Taiwan: CDC planning to expand eligibility for publicly funded HIV treatment for foreign nationals

The Centers for Disease Control (CDC) is planning to expand eligibility for publicly funded HIV treatment for foreign nationals next year, although it has not released many details on how the expansion would work.

CDC Director-General Lo Yi-chun (羅一鈞) told a press event on Monday last week that subsidy regulations are being revised and eligibility for publicly funded treatment for foreign residents would be expanded.

Lo at the time said the expansion would initially prioritize foreign nationals holding permanent residency and those under 18, but he offered no other details.

When the CDC was asked later in the week about how many more foreign nationals would become eligible for publicly funded treatment, it said it was still assessing the potential impact and “has no clear figure yet.”

Under its existing support program, the CDC covers costs for an HIV patient’s first two years on medication, after which expenses are covered by the National Health Insurance (NHI) system.

As of late last month, 36,494 Taiwanese and 615 foreign nationals in Taiwan were living with HIV, the CDC said in a written response on Friday.

Of the 615 foreign nationals, 343 were already covered under NHI, while the others have been on medication for less than two years and were not yet eligible for NHI coverage, although some have received financial help in other ways.

Patients are currently treated with highly active antiretroviral therapy, commonly known as “cocktail therapy” combining at least two to three antiretroviral drugs, with monthly medication costs capped at under NT$13,200.

At the news conference on Monday last week, Lo said the enrollment quota for the publicly funded HIV pre-exposure prophylaxis (PrEP) program would also be increased next year, to 9,500 people, from 8,000 this year.

The program, designed to prevent the incidence of HIV, is open to Taiwanese and foreign spouses of Taiwanese who meet the criteria and are assessed by physicians, the CDC said.

Lo said Taiwan would record about 850 new HIV cases this year, the lowest level since 2003 and down about 11 to 12 percent from last year, in part because of the PrEP program.

Kazakhstan: Healthcare access for documented and undocumented migrants in Kazakhstan

Translated with Deepl.com. For original article in Russian, please scroll down.

According to the UN, the health of migrants is a human right, not a factor for discrimination. Various international organisations are calling on countries to provide universal health coverage regardless of status, as migrants are often even more vulnerable than the local population to infections, injuries, mental disorders (stress, anxiety) and have special needs that must be taken into account in policies under the Global Compact on Migration. A Kazinform correspondent investigated the state of migrant health care in Kazakhstan.

As of autumn 2025, more than 14,000 foreign citizens are officially working in Kazakhstan, with figures varying: on 1 October there were 14,666 people, and on 1 November there were more than 14,400; The quota for attracting foreign workers in 2025 has been increased to 19,400.

Migrants in Kazakhstan are entitled to various types of medical care, depending on their legal status. Persons with residence permits and kandasy can receive full free medical care (GOBMP) and, upon payment of contributions, services under the compulsory medical insurance system (OSMS). Foreigners temporarily staying in the country are entitled to free emergency and urgent medical care.

Emir from Tajikistan is a doctor by training. He initially ended up in Kazakhstan because he wanted to obtain a visa to Europe through a local company for seasonal field work in order to earn money. But the company deceived him, so Emir decided that it was for the best and that he could officially work in his profession in Kazakhstan.

Emir obtained a work permit, and he tries to take care of his health and get medical check-ups whenever possible. Emir is lucky: he lives and works in Kazakhstan legally, so he can afford to enjoy all the benefits available to foreigners with a temporary residence permit (TRP) or a residence permit (RP).

But what about those who are migrants in Kazakhstan but outside the legal framework?

Anna Kozlova is a migration consultant at the non-governmental organisation Community Friends. Her main focus is on helping foreigners who find themselves in an illegal situation, either deliberately or through circumstances beyond their control.

“From our experience, I can say that Kazakhstan’s legislation is quite loyal to migrants, especially compared to other post-Soviet countries. We have access to medical care and treatment for illnesses. This attracts a large number of migrants to the country. But the problem is that not all of them end up working officially. Only migrants who are legally in the country can enjoy all the benefits. People who are here illegally cannot count on anything, except perhaps the kindness of Kazakhstani people who will help them,” said Anna Kozlova.

In practice, there are cases where people find themselves hostage to bureaucracy. Anna told the story of a woman from Kyrgyzstan who crossed the Kazakh border 10 years ago with a bag of heroin.

She was detained in Kazakhstan, sentenced to 10 years in prison, and released on parole after seven years. Parole requires that a person not only be firmly committed to rehabilitation, but also have a place to live, where they can register and be monitored by law enforcement agencies, and have the opportunity to find employment, because there are lawsuits, and because that is what is required for resocialisation.

In this case, a citizen of another country is released on parole, but she has no opportunity to obtain a temporary residence permit as a migrant in order to legally stay here, serve the remainder of her sentence, find employment and live, because she has already served seven years of her sentence.

But the problem is that the court has sentenced her to five more years of supervision, which means that after her sentence ends, she must remain in Kazakhstan for another five years under the supervision of law enforcement agencies. And then she becomes pregnant. She came to me in her seventh month of pregnancy. When she gave birth, we thought that since she had served her sentence, we would be able to send her back to her homeland with her child. But the migration service and the prosecutor’s office said they had no right to ignore the court’s decision on five years of supervision. Even though she cannot find a job, receive benefits, free medical care for herself or her child, or vaccinations. I was told to apply to the court through the Kyrgyz embassy to have the supervision order revoked, and only then would we be able to send her back to her homeland. For now, she is staying at the Mother’s House and her status is in limbo: she is illegal because she cannot obtain a temporary residence permit, but she is also legal because she is under supervision, said Anna Kozlova.

How migrants’ illnesses are treated in Kazakhstan

Getting checked for certain illnesses is very important. However, not every migrant is willing or able to do this on a regular basis, especially when it comes to HIV testing.

As part of a special programme called ‘Migrant Health’, implemented by private public foundations, a goal was set to expand the model of HIV prevention among migrants.

The project covered almost two thousand migrants, of whom 85 were found to be HIV-positive. In other words, 90% of those covered were HIV-negative, while 10% were HIV-positive. Most of the migrants were from Tajikistan (25%), Uzbekistan (22%) and Kyrgyzstan (17%), with returnees accounting for 30% of the total.

Key populations accounted for 82% of the total number of people covered, while non-key populations accounted for 18%. It should be noted that the project did not check whether these people had previously been registered as HIV-positive in their home countries, or whether they were previously unaware of their status, or whether they became infected while in Kazakhstan.

Be that as it may, the results showed that in order to preserve the health of migrants, it is necessary not only to shift responsibility onto them, but also to take measures on the other side.

What is available to migrants with HIV in Kazakhstan

Foreigners with HIV in Kazakhstan are not legally entitled to free ARV therapy if they are in the country temporarily, as it is part of the guaranteed free medical care for citizens and kandas. However, thanks to the support of the Global Fund and NGOs, such people are provided with medication and counselling through special programmes, such as PEP (post-exposure prophylaxis), so that they can receive treatment and continue therapy, sometimes with legal support.

Samir, a 27-year-old migrant from Tajikistan, learned about his HIV status by contacting the Migrant Health 2 project in Kazakhstan. He thought the diagnosis meant the end of a normal life, but peer counsellors (people who have lived with the disease themselves) helped him understand that HIV is treatable and that U=U: with treatment, the virus is not transmissible.

Because foreigners in Kazakhstan cannot receive ARV therapy, the project team registered Samir remotely with the AIDS centre in Tajikistan: he took tests in Kazakhstan, received consultations online, and the medicines were delivered to his place of work.

When it became clear that his wife was pregnant, the project helped to conduct testing, maintaining confidentiality, and the test was negative.

After three months of treatment, Samir’s viral load became undetectable. He remained healthy and protected his family.

Why is HIV treatment important for everyone? Firstly, to control the disease. HIV is well controlled today: people who receive treatment live normal lives. Secondly, it is necessary to achieve zero transmission. Modern therapy reduces the amount of virus in the blood to zero. This means that the health of a person with HIV does not deteriorate, and the person does not transmit HIV to others. It is also important to stop the epidemic. When all people living with HIV — locals, migrants and relocants — receive treatment, the epidemic slows down and stops. Providing treatment to migrants is not only a matter of humanity, but also an effective public health measure, said Oksana Ibragimova, an advocacy specialist at the Kazakh Union of People Living with HIV.

