Russia: New bill proposes requiring HIV-free certificates for migrant entry

Translated with Deepl, scroll down for original article in Russian.

The State Duma proposed to ban migrants from entering the Russian Federation without a certificate of absence of HIV.

The head of the State Duma Committee on Labor, Social Policy and Veterans Affairs Yaroslav Nilov developed a bill according to which migrants will be obliged to present a certificate of absence of HIV and tuberculosis when crossing the border with the Russian Federation.

“A citizen must have… medical insurance, test results confirming the absence of infection with the human immunodeficiency virus (HIV), hepatitis B and C, as well as the absence of syphilis and tuberculosis…” – says the explanatory note of the document, which was read by TASS.

If the law is passed, it will obligate migrant workers to present a test for the absence of drugs in the blood when entering the Russian Federation, made no earlier than 72 hours in advance. According to Mr. Nilov, this will reduce the burden on health care and prevent the entry of migrants with dangerous diseases.

В ГД предложили запретить мигрантам въезжать в РФ без справки об отсутствии ВИЧ

Глава комитета Госдумы по труду, социальной политике и делам ветеранов Ярослав Нилов разработал законопроект, согласно которому мигранты будут обязаны при пересечении границы с РФ предъявлять справку об отсутствии ВИЧ и туберкулеза.

«Гражданин при пересечении границы обязан иметь… медицинскую страховку, результаты анализов, подтверждающих отсутствие инфицирования вирусом иммунодефицита человека (ВИЧ), гепатита В и С, а также отсутствие заболевания сифилисом и туберкулезом…» — говорится в пояснительной записке документа, с которым ознакомился ТАСС.

Если закон примут, он обяжет трудовых мигрантов предъявлять при въезде в РФ тест на отсутствие в крови наркотиков, сделанный не ранее чем за 72 часа. По словам господина Нилова, это снизит нагрузку на здравоохранение и предотвратит въезд мигрантов с опасными заболеваниями.

UAE: New Dubai regulations define traveler obligations and health responsibilities

Dubai’s new public health law could affect your next trip — here’s how

His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE, has issued a new public health law in Dubai.

Law No. (5) of 2025 on Public Health in Dubai seeks to minimise health risks by stopping the spread of illnesses and putting restrictions on travel for those with confirmed communicable diseases.

Set to come into force 90 days after it is published in the Official Gazette, the new law supersedes any previous legislation that may conflict with its provisions.

The new law states that any travellers must adhere to official health protocols, provide requested information at Dubai’s entry points and report any suspected or confirmed communicable diseases.

Anyone who is infected or suspected of having a communicable disease must avoid contact that could spread their illness. The new law states that you must refrain from travelling or moving, except to healthcare facilities, without the approval of the Dubai Health Authority.

If you are travelling while ill, then you must observe hygiene measures such as wearing masks and maintaining physical distancing in line with approved guidelines.

The law prohibits concealing infections or spreading them, whether intentionally or unintentionally, and mandates individuals to comply with measures to prevent the spread of disease, following guidelines issued by relevant authorities and healthcare providers.

The new public health law has established a comprehensive framework to promote public health and safeguard community and environmental well-being. It outlines a focus on disease prevention, healthcare, food and product safety and sustainable efforts to improve overall quality of life.

It aims to minimise any health risks affecting individuals and communities in Dubai through precautionary measures and evidence-based practices that align with both local and international health regulations.

The new law promotes greater coordination and collaboration at all levels to strengthen preparedness and response to deal with any public health challenges in the emirate.

It also aims to increase public awareness of health risks and prevention methods by fostering a sustainable environment that attracts investment.

The new public health law has also formally defined the roles and responsibilities of relevant authorities in managing communicable diseases.

These authorities include local government entities tasked with overseeing public health in Dubai, such as Dubai Health Authority, Dubai Municipality, the Dubai Environment and Climate Change Authority, the Dubai Academic Health Corporation and the Dubai Corporation for Ambulance Services.

The law has also outlined the responsibilities of relevant authorities in food safety, specified obligations for food-related establishments and set out some rules for consumer product activities.

It has detailed responsibilities in areas such as built environmental health, labour accommodations, pest control and the Dubai Health Authority‘s role in managing health risks, emergencies and crises.

Dominican Republic: New health protocol requires migrants to pay for care and face deportation after treatment

Rights group condemns Dominican Republic new health protocol for discriminating migrants.

Amnesty International condemned Thursday the Dominican Republic’s new health protocol that requires migrants to provide documentation and pay fees to access public health services. The group argued that the new protocol is discriminatory and may violate international human rights standards.

On April 6, the government announced a new health protocol consisting of 15 migration measures. Apart from requiring documentation and fees, a migrant patient who received medical care, relating to emergencies, hospitalization or childbirth, will be repatriated to their home country aftercare.

The group voiced strong concerns against the discriminatory policy, describing the protocol as “reinforcing racism in migration policies.” The group also argued that the practice threatens the right to health, privacy, and physical integrity, by deterring people at risk, especially pregnant women, children, and survivors of violence, from seeking the healthcare they urgently need. According to the group, the protocol violates the country’s own constitutional principle on free and universal access to health enjoyed by marginalizing migrants, undocumented Haitians, asylum seekers, stateless persons, and Dominicans of Haitian descent.

Ana Piquer, Americas director at Amnesty International, said:

President Luis Abinader must opt for measures that strengthen the health system. Implementing a system that exposes migrants to deportation after receiving medical care not only violates the right to health but also dehumanizes undocumented persons and will, in all probability, deter them from seeking hospital care, thus putting lives at risk.

Collective expulsion of aliens may amount to violations of multiple international conventions including the non-refoulement principle under the 1951 Refugee Convention and the Convention against Torture. National laws on expulsion on the basis of national origin may also engage with the Convention on the Elimination of Racial Discrimination.

On April 21, Amnesty International issued an urgent action demanding an end to the collective expulsion of Haitian migrants and the repeal of discriminatory migration policies in the Dominican Republic, stating that “since October 2024, more than 180,000 people have been deported.” In their urgent action, Amnesty International urged the Dominican population to reject these cruel and racist measures by action.

Escalating gang violence in Haiti has prompted many Haitians to flee to the Dominican Republic. On April 22, UN Special Representative Maria Isabel Salvador warned the Security Council that the political chaos, gang violence and displacement that follows are “approaching a point of no return,” urging for stronger international intervention.

Canada: Montreal’s only anglophone HIV/AIDS care centre helps migrants living with HIV navigate their integration into the province

A path to new beginnings: migrants with HIV

Montreal’s only anglophone HIV/AIDS care centre supports newcomers beyond healthcare.

Colombian immigrant Ferney Mendoza sits in a warmly lit room watching a PowerPoint presentation at Montreal’s only anglophone and allophone HIV/AIDS support centre.

He is joined by four other newcomers on a ring of couches, with a spread of snacks in the centre.

The workshop is part of a three-month program designed to help migrants living with HIV navigate their integration into the province.

On the screen, Quebec is highlighted on a map of Canada and labelled with a bold “14 per cent”—the province’s minimum tax rate. Today’s topic: how to file taxes.

For many newcomers with HIV, immigrating to a new country isn’t just about accessing medication. For Mendoza, workshops like this one—focused on understanding tax rules in Canada—helped him stabilize his income and better support his three children.

The aptly named “New Horizons” workshop series is hosted by AIDS Community Care Montreal (ACCM). The five-year-old program was initially geared towards Spanish-speaking immigrants with HIV, but has expanded in recent years to meet the changes in Canada’s immigrant population.

