Andorra: People refused entry to the country for a variety of health reasons, including HIV

A doctor’s complaint against the Andorran government for the ‘grave violation of human rights’ of immigration medical services

Translated from Spanish via Deepl.com; Scroll down for the original article in Spanish.

Ricardo Villanueva, a doctor who worked for three years in a hospital in Andorra, has filed a complaint against the government of the Principality. The doctor claims that people have been refused entry to the country for various health reasons: HIV, hepatitis, diabetes, myopia, obesity, anxiety and deafness.

‘The objective is purely economic, as vulgar as that’, he denounces, adding: “an HIV-positive patient is going to be an economic burden for them in the future, and for an obese patient the capacity to develop illnesses is going to be much greater, which is going to have repercussions on their coffers”.

In this sense, the doctor highlights a fact: ‘The average life expectancy in Andorra is 90 or 91 years, more than anywhere else in Europe, this is due to the fact that “sick, no thanks”’. ‘When they have an illness or whatever, the Andorran service automatically takes away their residence permit, and if they don’t have a residence permit, they have to go to their country of origin,’ he laments.

Moreover, Villanueva assures that ‘this situation has not changed nowadays’, according to what he has heard ‘from doctors who continue to work in Andorra’, to which he adds that ‘what has happened is that there is better surveillance in the flow of data referring to these problems’.


La denuncia de un médico al Gobierno de Andorra por la “grave violación de los derechos humanos” de los servicios médicos de inmigración

Ricardo Villanueva, un médico que trabajó tres años en un hospital de Andorra, abandera una denuncia contra el Gobierno del Principado. El doctor asegura que han denegado la entrada al país por diferentes cuestiones de salud: VIH, hepatitis, diabetes, miopía, obesidad, ansiedad o sordera.

“El objetivo es meramente económico, así de vulgar”, denuncia, tras lo que añade: “un paciente seropositivo va a ser para ellos el día de mañana una carga económica y para un paciente obeso la capacidad de desarrollar enfermedades va a ser mucho más amplia, con lo que eso va a repercutir en sus arcas”.

En este sentido, el doctor destaca un dato: “El promedio de vida en Andorra son 90 o 91 años, más que en ninguna parte de Europa, esto es debido a que ‘enfermos, no gracias'”. “Cuando tienen una enfermedad o lo que sea, automáticamente el servicio de Andorra les quita el permiso de residencia, y si no tienen permiso de residencia, tienen que irse a sus países de orígenes”, lamenta.

Además, Villanueva asegura que “esta situación no ha cambiado en la actualidad”, según lo que le llega “por parte de médicos que siguen trabajando en Andorra”, a lo que apostilla que “lo que ha ocurrido es que hay una mejor vigilancia en los flujos de datos que hacen referencia a estos problemas”.

Jordan: Health professionals mandated to report individual’s HIV status to the government

Foreigners Living with HIV in Jordan Face an Impossible Choice

Government Mandates Reporting HIV Status, Deports People Living with HIV

In Jordan, medical professionals and health facilities are mandated to report an individual’s HIV status to the government. Foreign nationals found to be HIV-positive are summarily deported regardless of the consequences to their health and safety and banned for life from returning.

Earlier this year, an Iraqi gay man living with HIV fled to Jordan to escape persecution he faced at home for being gay, yet he could not access HIV treatment without being immediately deported. When his health rapidly deteriorated, he could not seek medical attention for fear of being deported. Whatever decision he made would threaten his life.

Jordan also obliges nationals to undergo HIV testing when seeking employment in the public sector and for non-nationals obtaining work permits, and denies them jobs if they are HIV-positive. It also requires testing for non-nationals renewing residency permits. For LGBT people living with HIV, the stigma and discrimination by medical professionals and employers often bars them from accessing basic rights, without any legal recourse.

Abdallah Hanatleh, executive director of “Sawaed,” an Amman-based organization that facilitates access to HIV treatment, told Human Rights Watch that his organization documents dozens of deportations based on HIV status annually.

Jordan is not alone in this abusive practice. Gulf states including Saudi Arabia and the United Arab Emirates also deport people found to be HIV-positive without any provision for continuity of care. Worse yet, in Jordan, as in Saudi Arabia and the UAE, HIV-positive foreign nationals in the criminal justice system are denied adequate access to treatment in prison. “They are placed in solitary confinement, further isolating and stigmatizing them,” Hanatleh said.