She is convinced that treating HIV, as well as other diseases among migrants, protects society, as migrants are part of society; they work, study and start families. Their health directly affects the health of local communities.

However, restrictions and deportation of HIV-positive migrants, she said, do not stop the epidemic: people continue to move, and the lack of treatment is the main factor in the spread of HIV.

In addition, prohibitive measures create fear and lead to people avoiding testing and help, which increases the number of undetected cases. The most effective approach is to ensure access to treatment: a person on therapy does not transmit the virus, which means that this is the most effective way to protect public health.

Thanks to the conditions created by the state and the activities of public figures, migrants with HIV-positive status in Kazakhstan can not only receive advice on access to treatment in Kazakhstan, but also referrals for testing at the AIDS Centre at the expense of public funds, as well as assistance in obtaining therapy (from their home country, at the expense of the GFSMT quota, issuance from a mutual aid first aid kit), peer-to-peer support to start treatment and maintain adherence.

What else can migrants be treated for in Kazakhstan

If a migrant is in Kazakhstan legally, i.e. has a temporary residence permit or permanent residence permit, they are entitled to medical assistance under medical insurance if they have made contributions.

If a foreigner is in the country legally but is not working, then in the event of illness, they will be offered two options: to return home for treatment or to pay for treatment in Kazakhstan.

I had a case with a girl from Afghanistan who was living here legally with her husband — he was working, and she had a temporary residence permit as a family reunion, but she had not made any contributions because she was not working here. One day, she was diagnosed with tuberculosis and admitted to hospital. The open form of tuberculosis was treated, and then she had to either be sent back to her home country to complete her treatment or pay for it here. They wanted to send her to Afghanistan, but with our help, we managed to get permission for her to stay, and her husband paid for her treatment,” Kozlova explained.

The health of migrant children in Kazakhstan

Migrant children, like adults, face certain restrictions.

For example, if a migrant child needs to be vaccinated, they have to go to private medical centres if their parents are staying in Kazakhstan illegally or semi-legally. The same problem applies to their education.

‘In some places, doctors make concessions and examine these children. Teachers make concessions in schools because they understand that the children are hanging around, and they take them in for education, figuring something out there. But if migrants are in the country illegally, then according to the law, their children cannot count on anything either,’ concluded Anna Kozlova.

As we can see, if a foreigner comes to Kazakhstan, lives and works here legally, they have good opportunities for social security, including health care.

However, in the case of illegal status, the situation becomes more complicated, and only with the support of competent consultants and in close contact with the authorised state bodies is it possible to solve problems on an individual basis.

Experts believe that maintaining the health of everyone in Kazakhstan is not just a matter of image, but also a direct contribution to the epidemic well-being and health protection of society.

As a reminder, the new rules for registering immigrants in Kazakhstan will come into force on 1 July 2026.

Легально и нелегально: какие медуслуги доступны мигрантам в Казахстане

По данным ООН, здоровье мигрантов — это право человека, а не фактор дискриминации. Различные международные организации призывают страны ко всеобщему охвату услугами здравоохранения без учета статуса, так как мигранты нередко даже больше местного населения подвержены риску инфекций, травм, психических расстройств (стресс, тревога) и имеют особые потребности, которые должны учитываться в политике, в рамках Глобального договора по миграции. О том, как обстоят дела с охраной здоровья мигрантов в Казахстане, узнавал корреспондент Kazinform.

По состоянию на осень 2025 года, в Казахстане официально работают более 14 тысяч иностранных граждан, причем цифры варьируются: на 1 октября было 14 666 человек, а на 1 ноября — более 14,4 тысячи; квота на привлечение ИРС в 2025 году увеличена до 19,4 тысячи.

Мигранты в Казахстане имеют право на разные виды медицинской помощи, зависящие от их правового статуса. Лица с видом на жительство и кандасы могут получить полный объем бесплатной медицинской помощи (ГОБМП) и при уплате взносов услуги по системе обязательного медицинского страхования (ОСМС). Иностранцы, временно пребывающие в стране, имеют право на экстренную и неотложную медицинскую помощь бесплатно.

Эмир из Таджикистана сам по образованию врач. В Казахстане изначально оказался в связи с тем, что хотел через местную компанию получить визу в Европу на сезонные полевые работы, чтобы заработать денег. Но компания обманула его и так Эмир решил, что оно и к лучшему, и в Казахстане можно официально поработать по специальности. Эмир получил разрешение на работу, он старается следить за своим здоровьем и по возможности проходить обследования.

Эмиру повезло: он живет и работает в Казахстане легально, поэтому может себе позволить пользоваться всеми преимуществами, которые доступны иностранцам с РВП (разрешение на временное пребывание) или ВНЖ (вид на жительство). А что делать тем, кто является в Казахстане мигрантом, но вне правового поля?

Анна Козлова является консультантом по вопросам миграции в неправительственной организации Сommunity friends. Основное направление ее деятельности — помощь тем иностранцам, кто оказался в положении нелегала осознанно или по стечению обстоятельств.

— Из опыта нашей работы могу сказать, что в Казахстане законодательство довольно лояльно к мигрантам, особенно по сравнению с другими странами постсоветского пространства, у нас есть доступ к медицине, лечат заболевания. Это привлекает в страну большое количество мигрантов. Но проблема в том, что не все из них в итоге работают официально. А ведь только легально находящиеся в стране мигранты пользуются как раз всеми благами. Пребывающие нелегально люди ни на что не могут рассчитывать, разве что на то, что казахстанцы по доброте будут помогать, — сказала Анна Козлова.

Встречаются на практике случаи, когда человек оказывается заложником бюрократии. Анна рассказала о ситуации женщины из Кыргызстана, которая 10 лет назад пересекала границу Казахстана с сумкой героина.

Ее задержали на территории Казахстана, осудили на 10 лет, спустя семь лет ее освободили по УДО. Условно досрочное освобождение предусматривает, что человек должен не просто твердо встать на путь исправления, но и иметь жилье, куда человек может приехать, прописаться, где его могут контролировать правоохранительные органы, и должна быть возможность трудоустроиться, потому что есть иски, ну и вообще так положено для ресоциализации.

В данном случае гражданка другой страны освобождается по УДО, но у нее нет никаких возможностей оформить себе РВП как мигранту, чтобы легально здесь находиться, отбывать остаток срока, трудоустроиться и жить, потому что она семь лет отбывала наказание.

— Но казус в том, что ей суд назначает еще пять лет надзора, то есть, после окончания срока, она еще пять лет должна находиться в Казахстане под надзором правоохранительных органов. А тут еще она беременеет. Она ко мне обратилась на седьмом месяце беременности. Когда случились роды, мы подумали, что раз она срок отбыла, мы ее сможем отправить на родину с ребенком. Но в миграционке и прокуратуре заявили, что не имеют права игнорировать решение суда о надзоре на пять лет. Хотя ей ни на работу ни устроиться, ни пособия, ни бесплатную медицину ни для себя, ни для ребенка не получить, ни прививки. Мне сказали обращаться в суд через посольство Кыргызстана, чтобы отменили решение по надзору, и только тогда мы ее сможем отправить на родину. Пока она в Доме мамы находится и ее статус в подвешенном состоянии: она и нелегал, так как не может получить РВП, но и легал, потому что находится под надзором, — рассказала Анна Козлова.

Как лечат заболевания у мигрантов в Казахстане

Проходить чек-апы (проверки) на те или иные заболевания — очень важная вещь. Другое дело, что не каждый мигрант готов или имеет возможность делать это на регулярной основе, особенно, если это касается проверки на ВИЧ.

В рамках специальной программы «Здоровье мигрантов», реализуемой частными общественными фондами, была поставлена цель: расширить модель профилактики ВИЧ-инфекции среди мигрантов.