Organizers at ACCM say that supporting successful integration has become increasingly important as more newcomers are being diagnosed with HIV.

The latest federal data reveals that over 2,000 migrants tested positive for HIV in 2022, an increase of close to 145 per cent within a single year.

In Quebec, the number of new recorded HIV cases in 2022 grew by over 75 per cent compared to the previous year. According to the Institut national de santé publique du Québec, the rise in cases is linkedto an overall increase in the number of migrants arriving in the province.

More than just healthcare

Mendoza came to Montreal in 2021 with his family after fleeing Colombia. Their safety was threatened due to discrimination against their transgender son and Mendoza’s own fears of being persecuted for living with HIV.

Migrants with HIV, he said, are at the intersection of multiple obstacles. Navigating an entirely new healthcare system is only one part of the challenge—having access to support for social and cultural integration is just as important.

“Human beings are dimensions: emotions, family, work and money,” he said. “[ACCM] really took me as a whole individual.”

Many migrants with HIV receive their diagnoses upon their arrival in Canada as part of a mandatory medical screening process required to obtain a working visa.

Jabulani Muzhizhizhi, ACCM newcomers support program coordinator, said that some migrants can feel alienated from their own cultural backgrounds after being diagnosed as HIV-positive. This is especially prevalent for those immigrating from countries where queerness is stigmatized or where toxic masculinity is the norm.

The New Horizons program, Muzhizhizhi said, aims to offer newcomers a sense of community during a time when living with HIV can feel especially isolating.

Roundtable discussions are a regular feature at these workshops. Topics like “migration stories” and “celebrating cultural traditions” are highlighted in the first weeks of the program to remind participants that they’re not alone.

“There is power in sharing,” Muzhizhizhi said. “If you know someone also faced the same stuff that you faced—that’s how bonds form.”

Prejudice was the first thing Mendoza was able to let go of after participating in ACCM’s workshops.

He explained that in Colombia, individuals living with HIV can become the target of attacks, particularly from extremist groups who unjustly perceive them as deliberately spreading HIV.

However, Mendoza said that the support of ACCM gave him the space to release the feelings of stigma that had previously been buried beneath the surface.

“I was finally able to expose that here,” he said, “and I felt safe that nothing was going to happen to me.”

Overcoming language barriers

As the only non-francophone HIV/AIDS care centre in Montreal, support services department manager Miguel Cubillos said that ACCM faces a distinct responsibility to offer a comprehensive range of services.

Their staff is not only equipped to provide emotional support and guidance through the healthcare system, but they also assist with the immigration process by accompanying newcomers to immigration hearings or connecting them with legal support.

According to Cubillos, language is often a barrier that stands between a newcomer with HIV and access to medical documents, treatment options and education about HIV-positive prevention.

“We have a high responsibility with the population we serve because we are a minority,” Cubillos said, referring to the fact that many participants in the newcomers program are not native French nor English speakers.

For Israel Mohamed Conteh, a court reporter from Sierra Leone who fled to Canada after receiving threats over his journalism, ACCM became “one of the greatest pillars of support.” Being diagnosed as HIV-positive upon his arrival, Conteh turned to the organization for help, particularly in accessing French language courses essential for finding employment.

Since arriving in Montreal in 2024, Conteh financially supports his wife and child, who live in Guinea.

A former scout, Conteh does not back down from challenges. Despite facing numerous obstacles on his path to fluency in French, he refuses to seek work in an English-speaking province.

He views his time in Quebec as a chance to fulfill a lifelong goal.

“God brought me to Quebec for a particular reason,” Conteh said with a characteristic smile. “That reason? All my life, I’ve been among people that speak French.”

While living in Sierra Leone, Conteh worked as a COVID-19 and Ebola support counsellor, helping people navigate their next steps after receiving a diagnosis. Now, as he begins a new chapter in Canada, he believes he must “counsel himself” through his own diagnosis—this time, with the support and guidance of ACCM.

“You must live with [HIV] for eternity,” he said. “But once you accept it and take your medication, it will help you greatly.”

Delays and costs in medical care

Many migrants, whether diagnosed with HIV upon arrival or aware of their status before coming, face delays in being connected to care.

Isabelle Boucoiran, a researcher and OB/GYN at CHU Sainte-Justine who specializes in caring for pregnant women living with HIV, says that some of her patients have had to wait up to one month before being referred to a specialist.

Delays like that, she said, can be the difference between preventing or allowing vertical transmission—the passing of HIV from mother to child.

“For newcomers, when they arrive in Canada, there is so much going on,” Boucoiran said. “When you are struggling to find a place to live, doing your test is not your priority at all.”

At ACCM, much of the work revolves around being the on-ramp to care. Last year alone, Cubillos said that the organization supported 110 clients through its newcomers program, many of whom needed to connect to an HIV clinic.

While HIV medication for refugee claimants is completely covered by the Interim Federal Health Program, newcomers with HIV coming to Canada under a working visa can struggle to find employment that covers treatment under insurance.

With data from 225 pregnancies from 2019-2023, across CHU Sainte-Justine, CHU de Quebec-Laval and CUSM, Boucoiran said that the median out-of-pocket cost for antiretrovirals during pregnancy before insurance was around $2,300 for non-permanent residents. This is over four times the amount paid by Canadian citizens or permanent residents, she added.

Some of Boucoiran’s patients, particularly women from African countries where antiretrovirals are free, arrive in Canada with six to nine months’ worth of medication, anticipating the difficulties in accessing medication once they arrive.

For migrants who arrive without health or insurance coverage, ACCM partners with pharmaceutical companies like Gilead through compassion programs to provide opportunities to obtain at least six months of medication.

While community organizations like ACCM cannot substitute themselves for formal medical care and rapid linkage to an HIV specialist, they play an important role in bridging the gap during the first years of settlement.

Despite recent provincial cuts to English-service community resources, particularly those related to employment support, ACCM’s newcomers’ program received an increase in allocated funds from the Direction régionale de santé publique in March. The new budget increase was granted following the latest data on HIV rates among Canadian migrants.

With the funding increase running until 2027, Cubillos believes the program will be better positioned to serve youth migrants with HIV, who make up a large proportion of HIV-positive newcomers.

The organization also hopes to one day have enough resources to tackle migrant food insecurity and expand its food bank through partnerships with grocery stores and restaurants.

Cubillos said that challenges for migrants with HIV will only continue to evolve. However, he said that ACCM staff remain committed to adapting the program as needed, based on the shifting experiences of their members.

“The best reward,” Cubillos said, “is seeing members establish themselves and say: ‘Okay, now I’m here. The limbo situation is gone and I’m flourishing in the country.’”

UK: Legal victory for HIV-positive migrant after prolonged detention

High Court grants interim relief and orders the Home Office to release HIV positive detainee

In R(DJR) v Secretary of State for the Home Department AC-2025-LON-000975, the High Court ordered the Secretary of State for the Home Department to release DJR from immigration detention.

DJR had been detained for several months and had been diagnosed with HIV while in detention. Due to the difficulties of him complying with his anti-retroviral medication regime while in detention, the Secretary of State for the Home Department had decided to release him.

However, over two months later, DJR had not been released and the Secretary of State for the Home Department had refused two applications for accommodation, despite insisting that he needed to be provided with accommodation before he could be released.

