work. This discrimination cannot be accepted, particularly
in view of the change in status of HIV from a fatal to a treatable
chronic disease, since PLHIV – just like any other citizens today – need
to plan their education and pursue a profession.
PLHIV are at constant risk of losing what they have built up: their job,
their financial basis, access to health care, their home, their friends
and family, and even their life. In this regard, some countries in Asia
and the Middle East set particularly poor examples. We have anecdotal
reports of people dying in deportation confinement, denied access to
treatment while waiting to return to their homeland. This usually
affects migrants who have been confined for deportation when their HIV
status is discovered. The excuse of ‘legal problems’ between the
authorities is often given. Authorities can even make it harder for
their own citizens to return home if it becomes known that they are
infected with HIV or have AIDS.
The true extent of the problem is unknown
The true scale of the daily discriminations experienced by PLHIV cannot be described, and the data compiled here can only provide a limited picture of the consequences of statutory regulations. There is currently no system and no organization which centrally collects relevant cases and reports on them. We only have individual, anecdotal reports. Further uncertainty about the true extent of these regulations is created by the fact that existing laws are sometimes not applied or only applied by some officials. The following information provides an overview of the extent of the problem:
- Approx. 40 million people worldwide are living with HIV. Most of the affected persons live in low and middle-income countries. Many of them have an urgent need for treatment options in order to survive.
- According to figures from the United Nations World Tourist Organisation (UNWTO), there were approx. 935 million international arrivals worldwide in 2010.
- Approx. 191 million migrant workers live outside their own countries, according to estimates by the IOM. The refugee commission of the United Nations (UNHCR) assesses the number of refugees and people seeking asylum at 20.8 million worldwide.
- With respect to the countries with discriminatory entry regulations, more reliable monitoring of actual conditions is required for the future. This is the only way we can show how PLHIV suffer disadvantages and discrimination on a global level.
A heavy burden for PLHIV
Application forms for entry visas often contain questions about general
health, such as “Do you suffer from a communicable disease?” Those who
decide to answer truthfully can expect entry to be refused. If
HIV-positive travellers decide to answer this question untruthfully,
they then encounter the subsequent problems of needing to hide any
medication they are carrying and needing to give the healthiest possible
impression to the border official(s). At border checks, it is the job
of officials to look at luggage and/or check completed forms. The checks
may also include checks of physical appearance.
If health certification is required when applying for the visa or for
entry at the border, the required tests and examinations are frequently
carried out by contractual doctors or other official bodies. Only those
who subject themselves to these regulations have a chance of entering
the chosen country – apart from the option of paying bribes, as
anecdotal reports suggest.
Some countries require foreigners to have regular routine examinations
which may include an HIV test. The costs for all these tests must
naturally be covered by the individual, putting financially weaker
groups of people at a disadvantage.
Other checks are performed by agencies whose task it is to hire workers
in foreign countries. In applications for healthcare professions
(physicians, nurses, etc.) a negative HIV test is a prerequisite for
even being invited to an interview. In this manner, for instance,
medical personnel is recruited from South Africa to work in the rich
north. Other employers and other institutions such as universities also
often openly require HIV tests as a prerequisite for employment,
allocation of study places, and grants.
In principle, anyone entering a country may find themselves in the
position of having to provide information about “suspicious” fellow
travellers. An HIV-positive passenger from Japan on his way to China,
when China still had its restrictions enforced, was sent back on the
next airplane after a fellow passenger on the plane listened in on a
conversation about HIV and reported him.
There is a particularly significant strain when a traveller’s physical
appearance makes it impossible to hide or deny illness. It is then often
at the discretion of the border official to order an examination.
People who refuse to subject themselves to this will not have the option
to enter the country, as examples from Malaysia and other countries
show.
Positive examples are rare
Positive examples are rare, but should give us courage that cooperative
commitment can bring about change. There are some countries which have
eased or removed their restrictions in recent years. The examples of the
USA and China are an important victory in the fight against the global
discrimination against PLHIV.
Canadian HIV and human rights activists did good work in advance of the
World AIDS Conference in Toronto 2006 and obtained changes in the entry
regulations for short-term visas. This made it possible for PLHIV to
participate in the conference and of course had longer-term benefits as
well.
Following this, in 2007 the International AIDS Society (IAS) re-stated
that it would not hold an international AIDS conference in any country
which refuses entry to PLHIV.
Pressure by the Global Fund to cancel a working meeting in China, if the
Chinese government did not remove questions about HIV from the entry
application form, shows that this subject has reached the global HIV
community.
The creation of an International Task Team by UNAIDS is another positive
sign that the situation regarding entry regulations for PLHIV is
changing. Last but not least, the request of the UN general secretary
Ban Ki-Moon in June 2008 to end this form of stigmatization has met with
worldwide resonance. Let us hope that Ban Ki-Moon’s authority paves the
way for the elimination of the harsh restrictions in South Korea, his
home country.
A prerequisite for these positive developments was and is that the scope
of the problem must be pointed out again and again. We are glad to see
that our data collection has proved to be an extraordinarily strong
political instrument in these processes. The examples given above
encourage us to keep combating the negative perception of PLHIV (cost
factor, virus carriers, source of danger) which are the background of
such discriminatory regulations. Clarifying how HIV has changed in
recent years and the contribution which PLHIV make to society is an
important step against the policy of exclusion.
Even after the legislative changes in the USA, the world at present is
still not a very open place for PLHIV. In order to change the situation
we need to fight for fundamental human rights, closely connected with
the lifesaving ability to secure financial survival and access to
treatment and care. To reach these goals, we require your support.