В рамках проекта были охвачены почти две тысячи мигрантов, из них выявлено 85 случаев ВИЧ. Иными словами, 90% охваченных лиц имели ВИЧ-отрицательный статус, в то время как 10% были ВИЧ-положительными. Большинство мигрантов были из Таджикистана (25%), Узбекистана (22%) и Кыргызстана (17%), а также релоканты составили 30% от общего числа.

Ключевые группы составили 82% от общего числа охваченных, а не ключевые группы — 18%. Отмечено, что проект не проверял, были ли эти люди ранее на учете по ВИЧ у себя на родине, или они ранее не знали о своем статусе, либо получили его, находясь в Казахстане.

Как бы там ни было, результаты показали, что для сохранения здоровья мигрантов необходимо не только перекладывать ответственность на них самих, но и предпринимать меры с другой стороны.

Что доступно мигрантам с ВИЧ в Казахстане

Иностранцам с ВИЧ в Казахстане бесплатно АРВ-терапия по закону не положена, если они находятся в стране временно, так как она входит в гарантированный объем бесплатной медпомощи для граждан и кандасов. Однако, благодаря поддержке Глобального фонда и НПО, таким людям предоставляются препараты и консультации через специальные программы, как, например, ДКП (доконтактная профилактика), чтобы они могли получить лечение и продолжить терапию, иногда с помощью правовой поддержки.

27-летний мигрант из Таджикистана Самир узнал о своем ВИЧ-статусе, обратившись в проект «Здоровье мигрантов 2» в Казахстане. Он думал, что диагноз означает конец нормальной жизни, но консультанты-равные (люди, которые сами пережили заболевание) помогли ему понять, что ВИЧ лечится и что Н=Н: при терапии вирус не передается.

Из-за того, что иностранцы в Казахстане не могут получать АРВ-терапию, команда проекта поставила Самира на дистанционный учет в СПИД-центр Таджикистана: анализы он сдал в Казахстане, консультации получил онлайн, а лекарства приехали туда, где он работал.

Когда выяснилось, что дома у него беременная жена, проект помог провести тестирование, сохранив конфиденциальность, тест оказался отрицательным.

Через три месяца лечения вирусная нагрузка Самира стала неопределяемой. Он сохранил здоровье и защитил свою семью.

— Почему лечение ВИЧ важно для всех? Во-первых, контроль заболевания. ВИЧ сегодня хорошо контролируется: человек, который получает лечение, живет обычной жизнью. Во-вторых, необходимо добиться нулевой передачи. Современная терапия снижает количество вируса крови до нуля. Это значит: здоровье человека ВИЧ не ухудшается, человек не передает ВИЧ другим. Также важна остановка эпидемии. Когда все люди, живущие с ВИЧ — и местные жители, и мигранты, и релоканты, получают лечение, эпидемия замедляется и останавливается. Обеспечение лечения мигрантов — это не только вопрос гуманности, но и эффективная мера общественного здоровья, — рассказала специалист по адвокации в Казахстанском союзе людей, живущих с ВИЧ Оксана Ибрагимова.

Она убеждена, что лечение ВИЧ, как и других заболеваний у мигрантов, защищает общество, так как мигранты — часть общества, они работают, учатся, создают семьи. Их здоровье напрямую влияет на здоровье местных сообществ.

А вот ограничения и депортация ВИЧ-положительных мигрантов, по ее словам, не останавливают эпидемию: люди продолжают перемещаться, а отсутствие лечения — главный фактор распространения ВИЧ.

Кроме того, запретительные меры создают страх и приводят к тому, что люди избегают тестирования и помощи, что увеличивает число невыявленных случаев. Наиболее эффективный подход — обеспечить доступ к лечению: человек на терапии не передает вирус, а значит, это самый действенный способ защитить общественное здоровье.

Благодаря условиям, которые создает государства, и деятельности общественников мигранты с ВИЧ-положительным статусом в Казахстане могут не просто пройти консультацию о доступе к лечению в Казахстане, но и направление для обследований в СПИД Центр за счет общественных фондов, а также помощь в получении терапии (с родины, за счет квоты ГФСТМ, выдачи из аптечки взаимопомощи), поддержку в формате «равный-равному» для начала лечения и поддержания приверженности

Что еще могут вылечить мигранты в Казахстане

Если мигрант находится в Казахстане легально, то есть, имея РВП или ВНЖ, он имеет право на медпомощь в рамках медицинского страхования при наличии отчислений.

Если же иностранец находится легально, но не работает, то в случае заболевания ему предложат два вариант: уехать долечиваться домой или лечиться в Казахстане платно.

— У меня был случай с девушкой из Афганистана, она здесь с мужем проживала легально — он работал, а у нее было РВП как воссоединение с семьей, но не было отчислений, так как она здесь не работала. Однажды у нее нашли туберкулез, положили в больницу. Открытую форму по ГОБМП купировали и потом должны либо на родину отправить долечиваться, либо платно здесь. И ее хотели отправить в Афганистан, но с нашей помощью нам удалось добиться разрешения остаться, муж ей оплачивал лечение, — пояснила Козлова.

Здоровье детей мигрантов в Казахстане

Дети мигрантов также как и взрослые сталкиваются с определенными ограничениями.

Например, если ребенку мигранта нужно получить прививку, приходится обращаться в частные медцентры в случае нелегального или полулегального пребывания его родителей в Казахстане. Такая же проблема и с получением ими образования.

— Где-то врачи идут на уступки, смотрят этих деток. Педагоги идут на уступки в школах, потому что понятно, что дети болтаются, и берут их на обучение, там придумывают как-то. Но если мигранты находятся нелегально, то по закону их дети тоже ни на что не могут рассчитывать, — заключила Анна Козлова.

Как мы видим, если иностранец приезжает в Казахстан, живет и работает здесь легально, то перед ним открываются хорошие возможности по социальному обеспечению, включая контроль за здоровьем.

А вот в случае с нелегальным статусом ситуация осложняется, и только при поддержке грамотных консультантов и в тесном контакте с уполномоченными государственными органами возможно решить проблемы индивидуально.

Сохранение здоровья всех, кто находится в Казахстане — не просто имиджевая задача, но и прямой вклад в эпидемическое благополучие и защиту здоровья общества, считают эксперты.

Напомним, новые Правила регистрации иммигрантов в Казахстане вводятся с 1 июля 2026 года.

South Africa: Immigrants report extortion for access to life-saving medication at Gauteng clinics

Immigrants say they are being charged for ARVs, chronic medication and baby immunisations at some Gauteng clinics

  • Immigrants say clinic staff at Spartan, Jeppe and Yeoville clinics in Gauteng are extorting money from them by charging them for antiretrovirals (ARVs), other chronic medicines and baby immunisations.
  • The going rate for a three-month supply of ARVs appears to be R300.
  • The National Department of Health says it is unaware of this but condemns it and requests that anyone with evidence contact the department or law enforcement.

Last week, the Gauteng High Court ordered the government and police to take firm action against “xenophobic vigilantes” blocking immigrants from accessing health services at clinics. This came after months of reportsthat vigilantes were screening out immigrants at Johannesburg clinics. In November, the high court interdicted Operation Dudula from demanding to see IDs of members of the public.

We have subsequently heard from immigrants that clinic and security staff, sometimes in cahoots with Operation Dudula members, are extorting money from them in return for access to state health services.

At some clinics, immigrants are admitted but then never served, or they are told that there is no stock of the medicines they require. The desperate patients are then open to extortion. This takes the form of clandestinely selling them ARVs and chronic medicines.

GroundUp went to various clinics in Gauteng and was told of extortion at all the hotspots where Operation Dudula has been blocking immigrants from healthcare.

Spartan clinic

We received a tip-off that some staff at Spartan clinic are secretly sharing their WhatsApp numbers with immigrants desperate to access healthcare. The staff then offer ARVs, other chronic medicine, baby immunisations, prenatal care for pregnant mothers, and other services for various fees. Those who agree to pay are admitted to the clinic by special appointment.

To protect our sources, we will not be naming patients.

Q, a patient at Spartan since 2019, would collect her ARVs from Spartan clinic every three months. But since October, because she is an immigrant, she has been chased away at the gate.