DJR initially asked the Court to order his release without accommodation, however, the Court was reluctant to make such an order because this might potentially lead to a breach of his post-sentence supervision requirements.

Instead, the Court decided to order the Secretary of State for the Home Department to provide DJR with accommodation on an urgent basis so that he could be released.

Australia: Brazilian migrants recount their experience from diagnosis to new beginnings in Australia

‘Life doesn’t end when you are diagnosed with HIV: it’s a new beginning’

Augusto, 32, from Brisbane, and Carolina, 38, from Byron Bay receive free medical treatment in Australia, a service available to everyone, including foreign students. With the medication they receive, Luiz and Carolina’s viral load is so low that they are able to lead a completely healthy life. They decided to talk to SBS Portuguese to reduce the stigma surrounding people living with HIV.

SBS in Portuguese interviewed Brazilians living with HIV in Australia, Augusto, from Brisbane who has been living with HIV for over ten years and Carolina, from Byron Baywho received a positive result two years ago.

To protect the privacy of both, their names have been changed.

Discovering the positive result for HIV

“I was deteriorating. Some days I could go to work; other days, I felt too weak. My family inquired about my delayed results and discovered I was HIV positive. That’s how my journey with HIV began, still in Brazil,” he recalled.

Carolina decided to get tested in New South Wales after discovering her boyfriend had been cheating on her.

Initially, the doctor hesitated to request the test, arguing that she wasn’t part of high-risk groups. However, after insisting, she was tested.

“My discovery was shocking. It changed my life forever, because the result came back positive for HIV,” she shared.

She remembers the doctor initially hesitating to request the exam, arguing that Carolina did not fit the risk group because she was heterosexual, but after the patient’s insistence, the test was performed.

Reaction to the Diagnosis: Always Seek Professional Help

Reactions to an HIV diagnosis vary. Augusto accepted it almost immediately, while Carolina faced deep distress, even contemplating suicidal thoughts.

“I accepted my condition and took care of myself. There are always doubts and stigmas, but over time, you learn to cope,” Augusto said.

Carolina, however, recounted, “it felt like the ground disappeared beneath my feet. I had no knowledge of HIV. I was on a student visa in a foreign country and thought it was the end of my journey and my Australian dream.”

“I received support from Positive Life NSW, an NGO that helps people living with HIV here in Australia.”

Augusto also found assistance: “I highly recommend the Melbourne Sexual Health Centre. They treated me with great care, provided free treatment when I was an international student, and even arranged an interpreter.”

The importance of medical treatment: undetectable = untransmittable (U=U)

Those who follow antiretroviral treatment become undetectable, meaning their viral load is so low that it cannot be detected or transmitted. As a result, they can live completely healthy lives.

Both Augusto and Carolina are currently undetectable.

HIV doesn’t prevent you from studying, working, living a healthy life

As both our interviewees had to navigate diagnosis and treatment in and out of Australia fears of losing heir visas status always hanged over their heads.

Augusto, who is now an Australian citizen, shares his experience: “A Brazilian migration agent told me it would be impossible to get permanent residency as I am living with HIV. But I didn’t give up and sought a second opinion from a different agent, who was amazing and explained the steps I could take.”

Carolina successfully applied for permanent residency and soon will become a citizen.

“The visa process wasn’t easy. For someone with HIV, you need a health waiver. My doctor confirmed I was undetectable, and with a specialist lawyer, we demonstrated that my condition wouldn’t affect my ability to contribute to the country.”

Serodiscordant relationships can be healthy and happy

A serodiscordant relationship is when one partner has HIV, and the other does not. Both Augusto and Carolina are in such relationships.

“When I told my boyfriend in 2017, he said he didn’t mind and loved me the same way. The most important thing is that I continue my treatment, and we can have a completely normal life,” Augusto said.

Carolina added, “After my diagnosis, I started a relationship with a man who doesn’t have HIV. He helped me realise that HIV doesn’t define who I am and that our relationship could be completely normal as long as I follow my medical treatment.”

Serodiscordant relationships are healthy and happy

In a serodiscordant relationship, one partner is living with HIV and the other is not. Augusto and Carolina are in serodiscordant relationships where their current partners are not living with HIV.

Augusto told his boyfriend, when he met him in 2017, that he was a person living with HIV.

“When I told him about my serology, he said that he didn’t care about it and that he loved me the same way. The most important thing is that I continue to do my treatment and then we could have a completely normal life, both of us being healthy and happy.”

“Soon after my diagnosis, I began a relationship with a man who is not living HIV-positive, and he was fundamental to my recovery process. He took care of me when I was depressed because of the diagnosis and he was the one who educated me about HIV. He made me realise that HIV doesn’t define who I am, and that our relationship could be completely normal, as long as I get my medical treatment.”

Having a Baby When You Are Living with HIV

With treatment and medical supervision, it is possible to have a safe pregnancy.

Carolina shared her dream: “I’m so excited I am able to have children! I take daily medication that suppresses the virus, making it undetectable, it won’t be transmitted to the baby.”

‘Life doesn’t end when you are diagnosed with HIV: it’s a new beginning’

At the end of the podcast, Augusto and Carolina shared messages for those newly diagnosed with HIV.

“I’ve been living a normal life since I found out I was HIV positive about 10 years ago. Life doesn’t end when you discover you have HIV, it just reboots,” Augusto said. “I take my medication every day, exercise, and follow my treatment.”

“Although the diagnosis may be a shock at first, it’s possible to live a healthy and full life with the right treatment. Being well-informed opens the doors to effective treatments. My message is one of hope: yes, it is possible to live a completely normal life, even with HIV,” said Carolina.

HIV (Human Immunodeficiency Virus) can be transmitted through unprotected sex, sharing contaminated needles, and from an untreated HIV-positive mother to her baby during pregnancy, childbirth, or breastfeeding.

People living with HIV in Australia can find support, free medical treatment, and specialised services at various organisations across the country.

Victoria – Living Positive Victoria or

Melbourne Sexual Health Centre

New South Wales (NSW) –

Positive Life NSW

or Multicultural HIV and Hepatitis Service (MHAHS)

Queensland – Queensland Positive People (QPP) or Queensland Council for LGBTI Health Northern

Territory – NAPWHA Peer Support (National Association of People) with HIV Australia) South Australia – SAMESH (South Australia Mobilisation + Empowerment for Sexual Health)

Tasmania – Tasmanian Council on AIDS, Hepatitis and Related Diseases (TAScaHRD)

Canberra – HIV/AIDS Legal Centre (HALC) or Canberra Sexual Health Centre

Mauritius: Experts of the Committee on the Elimination of Racial Discrimination raise questions on Mandatory HIV testing for migrant workers

The Committee on the Elimination of Racial Discrimination today concluded its consideration of the combined twenty-fourth and twenty-fifth periodic reports of Mauritius, with Committee Experts commending the State on the Intercontinental Slavery Museum, while raising questions on mandatory HIV testing for migrant workers, and the treatment of the Chagossian people.

