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ASEAN-UN report assesses ASEAN countries’ responses to HIV needs of mobile populations

Jakarta - A rise in migration within South-East Asia, and the conditions under which some people move, could make millions more vulnerable to HIV infection. A groundbreaking country-by-country assessment of HIV and migration among ASEAN countries reveals that despite their contributions to national economies, migrants have little or no right to legal or social protection and generally lack access to HIV/AIDS services and information.

HIV/AIDS and Mobility in South-East Asia, produced jointly by the Association of Southeast Asian Nations (ASEAN) and the United Nations Regional Task Force on Mobility and HIV Vulnerability Reduction in South-East Asia and Southern Provinces of China (UNRTF), presents key findings and recommendations of a rapid assessment conducted on HIV and mobility issues in the ten ASEAN Member Countries in 2007-2008. It is the first such publication to include information on current migration patterns along with the HIV situation across the region.

“Migrant workers are a vital force to national economies in Southeast Asia, yet when it comes to protecting their rights and ensuring HIV prevention and treatment, they are often among the forgotten,” says Dr. Ajay Chhibber, UNDP Regional Director for Asia and the Pacific.

“This assessment provides information that will be useful for policy makers, health givers and clinicians in ensuring that migrant workers and mobile populations are provided with high-quality prevention and treatment services,” says Dr Surin Pitsuwan, Secretary-General of ASEAN.

Although comprehensive data on HIV prevalence among migrants in Southeast Asia is unavailable, the report indicates that risk behaviour and HIV infection rates are in some cases considerably higher among migrants than in the general population.

In Thailand, where more comprehensive data exists, migrant fishermen showed HIV infection rates as high as 9%. In the Philippines, 35% of registered people living with HIV were returning migrants, as were 30% in Lao PDR.

”While migrants and their sexual partners are included as a vulnerable group in the national strategic plans of ASEAN countries, comprehensive programmes to address their needs have yet to be developed, funded and implemented,” says JVR Prasada Rao, Director of the UNAIDS Regional Support Team in Asia and the Pacific.
 
According to the report, most migrants are not covered by national AIDS programmes and their services. In Thailand, registered migrants have access to health services with subsidized medical costs, but anti-retroviral (ARV) treatment is not included. Subsidized ARV treatment is not available to migrants in any destination country. If migrants are found to be HIV-positive through routine testing in Malaysia, Singapore, Brunei Darussalam, they are repatriated.

Indonesia has shown a commitment to addressing HIV vulnerability among migrants and mobile populations, with their inclusion in national HIV prevention, care and treatment strategies, says the report. Policies have been developed to provide migrants with health and reintegration services, and to prohibit mandatory HIV testing during the recruitment process. However, limited information is available on HIV infection rates among migrant and mobile populations from Indonesia, according to the report.

Countries of origin, especially Cambodia, Indonesia, Lao PDR, the Philippines and Viet Nam have developed pre-departure training on HIV prevention for outbound, documented migrant workers. According to the report, many training sessions have proved to be ineffective because they are offered too late in the moving process and too brief in their duration.

Furthermore, mandatory HIV testing in health examinations is required by most ASEAN destination countries, except Thailand. Such testing, says the report, breaches migrant rights, including confidentiality and consent.

The aim of this report is to inform policy makers as they develop responses to the growing challenge of migrants and mobile people who are more vulnerable to HIV than populations who do not move. The report’s recommendations include:

•    Develop gender-sensitive epidemiological data
•    Strengthen regional cooperation to ensure a continuum of services for migrants
•    Create and fund coordinated, multi-sectoral, cross-border HIV efforts
•    Allocate sufficient financial and human resources to address migrants’ needs
•    Reinforce policies and commitments on HIV/AIDS such as the ASEAN Declaration on the Protection and Promotion of the Rights of Migrant Workers signed by the ASEAN Leaders in January 2007

The publication of HIV/AIDS and Mobility in South-East Asia is funded by the United Nations Development Programme (UNDP), the Canadian International Development Agency and the Joint United Nations Programme on HIV/AIDS. A directory and profile of the major organisations that are engaged in HIV and migration issues in the Southeast Asia region is also included in the report.