A fellow immigrant then gave her the WhatsApp number of a nurse, who told her she could get her ARVs if she paid.

“I was desperate and feeling sick from spending weeks without my medications,” says Q.

She made an appointment and was ushered in by the nurse. It surprised her that the same security guards and Operation Dudula members who had previously chased her away, did not stop her this time.

Inside, she paid R200 for a month’s supply of ARVs. She was told it would cost her much more at a private pharmacy.

“The money I earn as a food vendor is very little. My life is now in danger because I need to take my ARVs to survive,” says Q.

K, also an immigrant, shared screenshots of a conversation she had with a staff member at the clinic. ARVs are quoted at R200 for one month and R300 for three months supply. Diabetes medication was offered for R200.

GroundUp also received this price list after we messaged the clinic staff member.

“As immigrants we feel vulnerable, because clinic staff and Operation Dudula members are now taking advantage of our desperate need for chronic medication to make money. They should be stopped,” said K, who has been struggling to collect her ARVs for months.

Jeppe Clinic

When we visited Jeppe clinic last week there was a long queue. It included a few immigrants who had returned after being chased away previously.

P, an immigrant, said she had managed to get inside on Monday and Tuesday last week for the first time since August, but she left empty-handed, with the staff not willing to serve her.

P then bought ARVs for R300 from a woman who has connections with the clinic staff.

This woman, M, says she is helping fellow immigrants who are struggling to get their medication from clinics. We met her with bottles of ARVs in her backpack. She was delivering them to her “clients” in one of Johannesburg’s “dark buildings”.

M has chronic high blood pressure. Previously, she was also chased away from Jeppe clinic by members of Operation Dudula. Then a staff member gave her WhatsApp number and asked her to find other immigrants who need chronic medication.

M says she buys ARVs, PreP pills, diabetes and blood pressure medication from the clinic. The staff member gives her R50 kickback on every R300.

Yeoville clinic

At Yeoville clinic, immigrants told us Operation Dudula and clinic staff now allow them entry if they have valid permits and asylum documents. Meanwhile undocumented immigrants are turned away. Security guards confirmed this to GroundUp.

Z, who sells airtime on the street, has a Malawian passport that has expired. She says she was chased away from the clinic. She said her Zimbabwean neighbour paid R150 to a staff member to have her baby immunised at the clinic. We did not speak to the neighbour.

Ethel Musonza, from an organisation called Zimbabwe Isolated Women in South Africa, said a number of immigrants had contacted them, claiming chronic medication has to be bought from clinic staff at Jeppe, Yeoville and Rosettenville clinics.

“Many people have defaulted on their HIV and AIDS treatment, and some people who were on PreP can no longer access it,” Musonza said. She called for urgent intervention from law enforcement and the Department of Health.

“For us to act, we need information,” says governmentThe Gauteng health department did not respond to our requests for comment.

But spokesperson for the national health department, Foster Mohale, said the department is not aware of any extortion.

“If this is true, it is unlawful, and we condemn it with the strongest terms it deserves,” said Mohale.

“We request anyone with evidence to share it with the department or law enforcement agencies so they can swiftly investigate.”

He said none of the clinics we visited had reported a shortage of any medications.

“⁠The department treats these allegations seriously, but for us to act, we need information,” he said.

South Africa: Asylum seeker in Durban denied medication due to anti-migrant clinic blockades

Anti-migrant groups force asylum seeker with HIV and TB off medication

Ali Burundi,a 58-year-old living in Durban, is facing a life-threatening struggle. Living with both TB and HIV, he’s received his medication consistently from Gateway Clinic at Addington Hospital since 2019.

But for the past two months, he has been unable to access treatment due to blockades by a group known as March-and-March, a collective that describes itself as a “citizen-led movement tackling illegal immigration’s impact on SA”.

“I’ve always been able to go to the clinic and get my medicine. Now, since Dudula started, there’s no more medicine. Every time I go to the clinic, they fight me, and I run away,” says Burundi, referring to Operation Dudula – another anti-migrant group that has also been denying international migrants access to government health facilities.

Originally from Burundi, Ali has lived in South Africa for 20 years as an asylum seeker.  He works as a barber, cutting hair for a living, which means he interacts closely with many people every day.

“It’s harder for me to work because I’m afraid I could infect someone with TB, but I have to work to eat,” he says. “It’s even harder when you are a foreigner in South Africa. I have legal papers, and I was granted asylum, yet I am still being denied access to my medication. That puts me and everyone around me at risk.”

Sharing ARVS

Seeing his desperate situation, one neighbour took pity on Burundi and decided to share her HIV medication with him.

“It broke my heart to hear him cry because he couldn’t get his treatment, as we know how important the medication is,” says the 69-year-old woman who asked not to be named. She explains that she had received a three-month supply of antiretroviral drugs.

“I lost one of my children to HIV years ago, so it brought back painful memories, which is why I cannot let him suffer like that. I pray the government can resolve this soon.”

 

Mexico: Lack of national ID number leaves HIV positive migrants without medication

Migrants with HIV are left without treatment for not having CURP, AC denounces in Tijuana

Baltazar Lujano, a member of Al Otro Lado, urged health authorities to exercise greater discretion.

Foreign migrants are left without access to antiretroviral drugs because they do not have a CURP (Unique Population Registry Code), said Bridget Baltazar Lujano, coordinator of the programme for the LGBTIQ+ community at the organisation Al Otro Lado.
The activist reported that there are cases of people living with HIV who arrive in the city without medication and spend days or weeks without treatment because of this requirement.

There are people who have been living with HIV for years and arrive here without medication, and regaining access to this drug is a real challenge, she said.

Baltazar Lujano urged health authorities to be more flexible, as they do not authorise the delivery of these drugs if people do not have regular immigration status that allows them to have a CURP.

‘Being without medication for a day, two days, three days can have an impact. It is not a medicine that can be obtained in a pharmacy, only the State Secretariat has access to it,’ she said.

He stressed that this problem has worsened since the implementation of IMSS Bienestar, as the digital requirements have excluded people in a context of mobility who have not been able to establish themselves regularly in the entity because the process can take months.

‘There is a very serious violation of people’s rights to access healthcare. They are asking for documents that people do not have and are not looking for a solution,’ he said.

The coordinator of the programme for the LGBTIQ+ community at Al Otro Lado pointed out that migrants from Colombia, Venezuela, Honduras, Nicaragua, Guatemala, El Salvador and Russia are currently arriving in the city.

He mentioned that another problem facing the LGBTIQ+ migrant community is the severe difficulty in finding safe and adequate places to live, as the lack of specialised shelters and discrimination increase their vulnerability.

This problem has always existed, but now it is more complex because people are staying here, he concluded.

Baltazar Lujano, integrante de Al Otro Lado, urgió qué debe haber más criterio por parte de las autoridades sanitarias.

Migrantes extranjeros se quedan sin acceso a medicamentos antirretrovirales por no contar con CURP, expuso la coordinadora del programa para la comunidad LGBTIQ+ de la organización Al Otro Lado, Bridget Baltazar Lujano.

La activista acusó que hay casos de personas viviendo con VIH que llegan sin medicamento a la ciudad y pasan días o semanas sin tratamiento por la falta de este requisito.

Hay personas que llegan viviendo con VIH por años y llegan aquí sin medicamento, y volver a acceder a este fármaco es todo un retoexpresó.

Baltazar Lujano, urgió qué debe haber más criterio por parte de las autoridades sanitarias, que no autorizan la entrega de estos medicamentos si no cuentan con un estatus migratorio regular que les permita tener el CURP.

“Estar sin medicamento un día, dos días, tres días puede afectar. No es un medicamento que se pueda conseguir en una farmacia, solo la Secretaría del Estado tiene acceso”, comentó.

Recalcó que este problema se agravó tras la implementación de IMSS Bienestar, ya que los requisitos digitales han excluido a las personas en contexto de movilidad que no han logrado establecerse regularmente en la entidad debido a que el proceso puede tomar meses.

“Hay una falta muy grande a los derechos de las personas de poder acceder a la salud. Están pidiendo documentos que las personas no tienen y no están buscando una solución”, manifestó.