Chrispine Gwalawala Sibande, Committee Expert and Country Co-Rapporteur, said Mauritius still applied HIV related restrictions on the entry, stay and residence of non-nationals, with migrant workers being required to provide evidence of their negative HIV status to qualify for work and residence permits. Would the delegation clarify reports that Mauritius required HIV testing for any residency permit longer than 90 days, and applicants were denied on the basis of HIV status? What had the Government done to make sure it did not violate the rights of people, especially migrants, on the basis of HIV status? What were the plans to reform the HIV/AIDS and immigration laws in Mauritius?

ntroducing the report, Gavin Patrick Cyril Glover S.C, Attorney General of Mauritius and head of the delegation, said the Government Programme 2025–2029 announced the setting up of a Constitutional Review Commission to make recommendations on constitutional and electoral reforms. The work of the Commission would also address several issues of direct relevance to the Committee’s concerns, including the future of the Best Loser System, the use of Kreol as a parliamentary language, and broader questions of equality and representation in Mauritian institutions. He concluded by stating that Mauritius reaffirmed its deep commitment to the Convention and looked forward to a constructive exchange.

Mr. Glover, responding to questions, said all migrant workers had to comply with the law and present a HIV negative test result before being granted access to the country. If a test was positive, they were not allowed to work and had to leave the country. For those who contracted the disease in the country, they received the same treatment as nationals, regardless of their origin. There were currently 60 foreign workers receiving treatment for HIV/AIDS. There was no discrimination when this test was applied; it was applied across the board, wherever you came from. It was implemented as a public health policy by the Government, due to Mauritius’ small size. Unfortunately for the time being, this would stay in place.

In concluding remarks, Ms. Boker Wilson extended sincere thanks and appreciation to the delegation for the interactive dialogue. The delegation had delivered on its pledge to ensure openness and accountability, and the State party’s commitment to continuity was appreciated.

Mr. Glover, in his concluding remarks, extended thanks for the dialogue which had taken place. Mauritius viewed this exchange as an opportunity to reflect openly and recommit the State to the principles of the Convention. History left long shadows, but Mauritius believed that progress was possible. The State was committed to achieving unity, dignity and justice for all.

The delegation of Mauritius consisted of representatives of the Attorney General’s Office; the Ministry of Foreign Affairs, Regional Integration and International Trade; and the Permanent Mission of Mauritius to the United Nations Office at Geneva.

The Committee will issue its concluding observations on the report of Mauritius after the conclusion of its one hundred and fifteenth session on 9 May 2025. The programme of work and other documents related to the session can be found here. Summaries of the public meetings of the Committee can be found here, while webcasts of the public meetings can be found here.

The Committee will next meet in public on Tuesday, 29 April at 3.p.m to review the combined twentieth to twenty-second periodic reports of the Republic of Korea (CERD/C/KOR/20-22).

Report

The Committee has before it the combined twenty-fourth and twenty-fifth periodic reports of Mauritius (CERD/C/MUS/24-25).

Questions by Committee Experts

There had also been reports that the morality clauses in article 6 of the immigration act were rooted in colonial-era mentalities, and could have a disproportionate and discriminatory impact on minorities. Had Mauritius investigated this? Article 5 of the immigration act banned individuals with infectious, contagious, or communicable diseases. This could encompass HIV/AIDS, which disproportionately affected marginalised groups. Had Mauritius investigated this?

Responses by the Delegation

The State was aware of the discrepancies of the immigration act regarding communicable diseases, and acknowledged there was a need to review this legislation. There had previously been an abominable piece of legislation, the Hoffman law, which enabled a citizenship provided to a non-citizen to be revoked. This would also be reviewed.

Questions by Committee Expert

CHRISPINE GWALAWALA SIBANDE, Committee Expert and Country Co-Rapporteur, asked for more data on domestic workers? Mauritius still applied HIV related restrictions on the entry, stay and residence of non-nationals, with migrant workers being required to provide evidence of their negative HIV status to qualify for work and residence permits. Would the delegation clarify reports that Mauritius required HIV testing for any residency permit longer than 90 days, and applicants were denied on the basis of HIV status? What had the Government done to make sure it did not violate the rights of people, especially migrants, on the basis of HIV status? What were the plans to reform the HIV/AIDS and immigration laws in Mauritius?

Responses by the Delegation

All migrant workers had to comply with the law and present a HIV negative test result before being granted access to the country. If a test was positive, they were not allowed to work and had to leave the country. For those who contracted the disease in the country, they received the same treatment as nationals, regardless of their origin. There were currently 60 foreign workers receiving treatment for HIV/AIDS. Article 5 of the immigration act was a precautionary measure and was a new provision on the application for working in Mauritius. There was no discrimination when this test was applied; it was applied across the board, wherever you came from. It was implemented as a public health policy by the Government, due to Mauritius’ small size. Unfortunately for the time being, this would stay in place.

Questions by Committee Expert

Another Expert said the mandatory HIV test was not compliant with the Convention. It was ineffective as a public health policy and cast a negative stigma on migrant workers.

Responses by the Delegation

GAVIN PATRICK CYRIL GLOVER S.C, Attorney General of Mauritius and head of the delegation, said he took on board the views that the mandatory HIV law was ineffective and discriminatory and would act as an advocate in this regard. All domestic workers had to obtain a resident and work permit to work in Mauritius.

Closing Remarks

FAITH DIKELEDI PANSY TLAKULA, Committee Expert and Follow-up Rapporteur, said the Committee would send concluding observations which contained a follow-up for recommendations which needed to be implemented within one year.

PELA BOKER WILSON, Committee Expert and Country Rapporteur, extended sincere thanks and appreciation to the delegation for the interactive dialogue. The Government of Mauritius should be commended on its reassessed approach to the review which contributed to the quality of the exchange. The delegation had delivered on its pledge to ensure openness and accountability, and the State party’s commitment to continuity was appreciated.

CHRISPINE GWALAWALA SIBANDE, Committee Expert and Country Co-Rapporteur, thanked everyone who had been involved in the dialogue.

GAVIN PATRICK CYRIL GLOVER S.C, Attorney General of Mauritius and head of the delegation, extended thanks for the dialogue which had taken place. Mauritius viewed this exchange as an opportunity to reflect openly and recommit the State to the principles of the Convention. The contribution of Committee member Yeung Sik Yuen Yeung Kam John was very much appreciated. Mauritius had celebrated the richness of its cultural heritage and honoured the memory of historical injustices. The establishment of a Constitutional Review Commission marked an important step forward. History left long shadows, but Mauritius believed that progress was possible. The State was committed to achieving unity, dignity and justice for all.

MICHAL BALCERZAK, Committee Chair, thanked all for the dialogue. During these turbulent times, it was important to celebrate 60 years of the Convention, and the Committee looked to Mauritius to join them in these celebrations. It would be a good opportunity for Mauritius to consider accepting article 14 of the Convention on individual communications.

Botswana: New research shows healthcare worker face ethical challenges in the provision of healthcare to migrants

“No, it is not a breach of my oath because it is beyond my control; I use the policies that are in place.” Ethical challenges faced by healthcare workers in the provision of healthcare to cross-border migrants in Botswana

Abstract

Background

With a growing global population of migrants, understanding the complex dynamics between healthcare providers and policy restrictions is crucial for ensuring equitable access to healthcare. The main objective of this qualitative study was to explore the ethical challenges faced by health care providers in the provision of health care to migrants.

Methods

We conducted in –depth interviews with 11 healthcare providers, which were analysed using thematic analyse. Atlas ti software was used to analysis the data.

Results

Healthcare workers reported facing ethical challenges as a result of not being able to provide medical care to migrant patients because healthcare policies deny them access to healthcare. These policies make it difficult for healthcare professionals to fulfil their duties in accordance with their oath. Failure to provide healthcare to migrant patients can cause moral distress for healthcare workers and affect their well-being. Reporting migrant patients to the police was mentioned as another ethical challenge, which is a breach of confidentiality. Several healthcare providers have developed strategies to address the limitations of migrants’ access to healthcare, including encouraging migrants to access healthcare from their home country and using private healthcare facilities.