International law prohibits deportations based solely on HIV status. Jordan should explicitly ban discrimination based on HIV status and stop deporting HIV-positive individuals under the principle of non-refoulement. This principle applies to asylum seekers and refugees, and for people with HIV, it means that governments are prohibited from returning them — depending on how advanced the disease — to places where they do not have adequate access to medical care and social support, or where they risk being subjected to persecution or degrading treatment on account of their HIV status.

Jordan should not mandate reporting of HIV status and employers should not be requiring HIV testing in the first place. People living with HIV should never be forced to forego lifesaving treatment in order to avoid deportation to danger.

UNAIDS and UNDP urge countries to lift all forms of HIV-related travel restrictions

UNAIDS and UNDP call on 48* countries and territories to remove all HIV-related travel restrictions

New data show that in 2019 around 48* countries and territories still have restrictions that include mandatory HIV testing and disclosure as part of requirements for entry, residence, work and/or study permits

GENEVA, 27 June 2019—UNAIDS and the United Nations Development Programme (UNDP) are urging countries to keep the promises made in the 2016 United Nations Political Declaration on Ending AIDS to remove all forms of HIV-related travel restrictions. Travel restrictions based on real or perceived HIV status are discriminatory, prevent people from accessing HIV services and propagate stigma and discrimination. Since 2015, four countries have taken steps to lift their HIV-related travel restrictions—Belarus, Lithuania, the Republic of Korea and Uzbekistan.

“Travel restrictions on the basis of HIV status violate human rights and are not effective in achieving the public health goal of preventing HIV transmission,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “UNAIDS calls on all countries that still have HIV-related travel restrictions to remove them.”

“HIV-related travel restrictions fuel exclusion and intolerance by fostering the dangerous and false idea that people on the move spread disease,” said Mandeep Dhaliwal, Director of UNDP’s HIV, Health and Development Group. “The 2018 Supplement of the Global Commission on HIV and the Law was unequivocal in its findings that these policies are counterproductive to effective AIDS responses.”

Out of the 48 countries and territories that maintain restrictions, at least 30 still impose bans on entry or stay and residence based on HIV status and 19 deport non-nationals on the grounds of their HIV status. Other countries and territories may require an HIV test or diagnosis as a requirement for a study, work or entry visa. The majority of countries that retain travel restrictions are in the Middle East and North Africa, but many countries in Asia and the Pacific and eastern Europe and central Asia also impose restrictions.

“HIV-related travel restrictions violate human rights and stimulate stigma and discrimination. They do not decrease the transmission of HIV and are based on moralistic notions of people living with HIV and key populations. It is truly incomprehensible that HIV-related entry and residency restrictions still exist,” said Rico Gustav, Executive Director of the Global Network of People Living with HIV.

The Human Rights Council, meeting in Geneva, Switzerland, this week for its 41st session, has consistently drawn the attention of the international community to, and raised awareness on, the importance of promoting human rights in the response to HIV, most recently in its 5 July 2018 resolution on human rights in the context of HIV.

“Policies requiring compulsory tests for HIV to impose travel restrictions are not based on scientific evidence, are harmful to the enjoyment of human rights and perpetuate discrimination and stigma,” said Dainius Pūras, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of health. “They are a direct barrier to accessing health care and therefore ineffective in terms of public health. I call on states to abolish discriminatory policies that require mandatory testing and impose travel restrictions based on HIV status.”

The new data compiled by UNAIDS include for the first time an analysis of the kinds of travel restrictions imposed by countries and territories and include cases in which people are forced to take a test to renew a residency permit. The data were validated with Member States through their permanent missions to the United Nations.

UNAIDS and UNDP, as the convenor of the Joint Programme’s work on human rights, stigma and discrimination, are continuing to work with partners, governments and civil society organizations to change all laws that restrict travel based on HIV status as part of the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination. This is a partnership of United Nations Member States, United Nations entities, civil society and the private and academic sectors for catalysing efforts in countries to implement and scale up programmes and improve shared responsibility and accountability for ending HIV-related stigma and discrimination.