La coordinadora del programa para la comunidad LGBTIQ+ de Al Otro Lado, precisó que actualmente a la ciudad están llegando migrantes provenientes de Colombia, Venezuela, Honduras, Nicaragua, Guatemala, El Salvador y Rusia.

Mencionó que otro problema que enfrenta la comunidad LGBTIQ+ migrante, son severas dificultades para encontrar espacios seguros y adecuados donde vivir, ya que la falta de albergues especializados y la discriminación elevan la vulnerabilidad.

“Esta problemática siempre ha existido, pero ahora es más compleja porque las personas se están quedando aquí” concluyó.

Peru: Ombudsman urges national authorities to guarantee full health access for all people living with HIV

Translated with Google Translate – For original article in Spanish, please scroll down

Ombudsman urges the Peruvian State to guarantee access to health services for people living with HIV in Peru

  • On World AIDS Day, the importance of health education is recalled to prevent the disease, ensure timely diagnosis and access to antiretroviral treatments (ARTs); and to avoid any form of discrimination and stigma.

In commemorating World AIDS Day, the Ombudsman’s Office highlights the importance of the Peruvian State ensuring adequate health care to more than one hundred thousand citizens who would currently live with the HIV virus in our country, with a human rights approach that guarantees access to antiretroviral drugs and eliminates any form of stigma or discrimination; as well, to ensure the implementation of public health policies at all levels of government.

According to global figures, it is estimated that as of February of this year the number of HIV infections in Peru was around 110,000 people, which includes highly vulnerable populations such as sex workers, population deprived of liberty, indigenous people and migrants, among others, who face greater obstacles to access timely and quality health services.

Faced with this, the Ombudsman’s Office urges national authorities, such as the Ministry of Health and EsSalud, as well as regional health directorates or managements, to guarantee the continuous supply of antiretroviral treatments and diagnostic tests. As part of the requirements for health organizations, it is also requested to implement effective mechanisms aimed at avoiding any form of discrimination in health services, as well as ensuring the timely affiliation to Comprehensive Health Insurance (SIS) of all people who require it, without unjustified barriers.

It should be noted that the development of each of these actions must be based on a human rights approach that recognizes that all people, without distinction, have the right to access to timely, quality and discrimination-free health services. In this sense, the Ombudsman’s Office develops permanent supervisory actions that aim to identify barriers, delays and shortages of antiretrovirals, as well as to monitor that there are no discriminatory practices in health services and promote immediate corrections in the face of any violation of rights.

These actions, however, must be articulated with other sectors such as the Ministry of Education and educational management units at the national level to develop constant educational activities as a preventive measure to reduce the transmission of the virus among the population.

The Ombudsman’s Office reaffirms its commitment to the protection of the right to health and equality of all people living with HIV in Peru, we renew our vigilant work so that each policy or health service contributes to a more humane, equitable and respectful national response of the dignity of people. The protection of people living with HIV cannot depend on the situation, but on sustained public policies, strengthened health leadership and affirmative actions aimed at the most exposed populations.

Defensoría del Pueblo exhorta al Estado peruano a garantizar acceso a servicios de salud a las personas que viven con VIH en el Perú

  • En el Día Mundial de la Lucha contra el SIDA, se recuerda la importancia de la educación en salud para prevenir la enfermedad, garantizar el diagnóstico oportuno y el acceso a tratamientos antirretrovirales (TAR); asimismo, evitar cualquier forma de discriminación y estigma.

Al conmemorarse el Día Mundial de la Lucha contra el SIDA, la Defensoría del Pueblo destaca la importancia de que el Estado Peruano asegure una atención en salud adecuada a más de cien mil ciudadanos que vivirían actualmente con el virus del VIH en nuestro país, con un enfoque de derechos humanos que garantice el acceso a medicamentos antiretrovirales y se elimine cualquier forma de estigma o discriminación; así también, que asegure la implementación de las políticas públicas sanitarias en todos los niveles de gobierno.

De acuerdo a cifras globales, se estima que a febrero de este año la cifra de contagios por VIH en el Perú era de alrededor de 110 000 personas, que comprende a poblaciones altamente vulnerables como trabajadores sexuales, población privada de la libertad, personas indígenas y migrantes, entre otros, quienes enfrentan mayores obstáculos para acceder a servicios de salud oportunos y de calidad.

Frente a ello, la Defensoría del Pueblo exhorta a las autoridades nacionales, como el Ministerio de Salud y EsSalud, así como a las direcciones o gerencias regionales de salud, a garantizar el abastecimiento continuo de tratamientos antirretrovirales y pruebas de diagnóstico. Como parte de los requerimientos a los organismos de salud, se pide también implementar mecanismos efectivos dirigidos a evitar cualquier forma de discriminación en los servicios de salud, así como asegurar la afiliación oportuna al Seguro Integral de Salud (SIS) de todas las personas que lo requieran, sin barreras injustificadas.

Cabe precisar que el desarrollo de cada una de estas acciones debe sustentarse en un enfoque de derechos humanos que reconozca que todas las personas, sin distinción, tienen derecho a acceder a servicios de salud oportunos, de calidad y libres de discriminación. En ese sentido, la Defensoría del Pueblo desarrolla acciones de supervisión permanentes que tienen como objetivo identificar barreras, retrasos y desabastecimiento de antirretrovirales, así como vigilar que no existan prácticas discriminatorias en servicios de salud y promover correcciones inmediatas ante cualquier vulneración de derechos.

Estas acciones, sin embargo, deben ser articuladas con otros sectores como el Ministerio de Educación y las unidades de gestión educativas a nivel nacional para desarrollar actividades educativas constantes como medida preventiva para disminuir los transmisión del virus entre la población.

La Defensoría del Pueblo reafirma su compromiso con la protección del derecho a la salud y la igualdad de todas las personas que viven con VIH en el Perú, renovamos nuestra labor vigilante para que cada política o servicio sanitario contribuya a una respuesta nacional más humana, equitativa y respetuosa de la dignidad de las personas. La protección de las personas que viven con VIH no puede depender de la coyuntura, sino de políticas públicas sostenidas, rectoría sanitaria fortalecida y acciones afirmativas dirigidas a las poblaciones más expuestas.

Colombia: Constitutional Court affirms right to continuous HIV care for vulnerable migrants

Translated with Google translate – Scroll down for original article in Spanish

Court demands comprehensive and barrier-free care for migrants on the street with HIV

2025 Ruling T-415 requires the elimination of barriers and guaranteeing health care for homeless migrants with HIV and comorbidities.

The Constitutional Court ordered to guarantee comprehensive, continuous and unadministrative care to homeless migrants who face HIV, associated diseases, mental health and drug dependence. In Judgment T-415 of 2025, the Third Review Chamber concluded that responsible authorities violated fundamental rights by not managing in a timely manner the services ordered by specialists for a Venezuelan citizen in a situation of extreme vulnerability. The ruling establishes a reinforced standard of protection and details immediate obligations for the competent entities.

Constitutional Court sets a reinforced standard of health protection

The sentence originates from the guardianship presented by “Manuela” in favor of Josué, a homeless Venezuelan migrant diagnosed with HIV, tuberculosis, hepatitis C, seborrheic dermatitis, severe mental health effects and drug addiction problems.

The Third Review Chamber, composed of Magistrate Lina Marcela Escobar Martínez (rapporteur), and Magistrates Vladimir Fernández Andrade and Jorge Enrique Ibáñez Najar, determined that the entities involved violated the patient’s rights to life, equality, human dignity, health and social security.

The ruling recalls that article 100 of the Constitution guarantees foreign people the same civil rights as Colombian citizens, while article 4 establishes their duty to comply with the Constitution and the laws. In the face of extreme vulnerability scenarios, state attention must be guided by the principles of human rights, intersectional approach, pro persona, solidarity and human dignity.

Diagnosis and therapeutic continuity: essential pillars of the right to health

The Court reiterated that the right to diagnosis is an integral part of the fundamental right to health. For this right to be guaranteed, three essential components must be met:

  1. Adequate identification of the patient’s condition,
  2. Evaluation and follow-up by the specialist,
  3. Prescription and continuity of treatment.