Conclusions

Health policies influence the way health care providers carry out their tasks, which can either positively or negatively impact access for vulnerable migrant groups. To address the challenges faced by healthcare providers in implementing their professional ethics, inclusive policies should be introduced, and human rights and ethics training should be provided, as well as ongoing dialogue to ensure that healthcare providers fulfil their professional obligations toward all migrant patients.

The full study is available at: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-025-01195-4

Spain: Stigmatisation and bureaucratic barriers for LGBT migrants trying to exercise their right to health in Madrid.

Translated with Google translate. For original article in Spanish, please scroll down.

“I have been treated like garbage”: when discrimination against LGTBI migrants also creeps into health.

The COGAM collective denounces the stigmatization and bureaucratic barriers that these people face when trying to exercise their right to health in Madrid. ‘Infobae’ talks to a young Venezuelan who has applied for asylum in Spain.

The LGTBI collective continues to be the subject of harassment and violence around the world, a particularly complicated situation in some Latin American countries, where they live in a reality marked by homicides, attacks and discrimination. This is what happened in Venezuela to K.C., a 33-year-old homosexual man who suffered a rape “perpetrated by a policeman” in 2016 from which he is still trying to recover. Due to that aggression for which he contracted HIV and that caused him a state of tension and permanent fear, he decided to leave and settle in Colombia, where he lived until July last year, when he moved to Spain. The reason why K.C. (fictitious name) left this second country is because he met one of his aggressors and was not willing to live in fear.

“The first shock I had in the consultation is that they spoke to me in a very derogatory way when I just wanted to advise me, because I still didn’t know how things worked here. A doctor asked me what my nationality was, when in reality it was not a relevant fact, but she gave me to understand that we were the foreign people who brought the diseases to Spain,” this young man explains to Infobae. “Being a migrant does not mean that we have no rights,” he criticizes.

K.C. claims to have felt stigmatized both “for being Latino and for his HIV diagnosis.” “The doctors don’t listen to me and make me feel like I’m stealing the medical care that should be for Spaniards. I’ve been treated like trash and I only go to the health center when I have an emergency because I don’t want to feel humiliated,” he says. In addition, he mentions wrong diagnoses and inadequate treatments that, far from improving his condition, have aggravated his health: “I know I accessed health care, but at what cost?” he asks himself.

The only time he has been properly cared for, he says, was when he went to the Sandoval medical center, the only one in Madrid specialized in the prevention, diagnosis and treatment of sexually transmitted infections. This young man also assures that in Spain is where he has really “been aware of his skin color,” because he lives episodes of racism every day, especially when he goes to the supermarket or when he travels by subway.

Like K.C., there are many LGTBI+ migrants for whom access to public health continues to be a challenge in the region, as denounced by the Collective of lesbians, gays, transsexuals and bisexuals of Madrid (COGAM), which criticizes “discrimination, stigmatization and bureaucratic barriers that these people face daily when trying to exercise their fundamental right to health.” The difficulties, they assure, not only respond to the lack of administrative regularization, but also “to the dehumanizing treatment and the lack of empathy in primary care centers and hospitals,” as this is reflected in some of the testimonies collected by the organization, which show “stigmatization by nationality, sexual orientation, gender identity and serological status“.

This is the case of Nicolás Henríquez, a 28-year-old Chilean, who denounces the lack of access to preventive treatments such as the pre-exposure prophylaxis pill or PrEP, which is taken to reduce the chances of contracting HIV infection, due to bureaucratic delays: “I wanted to start PrEP, but they didn’t give me an appointment until five months later. I was finally diagnosed with HIV, something that I could perhaps avoid if I had been treated before,” he says.

The situation is also complicated for Vitória Ribeiro, a 27-year-old Brazilian student, because the private insurance required for her visa, she explains, “is very expensive and inefficient,” so that if something happens to her outside of business hours, “she cannot receive help.” “This generates constant concern and anxiety in me.”

For all this, from COGAM they demand that the Madrid health authorities guarantee “real and universal access to public health for all people, regardless of their migratory status or identity,” as well as combating stigma and discrimination through awareness programs and training of medical personnel.

Another of the collective’s claims is the specific training for health personnel in terms of LGTBI+ diversity and care for migrants and they ask that access to preventive and specific treatments, such as PrEP and antiretrovirals, be facilitated, “without bureaucratic obstacles.” The health system, they conclude, “must be a safe space where anyone receives dignified and quality care.”

“Me han tratado como basura”: cuando la discriminación hacia las personas migrantes LGTBI también se cuela en la sanidad.

El colectivo COGAM denuncia la estigmatización y barreras burocráticas a las que se enfrentan estas personas al intentar ejercer su derecho a la salud en Madrid. ‘Infobae’ habla con un joven venezolano que ha solicitado asilo en España.

El colectivo LGTBI sigue siendo objeto de acoso y violencia en todo el mundo, una situación especialmente complicada en algunos países de América Latina, donde viven una realidad marcada por homicidios, ataques y discriminación. Así le ocurrió en Venezuela a K.C., un hombre homosexual de 33 años que sufrió una violación “perpetrada por un policía” en 2016 de la que aún trata de recuperarse. Debido a esa agresión por la que contrajo VIH y que le provocó un estado de tensión y miedo permanente, decidió marcharse e instalarse en Colombia, donde vivió hasta julio del año pasado, cuando se trasladó a España. El motivo por el que K.C. (nombre ficticio) se marchó de este segundo país es porque se encontró con uno de sus agresores y no estaba dispuesto a vivir atemorizado.

En Madrid, donde reside desde hace ocho meses y ha solicitado asilo por razones humanitarias, se encuentra más seguro, pero también ha atravesado enormes dificultades para acceder a la sanidad pública, barreras que acaban afectando a su bienestar físico y emocional, perpetuando situaciones de desigualdad y vulnerabilidad.

“El primer choque que tuve en la consulta es que me hablaron de forma muy despectiva cuando solo quería asesorarme, porque aún no sabía cómo funcionaban las cosas acá. Una doctora me preguntó cuál era mi nacionalidad, cuando en realidad no era un dato relevante, pero me dio a entender que éramos las personas extranjeras quienes traíamos las enfermedades a España”, explica a Infobae este joven. “Ser migrante no significa que no tengamos derechos”, critica.

K.C. asegura haberse sentido estigmatizado tanto “por ser latino como por su diagnóstico de VIH”. “Los médicos no me escuchan y me hacen sentir como si estuviera robando la atención médica que debería ser para españoles. Me han tratado como una basura y ya solo acudo al centro de salud cuando tengo una urgencia porque no quiero sentirme humillado”, relata. Además, menciona diagnósticos erróneos y tratamientos inadecuados que, lejos de mejorar su estado, han agravado su salud: “Sé que accedí a la sanidad, pero ¿a qué costo?”, se pregunta.

La única vez que le han atendido adecuadamente, sostiene, fue cuando acudió al centro médico Sandoval, el único en Madrid especializado en la prevención, diagnóstico y tratamiento de las infecciones de transmisión sexual. Este joven también asegura que en España es donde realmente “ha sido consciente de su color de piel”, porque vive a diario episodios de racismo, especialmente cuando va al supermercado o cuando viaja en metro.

