Migration and HIV in Africa: Challenges and Recommendations
Increasingly, global responses to migration and to migrants are influencing responses to the HIV/AIDS epidemic itself. African migrants in particular have borne the brunt of xenophobia and discrimination directed toward outsiders. Those who are undocumented have little or no legal protections and limited access to basic health and social services that are fundamental to successful integration into a foreign environment. These barriers, coupled with the complex social, behavior and psychological dynamics of migrancy, form a constellation of risk factors that heightens vulnerability for contracting HIV/AIDS.
The African population has always been extremely mobile. Pre-colonial migratory patterns occurred without barriers or legal restraint, driven by agricultural resources, trade and labor. Similarly, in the post-colonial period migration has become a vehicle for economic betterment as well as an escape valve to overwhelming tensions caused by displacement, conflict, poverty, and resource deprivation. Today, international labor migration is commonplace.
With the increased sophistication of globalization a common pattern of regional and international African migration has emerged. The vast majority of migratory routes now steer northwards towards Europe and westwards towards the Americas. Migratory highways extend from as far as Somalia through Sudan, Libya to Tunisia and across the Mediterranean into Spain and Italy.
According to the International Labor Organization (ILO), over 20 million African men and women are migrant workers. The World Bank reports that remittances by Africans working aboard now account for a substantial portion of the gross domestic product of Lesotho, Senegal, Uganda and Nigeria. In spite of the critical role they play in the economic development of their adoptive countries, these workers are, at best, treated as second class citizens. Recognizing this reality, the international community has sought ways of achieving justice via the creation of specific international migrant worker rights conventions, including the Migration for Employment Convention (Revised) of 1949; the Migrant Workers (Supplementary Provisions) Convention of 1975; and the United Nations Convention on the Protection of the Rights of Migrant workers and their Families, adopted by the United Nations General Assembly in 1990. These legal instruments created principles for the establishment of national laws and judicial and administrative procedures related to the human rights of migrant workers (such as equal treatment in employment, social security, non-discrimination, and anti-trafficking activities). It is important to note that the U.S and most of the western European counties that receive migrant workers have not yet ratified or adopted the recommendations in these aforementioned treaties and therefore are under no legal obligation to extend to migrant workers the kind of protections envisaged in these conventions.
AIDS in Africa is a pandemic -- affecting the lives of over 22.5 million people in sub-Sahara Africa alone. In popular lure, migration and HIV/AIDS are often described as associated phenomena, with the migrant commonly considered the host and vector of HIV/AIDS. Despite the prevailing myth that migrants, refugees and other mobile populations spread HIV/AIDS, studies have shown that they have significantly lower prevalence rates than the surrounding communities wherein they reside. In no less than 60 countries, African migrants are forced to undergo mandatory HIV testing as a pre-condition for work permits and immigrant visas. In other countries, mandatory testing is a condition precedent for being granted an extension of work permits. A positive HIV test often leads to repatriation or denial of a visa or work permit for migrants. Mandatory HIV testing for purposes of exclusion must be discouraged; however HIV testing accompanied by assurances of access to appropriate treatment and care following a positive diagnosis should be made available.
In many African countries, regulatory frameworks are being revised with the objective of integrating HIV/AIDS-related human rights principles into a national legal fabric. Some countries are going as far as drafting provisions in the law that clearly stipulate that HIV positive people entering or returning will enjoy the same rights as non-infected persons, reaffirming that one's HIV status will have no bearing on the right of entry, freedom of movement or freedom to work. For example, the economically integrated regional trading blocs in Africa- known as the Regional Economic Communities (RECs) have subscribed to the commitments laid out in the 2001 United Nations General Assembly Special Session on HIV/AIDS Declaration. The declaration stipulates that RECs should develop and implement strategies that incorporate HIV/AIDS awareness, prevention, care and treatment into emergency response and national assistance programs that target refugees, internally displaced persons, and migrants. It is within this context that some African countries, already overburdened with the HIV/AIDS epidemic of their own nationals, have restructured their health systems so as to benefit foreign migrants by providing free HIV/AIDS-related medical services.
Governments have an obligation to safeguard human rights protections for all people, irrespective of HIV status. As such, a strategic conscious-raising and advocacy campaign needs to be undertaken to change worldwide perception on migrant populations. Restrictions imposed on travel, entry and procedures related to immigration and asylum based on one's HIV/AIDS status are a violation of the right to equality of treatment before the law. National governments must ensure that such rights do not disappear once a migrant leaves his or her country of origin.
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This article was provided by Gay Men's Health Crisis. It is a part of the publication GMHC Treatment Issues. Visit GMHC's website to find out more about their activities, publications and services.