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Financement de la lutte contre le sida

AIDS & Mobility’s betrayal : Do ’illegals’ have a right to health ?

1er novembre 1996 (MAHA)

PARIS, 1 November 1996 (MAHA)

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Undocumented immigrants and refugees living with HIV or AIDS were on the agenda of last year’s Meeting on Ethnic Minorities, Migrants, and Refugees and HIV/AIDS in Drierbergen, in the Netherlands. A close reading of the conference report reveals, however, that no consensus exists among AIDS community-based organizations that someone who is "illegal" or undocumented is entitled to equality in health care.

"Undocumented migrants" were one of the nine issues to be discussed at the 1995 conference, along with drug use, condoms, fundraising, material development, women, safer sex, men having sex with men, and community development.

Three arguments are given by the report against deportation of people with HIV/AIDS. First, the fact that the person is sick. Second, that they may be "integrated" in the host country, and third, that treatment may not be available in the country of origin.

In the report’s summary, we read that "access to treatment [for the undocumented] should be based on humanitarian principles," which of course implicitly rules out asking for residency and care as a right for those who are HIV+, rather than as a privilege. For humanitarian principles to be the only possible basis for demanding treatment implies that access to treatment is not itself a basic right : the right to health. The report does not address why a person’s legal status in a country would cause him or her to lose that right.

Recommendations include "strengthening community-based organizations," presumably because they are the ones which are de facto faced with the care and support of undocumented people living with HIV. According to the report, "profesionals" need to be trained about "specific needs" of the undocumented. These "needs" are not detailed in the report’s summary. Finally, the report states, information needs to be collected about the existing "informal services and networks" which currently provide (underground) care and support for the undocumented.

A workshop facilitated by Max Kyei (AFAPAC, Amsterdam) and Loes Singels (NIGZ, Amsterdam) is more explicit, stating that the "best way" for undocumented people who are gravely ill is to "stay underground" since "there is no legal basis to improve their situation" and "to avoid stigmatization." For community workers or policy makers to openly call on sick people to quietly accept their condition amounts to collusion in denying their right to decent health care.

Another workshop, this one led by K.A. Adanse-Pipim (also from AFAPAC) and Felix Calle (AKAM, Berlin) did at least conclude that the issue of the undocumented "needs to be put on the political agenda."

Nevertheless, participants agreed that a careful, low-key strategy is needed. "It makes more sense to demand provision of services, rather than to demand legalization of status," it maintained. More sense for whom, one may ask ? Certainly not for those who are sick. Organizing experience (see URMED’s report, in this issue) demonstrates that people’s right to care are certain to be denied as long as they stay in hiding, rely on "informal" networks, and as long as policy makers and community organizations do not actively and publicly campaign for these rights.

The report also holds that "informal networks can find solutions for many things." That may be true, and in fact it is important to sustain and support such networks. But unless we believe that "illegals" are somewhat less deserving of the full right and access to health care, we must take the position that such "informal" networks cannot substitute for a good hospital and full, dignified health care.

The report’s only assertion that the right to health is indeed a universal right was heard in a talk given by a representative of INPluss, the immigrant section of the Norwegian Body Positive Group. She explained that, if INPluss had 16 members, it was because two had been deported and one was in hiding. As a result, protection from deportation was one of the demands made by NIWAG+ (of which INPluss is a member) to the Scandinavian governments.

Last year’s Meeting made a point of listening to the "perspective of migrants living with HIV/AIDS." Let us hope that we will succeed in being more than selective listeners.