Al igual que K.C., son muchas las personas migrantes LGTBI+ para las que el acceso a la sanidad pública continúa siendo un desafío en la región, tal y como ha denunciado el Colectivo de lesbianas, gais, transexuales y bisexuales de Madrid (COGAM), que critica “la discriminación, estigmatización y barreras burocráticasque enfrentan estas personas a diario al intentar ejercer su derecho fundamental a la salud”. Las dificultades, aseguran, no solo responden a la falta de regularización administrativa, sino también “al trato deshumanizante y la falta de empatía en centros de atención primaria y hospitales”, pues así lo reflejan algunos de los testimonios que ha recogido la organización, que evidencian “estigmatización por nacionalidad, orientación sexual, identidad de género y estado serológico“.

Es el caso de Nicolás Henríquez, chileno de 28 años, denuncia la falta de acceso a tratamientos preventivos como la pastilla de profilaxis preexposición o PrEP, que se toma para reducir las posibilidades de contraer la infección por VIH, debido a retrasos burocráticos: “Quise iniciar la PrEP, pero no me dieron cita hasta cinco meses después. Finalmente fui diagnosticado con VIH, algo que quizá pude evitar si me hubieran atendido antes”, relata.

La situación también es complicada para Vitória Ribeiro, estudiante brasileña de 27 años, pues el seguro privado exigido para su visado, explica, “es muy caro y poco eficiente”, de forma que si le ocurre algo fuera del horario de atención, “no puede recibir ayuda”. “Esto me genera una constante preocupación y ansiedad”.

Por todo ello, desde COGAM reclaman a las autoridades sanitarias madrileñas que garanticen “un acceso real y universal a la sanidad pública para todas las personas, independientemente de su estatus migratorio o identidad”, así como combatir el estigma y la discriminación a través de programas de sensibilización y formación del personal médico.

Otro de los reclamos del colectivo es la formación específica para el personal sanitario en materia de diversidad LGTBI+ y atención a personas migrantes y piden que se facilite el acceso a tratamientos preventivos y específicos, como la PrEP y los antirretrovirales, “sin trabas burocráticas”. El sistema sanitario, concluyen, “debe ser un espacio seguro donde cualquier persona reciba atención digna y de calidad”.

Colombia: USAID Suspension cuts off lifesaving HIV medications for migrants

Translated with Deepl.com – Scroll down for original article in Spanish

Migrants with HIV in Colombia and others affected by the USAID suspension.

Undocumented Venezuelan migrants with HIV are facing a difficult situation: due to the suspension of USAID funds, they are unable to receive essential medicines from the organisations that used to provide them. The NGO Red Somos, for example, had to retain 3,000 units of medicines, as they are not yet authorised to deliver them.

In Soacha, Bogotá, Alfredo*, a doctor, says he is overwhelmed with work. ‘There is a collective fear,’ he says. ‘People believe they are going to run out of HIV medication, and the worst thing is that yes, they are at risk.’

The people Alfredo is referring to are Venezuelan migrants in an irregular situation, who do not have valid and current documentation to be in Colombia. He works for Red Somos, a non-profit organisation that provides support to this population with HIV. But since 20 January — on his first day in office — US President Donald Trump suspended funding for international cooperation, that humanitarian aid was left hanging by a thread: its main funder for medical care and delivery of treatments was the United States Agency for International Development (USAID).

In the face of the 90-day suspension of that agency, notice was given to stop all activities, including the delivery of medicines. In the words of Miguel Barriga, director of the Somos Network, this means putting at risk 350 Venezuelan migrants in an irregular situation who can only access medication through this NGO in Soacha, Bogotá and Barranquilla. Of those 350 people, Barriga says that 104 are in very advanced stages of HIV and require prioritisation. All of them receive antiretroviral drugs, which reduce the burden of the virus in the body, allowing patients a better quality of life. Some even manage to lower the virus load in their body.

Although Venezuelan migrants in an irregular situation can go to a Colombian health centre in the event of a life-threatening emergency, this does not apply to complex treatments such as cancer or HIV. Donna Catalina Cabrera Serrano, lecturer and researcher in international migration at the Javeriana University, explains it in simple terms: only those who have a PPT (Temporary Protection Permit), which is linked to the Temporary Protection Statute for Venezuelans (ETPV), as well as those who have a visa or dual Colombian nationality with their respective valid citizenship card, can access it.

‘The main response to undocumented migrants living with HIV is provided by international cooperation,’ adds Barriga.

In addition, the Somos Network has 3,000 bottles of antiretrovirals that correspond to the last donation made by USAID with an expiration date of October 2025, as well as 125 bottles of Dolutegravir that expire in July of the same year. The latter medicine is recognised as one of the most modern for treating the virus. ‘Although we have the medicine in storage, we cannot deliver it given the 90-day suspension. Normally, we supply patients with three months‘ worth of medication and, on some occasions, two months’ worth. The people with three months‘ worth will arrive at our headquarters on or around 28 February looking for their dose, and there is a risk as to how we are going to deliver it to them’, explains Barriga.

The Somos Network also delivers another type of medication, called PrEP (Pre-Exposure Prophylaxis), aimed at people who do not have HIV but who are at high risk of contracting it. ‘Some of the migrants who depend on our PrEP deliveries are in a highly vulnerable situation, as they engage in sex work or transactional sex in order to make a profit,’ says Barriga.

This NGO is able to provide this medication to 250 people for a month thanks to another of its sponsors, the French Development Agency (AFD), but Barriga emphasises that this is not enough to meet current demand. ‘We have not received an official response from USAID as to what to do with the medication we have there, or how to guarantee coverage for our other patients. We are looking for other donors to ensure treatment,’ explains Barriga.

For now, an interruption in antiretroviral drugs would have serious consequences not only for patients, but also for public health. Miguel Ángel López, from the organisation Más que tres letras (More than three letters) – which is dedicated to educating and accompanying people living with the virus in Colombia – points out that ‘the most serious risk is that the viral load of the virus will increase in their bodies, and this can happen in months, weeks or even days’. In his words, this could lower the patients’ defences, increase their susceptibility to acquiring other diseases, or make them transmitters of the virus again, which would lead to an increase in cases and a direct impact on public health.

But, according to López, another consequence is that, faced with the abrupt pause, the person develops pharmacological resistance to the medication they were already taking. ‘It doesn’t always happen, but there is that risk. If it does happen, it means that the patient has to access other, more complex medications, which are not always available or are much more expensive,’ says López.

In our country, according to a study carried out in 2022 by the US university John’s Hopkins, the Ministry of Health and the Somos Network, there are 22,500 Venezuelans living with HIV. Of that number, 8,500 people receive treatment through the Colombian health system and international cooperation.

An international mess

At the same time as the suspension of USAID was announced, another of the US government’s major programmes, the US President’s Emergency Plan for AIDS Relief (PEPFAR), also ran the risk of being suspended. After organisations such as the World Health Organisation (WHO) and UNAIDS sounded the alarm, the US government backed down and applied an exemption for the programme so that its services would not be interrupted. However, according to a statement issued by the deputy executive director of UNAIDS, Christine Sterling, there is a lack of clarity about the future of the plan’s funds, which could have a negative impact on the people who benefit from PEPFAR.

According to the WHO, the programme has saved more than 26 million lives and provided treatment to another 20 million people living with HIV, including 566,000 children under the age of 15. Currently, the UN/AIDS deputy executive director explained, 20 million of the more than 30 million people living with HIV worldwide depend on US funding for their treatment. ‘If PEPFAR is not reauthorised between 2025 and 2029 and no other resources are found for the HIV response, there would be a 400% increase in AIDS deaths,” the agency calculated.