In the case analyzed, the lack of timely authorizations prevented the continuity of specialized services ordered by treating doctors, which deepened the vulnerability of the patient. The corporation recalled that opportunity and continuity are mandatory principles of the health service, and that administrative barriers cannot be interposed when the life or integrity of the patient is compromised.

Mental health and drug dependence: non-negotiable components of care

The Court pointed out that mental health is an integral part of the fundamental right to health, so Josué had the right to access the psychiatric and toxicology care ordered by his attending physician.

Likewise, he specified that people in a street situation, due to low therapeutic adherence and the complexity of their needs, must receive a’rmative actions that facilitate access to rehabilitation treatments, with or without hospitalization, according to the medical order.

These a’rmative actions as indicated in the legal glossary included in the bulletin – exist to level the conditions of those who have faced historical barriers that prevent them from exercising their rights on equal terms.

Institutional shortcomings: violation of rights due to lack of timely management

The Third Chamber concluded that the entities responsible for the case were unaware of the condition of subject of special constitutional protection of the patient by not managing in a timely manner all the services ordered by the specialists.

The Court stressed that Joshua’s situation represented exceptional and borderline circumstances, requiring an intersectional approach and a comprehensive understanding based on the pro-person, solidarity and human dignity principles.

Denying or delaying services prescribed by dealing professionals, the corporation said, contradicts the constitutional jurisprudence that protects people with multiple conditions of vulnerability.

Orders and measures of immediate compliance

Judgment T-415 of 2025 establishes precise orders to ensure the patient’s effective access to services:

1. Entities responsible for social care

The Court ordered a new classification interview, ensuring that the patient is not excluded from the “street dweller” category, a condition that determines reinforced protection measures and guarantees access to differentiated care routes.

2. Territorial health authorities

The ruling instructed the competent entity to immediately and comprehensively authorize all the services ordered by the specialists regarding their diagnoses related to mental health and drug dependence.
This includes evaluations, therapeutic interventions, prescriptions and follow-ups defined by the treating clinical team.

All these procedures must be carried out without administrative barriers, in accordance with the principles of opportunity and continuity that govern the fundamental right to health.

New obligations for health authorities after Judgment T-415

The ruling of the Constitutional Court, sets guidelines that must be observed by the entities in charge of caring for people in extreme vulnerability:

  • Express recognition of homeless migrants as a population of special constitutional protection.
  • Effective guarantee of the right to diagnosis, specialized assessment and continuity of treatment.
  • Elimination of administrative barriers that prevent the attention ordered by specialists.
  • Application of affirmative actions to facilitate therapeutic adherence and access to comprehensive treatment in mental health and drug dependence.
  • Institutional responses articulated between social and health sectors to avoid interruptions in care.

This precedent reinforces the State’s responsibilities regarding the protection of people with multiple vulnerabilities, especially when they are at risk of life and require urgent intervention.

Corte exige atención integral y sin barreras para migrantes en calle con VIH

Fallo T-415 de 2025 obliga a eliminar barreras y garantizar atención en salud para migrantes habitantes de calle con VIH y comorbilidades.

La Corte Constitucional ordenó garantizar atención integral, continua y sin barreras administrativas a personas migrantes en habitanza de calle que enfrentan VIH, enfermedades asociadas, afectaciones en su salud mental y farmacodependencia. En la Sentencia T-415 de 2025, la Sala Tercera de Revisión concluyó que autoridades responsables vulneraron derechos fundamentales al no gestionar de manera oportuna los servicios ordenados por especialistas para un ciudadano venezolano en situación de extrema vulnerabilidad. El fallo fija un estándar reforzado de protección y detalla obligaciones inmediatas para las entidades competentes.

Corte Constitucional fija un estándar reforzado de protección sanitaria

La sentencia se origina en la tutela presentada por “Manuela” en favor de Josué, un migrante venezolano habitante de calle diagnosticado con VIH, tuberculosis, hepatitis C, dermatitis seborreica, afectaciones severas en su salud mental y problemas de farmacodependencia.

La Sala Tercera de Revisión, integrada por la magistrada Lina Marcela Escobar Martínez (ponente), y los magistrados Vladimir Fernández Andrade y Jorge Enrique Ibáñez Najar, determinó que las entidades involucradas vulneraron los derechos a la vida, igualdad, dignidad humana, salud y seguridad social del paciente.

El fallo recuerda que el artículo 100 de la Constitución garantiza a las personas extranjeras los mismos derechos civiles que a los ciudadanos colombianos, mientras que el artículo 4 establece su deber de acatar la Constitución y las leyes. Ante escenarios de vulnerabilidad extrema, la atención estatal debe guiarse por los principios de derechos humanos, enfoque interseccional, pro persona, solidaridad y dignidad humana.

Diagnóstico y continuidad terapéutica: pilares esenciales del derecho a la salud

La Corte reiteró que el derecho al diagnóstico es parte integral del derecho fundamental a la salud. Para que este derecho sea garantizado, deben cumplirse tres componentes esenciales:

1. Identificación adecuada de la condición del paciente,

2. Valoración y seguimiento por parte del especialista,

3. Prescripción y continuidad del tratamiento.

En el caso analizado, la falta de autorizaciones oportunas impidió la continuidad de servicios especializados ordenados por médicos tratantes, lo que profundizó la vulnerabilidad del paciente. La corporación recordó que la oportunidad y la continuidad son principios obligatorios del servicio de salud, y que las barreras administrativas no pueden interponerse cuando está comprometida la vida o la integridad del paciente.

Salud mental y farmacodependencia: componentes innegociables de la atención

La Corte señaló que la salud mental es una parte integrante del derecho fundamental a la salud, por lo que Josué tenía derecho a acceder a las atenciones por psiquiatría y toxicología ordenadas por su médico tratante.

Así mismo, precisó que las personas en situación de calle, debido a la baja adherencia terapéutica y a la complejidad de sus necesidades, deben recibir acciones afirmativas que faciliten el acceso a tratamientos de rehabilitación, con o sin internado, según la orden médica.

Estas acciones afirmativas según lo indicado en el glosario jurídico incluido en el boletín— existen para nivelar condiciones de quienes han enfrentado barreras históricas que les impiden ejercer sus derechos en igualdad de condiciones.

Falencias institucionales: vulneración de derechos por falta de gestión oportuna

La Sala Tercera concluyó que las entidades responsables del caso desconocieron la condición de sujeto de especial protección constitucional del paciente al no gestionar de manera oportuna la totalidad de los servicios ordenados por los especialistas.

La Corte destacó que la situación de Josué representaba circunstancias excepcionales y límite, exigiendo un enfoque interseccional y una comprensión integral basada en los principios propersona, solidaridad y dignidad humana.

Negar o retrasar servicios prescritos por profesionales tratantes, indicó la corporación, contradice la jurisprudencia constitucional que protege a personas con múltiples condiciones de vulnerabilidad.

Órdenes y medidas de cumplimiento inmediato

La Sentencia T-415 de 2025 establece órdenes precisas para garantizar el acceso efectivo del paciente a los servicios:

1. Entidades responsables de atención social

La Corte ordenó realizar una nueva entrevista de clasificación, asegurando que el paciente no sea excluido de la categoría “habitante de calle”, condición que determina medidas de protección reforzada y garantiza el acceso a rutas de atención diferenciadas.

2. Autoridades territoriales de salud

El fallo instruyó a la entidad competente a autorizar de manera inmediata e integral todos los servicios ordenados por los especialistas respecto de sus diagnósticos relacionados con salud mental y farmacodependencia.
Esto incluye valoraciones, intervenciones terapéuticas, prescripciones y seguimientos definidos por el equipo clínico tratante.

Todas estas gestiones deben adelantarse sin barreras administrativas, conforme a los principios de oportunidad y continuidad que rigen el derecho fundamental a la salud.