*The 48 countries and territories that still have some form of HIV related travel restriction are: Angola, Aruba, Australia, Azerbaijan, Bahrain, Belize, Bosnia and Herzegovina, Brunei Darussalam, Cayman Islands, Cook Islands, Cuba, Dominican Republic, Egypt, Indonesia, Iraq, Israel, Jordan, Kazakhstan, Kuwait, Kyrgyzstan, Lebanon, Malaysia, Maldives, Marshall Islands, Mauritius, New Zealand, Oman, Palau, Papua New Guinea, Paraguay, Qatar, Russian Federation, Saint Kitts and Nevis, Samoa, Saudi Arabia, Saint Vincent and the Grenadines, Singapore, Solomon Islands, Sudan, Syrian Arab Republic, Tonga, Tunisia, Turkmenistan, Turks and Caicos, Tuvalu, Ukraine, United Arab Emirates and Yemen.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on FacebookTwitterInstagram and YouTube.

Travel and long-stay restrictions for foreign nationals with HIV have no logical basis and have been deemed a human rights violation by the United Nations

Published in South China Morning Post on February 5, 2019

Visa restrictions for HIV-positive immigrants still in place in dozens of countries

  • Recent leak in Singapore of data of HIV-positive people renewed attention on its curbs on long-term stays by those who have the virus
  • Countries with restrictions include Russia and the United Arab Emirates; there’s no logical basis for them any more, UNAids says

A data leak of Singaporean medical records exposing the HIV-positive status of 14,200 people last month triggered concerns about a backlash for those whose health status was made public in a country that continues to stigmatise the disease.

But the case, involving the records of 8,800 foreign nationals who tested positive for HIV in Singapore, also shines a spotlight on the city state’s restrictive policies towards foreigners with HIV, who face barriers to staying in the country for more than 90 days unless married to a Singaporean national.

The records were leaked by a foreigner in just such a situation, American Mikhy Farrera Brochez, who was deported after serving jail time for drug-related crimes and fraud, including hiding his HIV status. He was able to access the records with help from his boyfriend, a Singaporean doctor.

Singapore is one of only a handful of developed nations that still have laws restricting the long-term stay of foreign nationals with HIV – laws that have been deemed a human rights violation by the United Nations.

“When this [1998] law was brought in there was a lot more fear of unknown issues around disease … but [today] the logic is just not borne out by any scientific or medical basis,” says Eamonn Murphy, UNAids regional director for Asia and the Pacific.

Instead, countries that still have such restrictions in place often do so because of “historical convention, ideology, or even passivity”, Murphy says. He notes that UNAids is renewing its focus on the issue this year, compiling a new report on national restrictions.

UNAids most recent comprehensive report on HIV-related travel and immigration laws in 2015 listed 35 countries with such restrictions.

However, incomplete data published in 2018 by UNAids named at least 18 countries that have policies restricting entry, stay or residence for people living with HIV. Information from many countries were left off the list, and will be updated this year to reflect the true extent. The same report found that 60 countries require testing for residence or other permits, including marriage, not limited to foreigners.

The exact numbers, however, are difficult to pin down, experts say. An independently researched global database counts 49 countries with HIV-related restrictions on long-term stay in 2018, based on information sourced from local embassies and reports from travellers and immigrants. Countries with restrictions include Russia, Singapore, and the United Arab Emirates.

“The data the countries present about themselves in diplomatic settings can be different from the policies that are actually executed,” says American epidemiologist Jessica Keralis, who has researched the public health impacts of such HIV-related restrictions.

For example, countries may not have regulations “on the books”, but employers can revoke visas for HIV-positive employees, or state insurance policy can make it difficult for immigrants to afford treatment, she says.

In other cases, official policy may not be known by regional or local officials and institutions.

These distinctions matter for HIV-positive immigrants, whether white-collar workers, migrant labourers or students, according to David Haerry, who publishes the Global Database on HIV-Specific Travel and Residence Restrictions, which names the 49 countries.

“Oftentimes people [sent abroad for work] don’t know and they fall in the trap: if you don’t know and you have to be tested on the ground, and then you are sent back on health grounds, your company knows,” he says. “It’s a big issue.”

Haerry receives daily emails through the database from people around the world wondering how to travel or relocate safely while living with HIV. In recent years, he’s seen restrictive policies become more of an issue for students looking to study abroad, but who fear the consequences of mandatory HIV testing even in countries where there is no explicit restriction on those who are HIV-positive.

For such situations, “we have no solution”, Haerry says.