This fund sends its money to various US agencies, including the Centers for Disease Control (CDC) and USAID. In turn, these agencies have fund managers all over the world who hire local implementers. In the case of Red Somos, they had contact with Family Health International (FHI 360), which is a USAID implementer. ‘That is why we are in a state of uncertainty: although there is an exemption from PEPFAR, our resources for HIV treatments come from that programme through USAID,” explains Barriga.

Along the same lines, the International AIDS Society (IAS) also raised its voice and stated in a press release issued on 6 February that “although an exemption was subsequently granted for ” vital humanitarian assistance’, which included HIV testing and treatment and, to a limited extent, HIV prevention in pregnant women, many PEPFAR-funded clinics had already closed, staff were sent home and confusion persists. The future of PEPFAR is now uncertain, and more than 20 million people are at risk of losing access to life-saving medicines.

Although PEPFAR does not have a direct impact in Colombia, in 2019 the programme donated antiretroviral drugs to support HIV/AIDS treatment for Venezuelan migrants in our territory. ‘And, two years ago, PEPFAR entered the country to contribute to the situation of irregular migrants through USAID,’ says Barriga.

Barriers within the system

Donna Catalina Cabrera Serrano, from the Javeriana University, explains that, currently, migrants in an irregular situation can apply for valid legal documentation in several ways: by applying for a visa or refugee status, and through PEP-TUTOR, which is only available to carers or parents of children and adolescents who have temporary protection permits. Another alternative is to demonstrate a situation of risk that could give them refugee status. ‘For this, when a person is living with HIV, they must demonstrate that their life is at risk and that they came to Colombia due to a lack of guarantees for their health,’ explains Barriga.

On the other hand, Jorge Luis Díaz, technical director for Latin America of Aid For Aids (AFA), the non-profit organisation that attends to the largest number of irregular Venezuelan migrants in our country, explains that there are some difficulties for those who come from the neighbouring country to obtain valid documentation. For example, currently the Colombian visa with visitor status includes a modality for Venezuelans, but only those who have legally entered the territory can apply.

‘Another barrier is that not everyone has a valid passport, as it is very expensive to obtain one in Venezuela. In addition, there is a group of people who started the regularisation process but did not complete it,’ says the director. Díaz also points out that, even with their documentation in order, Venezuelan migrants can face difficulties in accessing the health system. Many, lacking the ability to pay, seek to enter the subsidised regime, which requires completion of the survey of the System for the Identification of Potential Beneficiaries of Social Programmes (SISBEN), which classifies the population according to their living conditions and income.

One of the requirements of the form is to have a fixed address, ‘and many migrants do not have a rental contract, but live temporarily in guesthouses, shelters, and hotels. For this reason, they can be left out of the system. Furthermore, entering the system does not guarantee the timely delivery of antiretroviral treatment, which can take between three and six months. Nor does it imply permanence: those who enter the contributory regime must demonstrate their ability to pay, which is not always possible because some have unstable jobs,’ explains Díaz.

For now, in the words of Barriga, the suspension of USAID support and the uncertainty about PEPFAR generate a high risk: although the Somos Network guarantees treatment for 350 people, they are part of the group of 4,500 irregular migrants who depend exclusively on international cooperation to receive HIV treatments.

Migrantes con VIH en Colombia, otros de los afectados por la suspensión de USAID

Los migrantes venezolanos en situación irregular que tienen VIH están enfrentándose a una situación difícil: debido a la suspensión de fondos de USAID, no pueden recibir medicamentos esenciales de las organizaciones que se los daban. La ONG Red Somos, por ejemplo, tuvo que retener 3 mil unidades de medicinas, pues aún no les autorizan a entregarlas.

En Soacha, Bogotá, Alfredo*, médico, dice que está desbordado de trabajo. “Hay susto colectivo”, comenta. “Las personas creen que se van a quedar sin medicamentos para el VIH, y lo peor es que sí, están en riesgo”.

Las personas a las que Alfredo se refiere son migrantes venezolanos en situación irregular, que no cuentan con documentación válida y vigente para estar en Colombia. Él trabaja para la Red Somos, una organización sin ánimo de lucro que brinda apoyo a esta población con VIH. Pero desde que el 20 de enero —en su primer día en el cargo— el presidente de Estados Unidos, Donald Trump, suspendió los fondos para cooperación internacional, esa ayuda humanitaria quedó en la cuerda floja: su principal financiador para la atención médica y entrega de tratamientos era la Agencia de los Estados Unidos para el Desarrollo Internacional (USAID).

Ante la suspensión de 90 días de esa agencia, se dio aviso de parar todas las actividades, incluyendo la entrega de medicamentos. En palabras de Miguel Barriga, director de la Red Somos, esto implica poner en riesgo a 350 migrantes venezolanos en condición irregular que solo pueden acceder a la medicación a través de esta ONG en Soacha, Bogotá y Barranquilla. De esas 350 personas, Barriga cuenta que 104 se encuentran en fases muy avanzadas de VIH y requieren priorización. Todos ellos reciben medicamentos antirretrovirales, que se encargan de reducir la carga del virus en el organismo, permitiéndoles una mejor calidad de vida a los pacientes. Algunos, incluso, logran bajar las cargas del virus en su cuerpo.

Aunque los migrantes venezolanos en condición irregular sí pueden acudir a un centro de salud colombiano ante una situación de emergencia que amenace su vida, eso no aplica para tratamientos complejos, como el cáncer o el VIH. Donna Catalina Cabrera Serrano, docente e investigadora en migración internacional de la Universidad Javeriana, lo explica en términos sencillos: solo pueden acceder aquellos que cuenten con PPT (Permiso de Protección Temporal), que está vinculado al Estatuto Temporal de Protección para Venezolanos (ETPV), además de quienes tengan visa o doble nacionalidad colombiana con su respectiva cédula de ciudadanía vigente.

“La respuesta principal a migrantes indocumentados que viven con VIH la brinda la cooperación internacional”,añade Barriga.

Además, la Red Somos tiene 3.000 frascos de antirretrovirales que corresponden a la última donación realizada por USAID con fecha de vencimiento a octubre de este 2025, así como 125 frascos de Dolutegravir que vencen en julio de ese mismo año. Esta última medicina es reconocida por ser una de las más modernas para tratar el virus. “Aunque tenemos el medicamento en bodega, no lo podemos entregar dada la suspensión de 90 días. Normalmente, suministramos a los pacientes con medicamentos para tres meses y, en algunas ocasiones, para dos. Las personas de 3 meses llegarán aproximadamente el 28 de febrero a nuestra sede en busca de su dosis, y está en riesgo el cómo vamos a hacerles entrega”, explica Barriga.

La Red Somos también entrega otro tipo de medicamentos, llamados PrEP (Profilaxis Pre Exposición), dirigidos a personas que no tienen VIH pero que están en alto riesgo de adquirirlo. “Algunos de los migrantes que dependen de nuestras entregas de PrEP se encuentran en alta situación de vulnerabilidad, pues ejercen el trabajo sexual o el sexo transaccional para adquirir algún beneficio”, cuenta Barriga.