Nuevas obligaciones para autoridades de salud tras la Sentencia T-415

El pronunciamiento de la Corte Constitucional, fija lineamientos que deberán observar las entidades encargadas de atender a personas en extrema vulnerabilidad:

  • Reconocimiento expreso de los migrantes habitantes de calle como población de especial protección constitucional.
  • Garantía efectiva del derecho al diagnóstico, valoración especializada y continuidad del tratamiento.
  • Eliminación de barreras administrativas que impidan la atención ordenada por especialistas.
  • Aplicación de acciones afirmativas para facilitar adherencia terapéutica y acceso a tratamiento integral en salud mental y farmacodependencia.
  • Respuestas institucionales articuladas entre sectores sociales y sanitarios para evitar interrupciones en la atención.

Este precedente refuerza las responsabilidades del Estado respecto a la protección de personas con múltiples vulnerabilidades, especialmente cuando se encuentran en riesgo vital y requieren intervenciones urgentes.

 

 

South Africa: Court declares anti-migrant actions against health and education access illegal

Anti-migrant group ordered to stop blocking foreigners from South African healthcare

A South African court has ordered an anti-migrant group to stop blocking foreign nationals from accessing public health facilities and schools, saying such actions are illegal.

Operation Dudula has been picketing hospitals and clinics in Gauteng and KwaZulu-Natal provinces, checking identity cards and stopping anyone who is not South African from entering. This has since extended to schools.

But the high court in Johannesburg has ordered the group to stop “intimidating, harassing [or] interfering with access” to these facilities, following a case brought by rights groups.

South Africa is home to about 2.4 million migrants, just less than 4% of the population, according to official figures.

Most come from neighbouring countries such as Lesotho, Zimbabwe and Mozambique, which have a history of providing migrant labour to their wealthy neighbour.

Xenophobia has long been an issue in South Africa, which has been accompanied by occasional outbursts of deadly violence, and anti-migrant sentiment has become a key political talking-point.

Judge Leicester Adams, handing down judgment on Tuesday, also barred Operation Dudula from making statements that can be construed as hate speech, “unlawfully evicting foreign nationals from their homes… [or] from their trading stalls” and instigating others to do so.

“Dudula” means to remove something by force in the Zulu language.

He also barred law enforcement from conducting “warrant-less searches” in foreigners’ private spaces and said they must have “reasonable suspicion” that a person was in the country unlawfully before asking them to identify themselves.

South African police came under scrutiny after human rights organisations accused them of failing to act against Operation Dudula or protect the public from their unlawful conduct.

Several Operation Dudula members were arrested for blocking the entrances of public health facilities in August. They were later released with a warning.

The organisation says it is disappointed by the ruling and intends to appeal against it, according to South African online publication News24.

Kopanang Africa Against Xenophobia, one of the organisations that took the case to court, said the “judgment provides critical protection for those targeted by xenophobic attacks”.

“In a country founded on the rejection of apartheid, we cannot allow ourselves to be subjected to the xenophobic hate promoted by Operation Dudula,” the human rights organisation said in a statement.

Kopanang said there would be proactive monitoring at schools and clinics to ensure compliance with the order and that it would hold the police accountable for enforcing it.

“Should the police fail in their duty to enforce the order… we are prepared to report their inaction to formal oversight bodies,” the organisation told the BBC.

South Africa’s Health Minister Dr Aaron Motsoaledi said the ruling “was to be expected” as it echoed the government’s stance that no-one should be denied access to healthcare, irrespective of their legal status.

Dr Motsoaledi met Operation Dudula leaders in August, at the height of their protests at health facilities, and criticised their methods.

“I told them [at the time] that whatever concerns they have, some of which might be legitimate by the way, they are [using] the wrong method,” he told local broadcaster 702 on Tuesday.

One of the demands the group had for the minister when they met was that anyone without documentation be turned away at healthcare facilities but Dr Motsoaledi said this would be difficult as 11% of South Africans do not have national ID cards.

The minister also criticised South Africa’s neighbours for not doing more to help reduce the pressure on the country’s overburdened healthcare system, suggesting this was being worsened by the influx of migrants.

“It is South Africa which is suffering, not them. In fact, many of them are relieved,” he said.

European studies reveal systemic gaps in HIV care for migrants

EACS 2025: Are Europe’s migrants acquiring HIV after arrival?

More than 60% of HIV diagnoses among migrants in Switzerland occur after arrival, with some groups waiting up to 6 years before detection; findings that expose significant gaps in the country’s prevention and screening strategies.

A new analysis of the Swiss HIV Cohort Study shows that among 1713 migrants diagnosed between 2010 and 2024, 62.1% were diagnosed post-migration. This challenges the longstanding assumption that most infections occur before arrival from high-prevalence regions and aligns with another recent analysis estimating that about 30% of migrants acquire HIV after migration, underscoring ongoing risk in host countries despite prevention programs.

Presenting the 15‑year analysis at the European AIDS Clinical Society (EACS) 2025 Annual Meeting, PhD researcher Jessy J. Duran Ramirez of University Hospital Zurich, Zurich, reported that migrants now account for 49% of new HIV diagnoses in Switzerland — a share that has risen steadily even as rates in other European populations stabilize or decline.

“Despite the overall decrease and stagnation in new HIV diagnoses, migrants remain disproportionately affected,” Duran Ramirez said.

Delayed Diagnosis Patterns Emerge

Among the study’s key findings were notable diagnostic delays across migrant populations. Compared with 5 years for men who have sex with men (MSM) and just 2 years for female heterosexuals, male heterosexuals from migrant populations wait a median of 6 years from immigration to HIV diagnosis.

Key Statistics from 3490 participants (2010-2024):

  • 1777 Swiss nationals; 1713 migrants
  • 62.1% of migrant diagnoses occurred post-migration
  • Median age at diagnosis: 38 years (migrants) vs 44 years (Swiss nationals)
  • CD4 count at diagnosis: 339 cells/µL (migrants) vs 404 cells/µL (Swiss nationals)

Migrants from Asia experienced the longest delays overall, with a median of 12 years from immigration to diagnosis.

These delays resulted in significantly lower CD4 counts at diagnosis compared with Swiss nationals, indicating more advanced disease progression.

The demographic profile of post-migration diagnoses also differed markedly from that of Swiss nationals. Women accounted for 27% of migrant diagnoses vs only 11% among Swiss nationals, while MSM represented 43% of migrant cases compared with 63% of Swiss cases.

Cultural and Structural Barriers

Jürgen Rockstroh, MD, head of the HIV outpatient clinic at the University of Bonn, Bonn, Germany, identified multiple obstacles preventing effective screening among migrant populations across Europe.

“People who are migrating to Europe, or are refugees, have difficulties in accessing the healthcare system because there are language barriers, there are insurance and cost coverage barriers,” he said. “The question is, how can you reach these populations?”

He pointed to successful European models like Malta’s mobile health units, which embed HIV testing within general healthcare services, and Athens’ targeted health centers designed specifically for migrants and refugees, where peers guide others from their community to access care.

“African women, for example, are not going to go to a more gay-dominated testing space. They just don’t feel comfortable there. I think we need more targeted, market-specific checkpoints,” he explained.

Promising Innovative Approaches

The PARTAGE project in France demonstrates one effective strategy for reaching migrant men, a traditionally difficult population to engage in healthcare. By offering health checkups to expectant fathers during their partner’s pregnancy, the program achieved HIV screening rates of 95%-96% across all groups.

PARTAGE Project Results (1347 expectant fathers):

  • 63% held immigrant status; 8% without health coverage
  • HIV screening achieved in 95%-96% across all groups
  • Medical diagnoses: 18% (all participants), 22% (immigrants), and 41% (immigrants without coverage)
  • Healthcare referrals: 17% (all), 20% (immigrants), and 41% (immigrants without coverage)
  • Social support referrals: 11% (all), 17% (immigrants), and 72% (immigrants without coverage)
  • Vaccination updates: 44% (all), 52% (immigrants), and 73% (immigrants without coverage)

Pauline Penot, MD, from Centre Hospitalier André Grégoire, Montreuil, France, who led the PARTAGE study, found the intervention particularly effective among disadvantaged migrants, leading to (any) medical diagnoses and healthcare referrals in 41% of participants without health coverage.