Many national restrictions are holdovers from the 1980s, before the disease’s transmission was understood and the antiretroviral therapies and daily medications that can prevent its spread became widely available, according to UNAids’ Murphy. But he has seen progress globally.

A number of countries changed their policies after UNAids launched a 2008 campaign against the 59 governments that had bans at that time. The United States, South Korea and China were among the nations to remove restrictions in 2010, although South Korea retained some related to immigration, while China reportedly has mandatory HIV testing for some visas.

Singapore revised its own regulations in 2015 to allow people living with HIV to enter the country for short-term stays of less than three months, while South Korea in 2017 removed its final restriction, which mandated the testing of foreign teachers.

But conservative cultures, social stigma and inertia have kept some restrictions in play in other nations, experts say. The majority of such restrictions are found in conservative countries; more countries in the Middle East than anywhere else have them.

“The basis of discrimination is misconception and fear, and with HIV these boil down to drug use, men who have sex with men, and all these realities that countries don’t want to face,” says Peter Wiessner, who co-authors the global database. “There’s also xenophobia mixed in.”

That element can have a negative public health impact, according to Keralis.

“It communicates that HIV is a foreign contagion and a foreigners’ problem, and if [citizens] don’t mix with foreigners then they are not at risk,” she says. She notes that, paired with a lack of proper sex education, this can create a dangerous situation.

“There’s no incentive for people to seek more information or modify their behaviours,” she says.

Turkmenistan: New law provides free HIV treatment but mandates HIV testing prior to marriage, and for people who use drugs, prisoners, blood donors and foreigners seeking work visas.

Turkmenistan has passed a law under which all people seeking a marriage license must be tested for HIV.

The law implies that anyone found to be infected with the virus that is the precursor to AIDS would be denied a marriage license.

Reports in state-controlled media on April 6 said the law was enacted “in order to create conditions for forming healthy families and avert the birth of HIV-infected children.”

Authoritarian Turkmenistan has given little public information about the extent of HIV infection in the country.

The new law also requires HIV tests for anyone suspected of using narcotics, foreigners seeking work visas, prisoners, and blood donors.

Under the legislation signed by President Gurbanguly Berdymukhammedov, the government will guarantee free treatment to people infected with AIDS.

In 2002, Turkmenistan’s Health Ministry claimed the country had only two cases of HIV and that both patients had been infected outside the Central Asian state.

Based on reporting by AP and AFP

South Korea: Office of the UN High Commissioner for Human Rights says mandating HIV testing only for foreigners is "discriminatory and an affront to..dignity"

A New Zealand woman’s rights were violated when her employers in the Republic of Korea demanded that, as a foreign English teacher, she undergo HIV/AIDS and drug tests as a condition of having her contract renewed, United Nations experts have found.

The Geneva-based Committee on the Elimination of Racial Discrimination (CERD) was considering the case of the woman, whose contract was not renewed in 2009 after she refused to undergo a secondary mandatory HIV test required only of foreigners, arguing it was “discriminatory and an affront to her dignity.”

In a statement released by the Office of the UN High Commissioner for Human Rights (OHCHR) today, CERD members noted that the Republic of Korea did not provide any reasons to justify the mandatory testing, from which Korean and ethnic Korean teachers were exempt.

They also noted that, during arbitration proceedings, the woman’s employers, the Uslan Metropolitan Office of Education (UMOE), said that HIV/AIDS tests were viewed as a means to check the values and morality of foreign English teachers.

The testing policy, the Committee wrote in its findings , “does not appear to be justified on public health grounds or any other ground, and is a breach of the right to work without distinction to race, colour, national or ethnic origin.”

The Committee called on the Republic of Korea to grant the woman adequate compensation for the moral and material damages she suffered. The Committee also urged the authorities to take steps to review regulations and policies related to the employment of foreigners and to abolish, in law and in practice, any legislation which creates or perpetuates racial discrimination.

“The Committee recommends the State party to counter any manifestations of xenophobia, through stereotyping or stigmatizing, of foreigners by public officials, the media and the public at large,” members wrote. The Committee has asked the Republic of Korea to inform it within 90 days of the steps it has taken.

In its submission to the Committee, the Republic of Korea said that, since 2010, its guidelines on the employment of foreign teachers do not specify that they have to submit results of HIV/AIDS and drugs tests to have their contracts renewed, and that mandatory testing is no longer required by the UMOE.

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