Esa ONG tiene capacidad para entregar esta medicación a 250 personas durante un mes gracias a otro de sus patrocinadores, la Agencia Francesa para el Desarrollo (AFD), pero Barriga hace énfasis en que esto no es suficiente para cubrir su demanda actual. “No hemos conocido una respuesta oficial por parte de USAID para saber qué hacer con los medicamentos que tenemos ahí, o cómo garantizar la cobertura de nuestros demás pacientes. Estamos buscando otros donantes para asegurar el tratamiento”, explica Barriga.

Por ahora, una interrupción en los medicamentos antirretrovirales tendría unas graves consecuencias no solo en los pacientes, sino también en la salud pública. Miguel Ángel López, de la organización Más que tres letras -que se dedica a hacer pedagogía y acompañamiento a personas que viven con el virus en Colombia- señala que “el riesgo más grave es que la carga viral del virus aumente en sus organismos, y esto puede ocurrir en meses, semanas o, incluso, días”. En sus palabras, esto podría bajar las defensas de los pacientes, aumentar su susceptibilidad para adquirir otras enfermedades, o hacerlos nuevamente transmisores del virus, lo que conllevaría a un aumento de casos y un impacto directo en la salud pública.

Pero, según López, otra consecuencia es que, ante la pausa abrupta, la persona desarrolle resistencia farmacológica a la medicación que ya estaba tomando. “No siempre pasa, pero se corre ese riesgo. En caso de que sí suceda, eso implica que el paciente deba acceder a otros medicamentos más complejos, que no siempre están disponibles o que son mucho más caros”, afirma López.

En nuestro país, según un estudio realizado en 2022 por la universidad estadounidense John’s Hopkins, el Ministerio de Salud y la Red Somos, hay 22.500 venezolanos que viven con VIH. De esa cantidad, 8.500 personas reciben tratamiento mediante el sistema de salud colombiano y la cooperación internacional.

Un lío internacional

Al mismo tiempo que se declaraba la suspensión de USAID, otro de los grandes programas del gobierno de Estados Unidos, el Plan de Emergencia del Presidente de los Estados Unidos para el Alivio del SIDA (PEPFAR, por sus siglas en inglés), también corrió el riesgo de ser suspendido. Luego de que entidades como la Organización Mundial de la Salud (OMS) y ONU/SIDA prendieran las alarmas, el Gobierno de Estados Unidos reculó y aplicó una exención para ese programa, para que así no se interrumpieran sus servicios. Sin embargo, de acuerdo con un comunicado emitido por la subdirectora ejecutiva de ONU/SIDA, Christine Sterling, hay una falta de claridad sobre el futuro de los fondos del plan, lo cual podría tener un impacto negativo en las personas que se benefician de PEPFAR.

Según la OMS, ese plan ha salvado más de 26 millones de vidas y ha proporcionado tratamiento a otros 20 millones que viven con VIH, incluidos 566.000 menores de 15 años. En la actualidad, explicó la subdirectora ejecutiva de ONU/SIDA, 20 millones, de los más 30 millones de personas que viven con VIH en el mundo, dependen del dinero que gira Estados Unidos para su tratamiento. “Si el PEPFAR no se volviera a autorizar entre 2025 y 2029 y no se encontraran otros recursos para la respuesta al VIH, se produciría un aumento del 400 % en las muertes por SIDA”, calculó la agencia.

Este fondo envía su dinero a varias agencias de Estados Unidos, entre ellas los Centros de Control para las Enfermedades (CDC, por sus sigla en inglés) y USAID. A su vez, estas agencias tienen administradores de fondos que están en todo el mundo y que contratan implementadores locales. En el caso de Red Somos, ellos tenían contacto con Family Health International (FHI 360), que es una implementadora de USAID. “Por eso estamos en una incertidumbre: aunque está la exención a PEPFAR, nuestros recursos para los tratamientos de VIH provienen de ese programa a través de USAID”, especifica Barriga.

Por la misma línea, la Sociedad Internacional del Sida (IAS, por sus siglas en inglés), también levantó la voz y declaró en un comunicado emitido el pasado 6 de febrero que “aunque posteriormente se otorgó una exención para la “asistencia humanitaria vital”, que incluyó las pruebas y el tratamiento del VIH y, de manera limitada, la prevención del VIH en mujeres embarazadas, muchas clínicas financiadas por PEPFAR ya habían cerrado, el personal fue enviado a casa y la confusión persiste. El futuro de PEPFAR es ahora incierto, y más de 20 millones de personas corren el riesgo de perder acceso a medicamentos que salvan vidas.

Aunque PEPFAR no tiene impacto directo en Colombia, en 2019 ese programa donó medicamentos antirretrovirales para apoyar el tratamiento del VIH/SIDA a los migrantes venezolanos que se encontraban en nuestro territorio. “Y, hace dos años, PEPFAR ingresó al país para aportar a la situación de los migrantes irregulares a través de USAID”, dice Barriga.

Barreras dentro del sistema

Donna Catalina Cabrera Serrano, de la Universidad Javeriana, cuenta que, actualmente, los migrantes en condición irregular pueden solicitar documentación legal vigente por varias vías: mediante la solicitud de una visa o refugio, y a través del PEP-TUTOR, que solo está disponible para cuidadores o padres de niños, niñas y adolescentes que tengan PPT. Otra alternativa es que se demuestre una situación de riesgo que les pueda dar el estatus de refugiados. “Para esto, cuando una persona vive con VIH, se debe demostrar que está en riesgo su vida y que vino a Colombia por falta de garantías para su salud”, explica Barriga.

Por otro lado, Jorge Luis Díaz, director técnico para Latinoamérica de Aid For Aids (AFA), -la organización sin ánimo de lucro que atiende mayor cantidad de migrantes irregulares venezolanos en nuestro país-, explica que existen algunas dificultades para que quienes provienen del vecino país obtengan documentación vigente. Por ejemplo, actualmente el visado colombiano con categoría de visitante incluye una modalidad para personas venezolanas, pero solo pueden aplicar quienes hayan ingresado legalmente al territorio.

“Otra barrera es que no todos tienen pasaporte vigente, ya que obtenerlo en Venezuela es muy costoso. Además, hay un grupo de personas que iniciaron el proceso de regularización, pero no lo completaron”, cuenta el director. Díaz también señala que, incluso con la documentación en regla, los migrantes venezolanos pueden enfrentar dificultades para acceder al sistema de salud. Muchos, al no contar con capacidad de pago, buscan ingresar al régimen subsidiado, lo que requiere completar la encuesta del Sistema de Identificación de Potenciales Beneficiarios de Programas Sociales (SISBEN), que clasifica a la población según sus condiciones de vida e ingresos.

Uno de los requisitos del formulario es tener un domicilio fijo, “y muchos migrantes no cuentan con un contrato de alquiler, sino que viven temporalmente en pensiones, refugios, y hoteles. Por este motivo, pueden quedar por fuera del sistema. Además, ingresar no garantiza la entrega oportuna de tratamiento antirretroviral, que puede tardar entre tres y seis meses. Tampoco implica permanencia: quienes entran al régimen contributivo deben demostrar capacidad de pago, que no siempre es posible porque algunos tienen trabajos inestables”, explica Díaz.

Por ahora, en palabras de Barriga, la suspensión del apoyo de USAID y la incertidumbre sobre PEPFAR generan un riesgo alto: aunque la Red Somos garantiza tratamiento para 350 personas, estas hacen parte del grupo de 4.500 migrantes irregulares que dependen exclusivamente de la cooperación internacional para recibir tratamientos del VIH.