“This is the first structured health intervention to address adult men’s health by using the symbolic event of expecting a child,” Pinot said. “It showed greater attendance, and more effects were observed among disadvantaged migrants.”

Pinot noted that migrants often arrive in Europe healthier than native populations, but their health deteriorates faster, especially among those from poorer regions. She suggested that scaling the PARTAGE model across France and other European countries could help reduce social and gender health inequalities.

Policy Implications

The Swiss data underscores an urgent need for culturally sensitive, accessible screening programs that can identify HIV infections earlier in migrant populations across Europe. With roughly one third of post-migration diagnoses occurring within the first year of arrival — a period of particular vulnerability — the window for intervention remains narrow but critical.

For Duran Ramirez, the next phase of research will focus on determining whether these post-migration diagnoses represent infections acquired after arrival or pre-existing infections that went undetected.

“Understanding the timing of HIV acquisition and diagnosis in migrant populations is essential to designing prevention strategies that reach them earlier,” she said.

The findings suggest that current European prevention infrastructure, while effective for established populations, requires significant adaptation to address the complex healthcare needs of its increasingly diverse migrant communities.

Duran Ramirez reported receiving research grants or fellowships to her institution from Gilead Sciences Switzerland Sàrl and ViiV Healthcare that were unrelated to this work. Rockstroh reported receiving honoraria for educational talks for ViiV Healthcare, Merck, and Gilead Sciences. Penot reported having no relevant financial relationships.

US: Groups of lawfully present immigrants to lose access to federally funded health coverage

1.4 Million Lawfully Present Immigrants are Expected to Lose Health Coverage due to the 2025 Tax and Budget Law

Congressional Republicans and President Trump passed the tax and budget reconciliation bill in July 2025. The new law includes significant cuts to the Medicaid program as well as eligibility restrictions for many lawfully present immigrants, including refugees and asylees, to access Medicaid and the Children’s Health Insurance Program (CHIP), subsidized Affordable Care Act (ACA) Marketplace, and Medicare coverage. Under longstanding federal policy, undocumented immigrants already are ineligible for federally funded health coverage. This policy watch outlines the groups of lawfully present immigrants that will lose access to federally funded health coverage due to the 2025 tax and budget law and the Congressional Budget Office’s (CBO’s) estimates of the increases in the number of uninsured and federal savings and revenue changes due to these provisions.

CBO estimates that the law’s restrictions on eligibility for federally funded health coverage for lawfully present immigrants will result in about 1.4 million lawfully present immigrants becoming uninsured, reduce federal spending by about $131 billion, and increase federal revenues by $4.8 billion as of 2034. Additional lawfully present immigrants are likely to lose Marketplace coverage and become uninsured due to the anticipated expiration of the enhanced subsidies for this coverage. Moreover, under Trump administration regulatory changes, the more than 530,000 Deferred Action for Childhood Arrivals (DACA) recipients are ineligible for federally funded coverage options.

Changes in Eligibility for Lawfully Present Immigrants Under the 2025 Tax and Budget Law

Medicaid and CHIP

Under prior law, to be eligible for Medicaid and CHIP, immigrants were required to have a “qualified” immigration status in addition to meeting other eligibility requirements such as income. Qualified immigrants, as defined by the 1996 Personal Responsibility and Work Opportunity Act and subsequent additions, include lawful permanent residents (LPRs or “green card” holders); refugees; individuals granted parole for at least one year; individuals granted asylum or related relief and certain abused spouses and their children or parents; certain victims of trafficking; Cuban and Haitian entrants; and citizens of the Freely Associated (COFA) nations of the Marshall Islands, Micronesia and Palau residing in U.S. states and territories. In addition, many had to wait five years after obtaining qualified status before they could enroll in Medicaid even if they met other eligibility requirements. States have an option to extend Medicaid and/or CHIP coverage to all children and/or pregnant individuals who are lawfully residing and waive the five-year wait for these groups, which 39 states plus D.C. had taken up as of January 2025. States also have the option in CHIP to provide prenatal care and pregnancy related benefits to targeted low-income children beginning from conception to end of pregnancy (FCEP) regardless of their parent’s immigration status, which 24 states plus D.C. had taken as of April 2025.

The 2025 tax and budget law will restrict Medicaid or CHIP eligibility to LPRs, Cuban and Haitian entrants, people residing in the U.S. under COFA, and lawfully residing children and pregnant immigrants in states that cover them under the Medicaid and/or CHIP option (Table 1). States also will still have the option to extend prenatal and pregnancy-related benefits to targeted low-income children from conception through the end of pregnancy through the FCEP option. These restrictions will eliminate eligibility for many other groups of lawfully present immigrants, including refugees and asylees without a green card, among others (Table 1). This provision will become effective October 1, 2026, and CBO estimates that it will reduce federal spending by $6.2 billion and lead to an additional 100,000 individuals becoming uninsured by 2034.

ACA Marketplaces

Under prior law, lawfully present immigrants have been eligible to enroll in ACA Marketplace coverage and receive premium subsidies and cost-sharing reductions, including individuals with Temporary Protected Status (TPS), those with Deferred Enforced Departure, and people on work visas. In general, Marketplace coverage is limited to individuals with incomes at or above 100% of the federal poverty level (FPL), since most of those with lower incomes would be eligible for Medicaid. However, some lawfully present immigrants with lower incomes remain ineligible for Medicaid (e.g., due to the five-year waiting period and eligibility limits to qualified immigrants). To address this gap, Marketplace eligibility was also extended to lawfully present immigrants with incomes under 100% FPL who do not qualify for Medicaid due to their immigration status, including those in the five-year waiting period for Medicaid coverage. In the years after the ACA was passed, DACA recipients were excluded from eligibility for the Marketplaces despite being lawfully present. Under regulations issued by the Biden Administration in May 2024, DACA recipients were made newly eligible for the Marketplaces and to receive subsidies to offset costs starting November 2024. However, this coverage was blocked in some states due to legal challenges, and on June 25, 2025, the Trump administration finalized a rule that once again made DACA recipients ineligible to purchase ACA Marketplace coverage as of August 25, 2025. Most states will terminate coverage for enrolled DACA recipients on September 30, 2025.

The law will also limit eligibility for subsidized ACA Marketplace coverage to lawfully present immigrants who are LPRs, Cuban and Haitian entrants, and people residing in the U.S. under COFA. (Table 1). A broader group of lawfully present immigrants will lose access to subsidized Marketplace coverage under this change, including refugees and asylees without green cards, people with TPS, and individuals on work visas, among others, beginning January 1, 2027. The CBO estimates that this provision will lead to an additional one million individuals becoming uninsured and reduce federal spending by $91.4 billion over the 2026 to 2035 time period. In addition, the provision is expected to increase federal revenue by $4.8 billion as of 2034. The law also eliminates access to subsidized Marketplace coverage for lawfully present immigrants earning less than 100% FPL who are not eligible for Medicaid due to immigration status, including those in the five-year waiting period for coverage, beginning January 1, 2026. During the 2025 open enrollment period, nearly 550,000 people with incomes under 100% FPL were enrolled in a Marketplace plan, who are likely primarily lawfully present immigrants who are ineligible for Medicaid due to immigration status. The CBO estimates that this provision will lead to an additional 200,000 individuals becoming uninsured and reduce federal spending by $27.3 billion over the 2026 to 2035 time period. In addition, the provision is expected to increase federal revenue by $176 million as of 2034.

Medicare

Lawfully present immigrants have been eligible for Medicare if they have the required work quarters and meet the disability or age requirements. Those without required work history could also purchase Medicare Part A after residing legally in the U.S. for five years continuously.

Under the new law, Medicare eligibility also will be limited to lawfully present immigrants who are LPRs, Cuban and Haitian entrants, and people residing in the U.S. under COFA, eliminating eligibility for refugees and asylees without a green card, people with TPS, and people with work visas, among others (Table 1). Current beneficiaries subject to the new restrictions will lose coverage no later than 18 months from the enactment of the legislation (January 4, 2027). The CBO estimates that this provision will lead to an additional 100,000 individuals losing coverage, with a federal spending reduction of $5.1 billion and a federal revenue decrease of $123 million as of 2034.