Geneva/New York, 31 October 2009 — UNAIDS welcomes President Obama’s announcement of the final rule removing entry restrictions based on HIV status from US policy.  The removal of HIV-related travel restrictions in the US overturns a policy that had been in place since 1987. Such restrictions, strongly opposed by UNAIDS, are discriminatory and do not protect public health.

“I congratulate President Obama on announcing the removal of the travel restrictions for people living with HIV from entering the United States,” said United Nations Secretary-General Ban Ki-moon. “I urge all other countries with such restrictions to take steps to remove them at the earliest.”

The United Nations Secretary-General has made the removal of stigma and discrimination faced by people living with HIV a personal issue. He called for the removal of travel restrictions for the first time in his address to the General Assembly during the High Level Meeting on AIDS in 2008. “That they should be discriminated against, including through restrictions on their ability to travel between countries, should fill us all with shame,” said Secretary-General Ban in a speech to the Global AIDS Conference in August last year.

At his request, several countries including his home country, the Republic of Korea, are in the last stages of removing travel restrictions. Other countries that are considering removal of travel restrictions include China and Ukraine. In 2008, the UNAIDS board strongly encouraged all countries to eliminate HIV-specific restrictions on entry, stay and residence and ensure that people living with HIV are no longer excluded, detained or deported on the basis of HIV status.
“Placing travel restrictions on people living with HIV has no public health justification. It is also a violation of human rights,” said Michel Sidibé, Executive Director of UNAIDS. “We hope that other countries that still have travel restrictions will remove them at the earliest.”

Nearly 59 countries impose some form of travel restrictions on people living with HIV. The International Guidelines on HIV/AIDS and Human Rights state that any restriction on liberty of movement or choice of residence based on suspected or real HIV status alone, including HIV screening of international travellers, is discriminatory. Travel restrictions do not have an economic justification either. People living with HIV can now lead long and productive working lives, a fact that modifies the economic argument underlying blanket restrictions; concern about migrants’ drain on health resources must be weighed with their potential contribution.

The UN Economic and Social Council (ECOSOC) passed a resolution on UNAIDS by consensus at its 2009 substantive session on 24 July. Negotiations on the text were led by the Delegation of the Netherlands, in its capacity as Vice Chair of the UNAIDS Programme Coordinating Board and ECOSOC member, and 31 countries – from all regions – co-sponsored the text.

The resolution welcomes the UNAIDS Outcome Framework as a tool for achievement of the goal of universal access and its emphasis on the prevention of sexual transmission. Moves to leverage AIDS to respond to broader health and development agendas, in particular the health Millennium Development goals (MDGs) – through the removal of socio-economic and legal barriers, and the maximum use of flexibilities under the TRIPS agreement to provide access to affordable antiretroviral drugs of assured quality – were applauded as central to the mandate of UNAIDS.

ECOSOC urged all member states to eliminate HIV-specific restrictions on entry, stay and residence, and for all stakeholders to come together at the country level to develop transparent, accountable and effective national responses within the “Three Ones” principles. Ongoing financial and political support for research and development of prevention technologies – including an effective HIV vaccine – was needed.

Recognition was also given to the need for the Joint Programme to significantly expand and strengthen its work to address the gap in services for injecting drug users in all settings. Barriers to the response continue and partnerships in addressing them will be key – as outlined in the welcome UNAIDS Action Framework: Universal Access for Men Who Have Sex With Men and Transgender People.

In recognizing the interrelated nature of the health and gender-related MDGs, Member States welcomed the ongoing development and operationalization of an Action Framework addressing women, girls, gender equality and HIV, under the leadership of the UNAIDS Executive Director.

At country level, efforts were encouraged to strengthen the UNAIDS technical support division of labour, and the concept of a joint United Nations team and programme on AIDS, with the aim of harmonizing technical support, strengthening programmatic coherence and improving the collective accountability of the United Nations system. UNAIDS ongoing role in the process of UN reform, and in the delivery of broader United Nations development assistance – was recognized and encouraged.

Finally, ECOSOC welcomed the submission by Member States of a total of 147 country progress reports in 2008, as part of the reporting process established by the Declaration of Commitment n HIV/AIDS, which had provided the most comprehensive overview to date of the response at country level, and encouraged all Member States to fully support the next round of reports due on 31 March 2010.

The International Task Team on HIV-related Travel Restrictions concluded its third meeting with draft recommendations towards the elimination of HIV-specific restrictions on entry, stay and residence. In the coming months, these will be finalized and presented to the boards of the Global Fund and UNAIDS this November and December.

Restricting entry, stay or residence in a country due to HIV positive status alone is discriminatory, and in today’s highly mobile world, such restrictions have even greater impact on people living with HIV. In 2008, some 67 countries continue to have such restrictions.

In early 2008, UNAIDS set up an international task team of governments, civil society groups and international organizations to bring the issue of HIV-related travel restrictions back onto the agenda and promote action towards their elimination. Co-chaired by UNAIDS and the Government of Norway, the Task Team met for the first time in Geneva in February 2008, followed by a second meeting at the Office of the UN High Commissioner for Human Rights in Geneva in April, and the third and final meeting in Madrid at the headquarters of the World Tourism Organization (UNWTO).

The third meeting, which took place from 24-26 June, was opened by Francisco Elías de Tejada Lozano, former Spanish Ambassador to the Global Fund, Spanish Ministry of Foreign Affairs, and Francesco Frangialli, Secretary-General of UNWTO. Frangialli underlined that travel restrictions based on HIV status are discriminatory, and are a major concern to the entire tourism sector.

“HIV is not something that transmits through the air. If there are going to be restrictions, they have to be rational and reflect legitimate public health concerns. For HIV, what’s needed is prevention information and dialogue,” said Frangialli.

At the third meeting, the Task Team took stock of all the advocacy and activities conducted by Task Team members against travel restrictions and noted that there indeed is much greater momentum toward their elimination.

For example, civil society groups conducted significant advocacy leading up to the High-Level Meeting on AIDS at the UN General Assembly in June. At that meeting, both UN Secretary-General Ban Ki-Moon and UNAIDS Executive Director Peter Piot called for the end of HIV-related travel restrictions in their speeches at the opening session of the General Assembly. “Stigma and discrimination around AIDS remain as strong as ever: and in this context I join my voice with the Secretary General and I call on all countries to drop restrictions on entry to people simply because they are living with HIV,” said Dr Piot.

Task Team members also underlined during the third meeting that ongoing awareness-raising is needed, and that the Task Team’s work has to be followed by intense country-level action that leads to the elimination of travel restrictions.

“At this point in the epidemic, with over 25 years of experience, it’s hypocrisy if there’s no change and governments say that they’re committed to ending stigma and discrimination,” said Craig McClure, Executive Director of the International AIDS Society.

Susan Timberlake, Task Team Co-chair and Senior Human Rights and Law Adviser at UNAIDS, stated that more effort is needed to ensure that tourists, migrants and other mobile populations are addressed in national AIDS responses.

“Countries need to understand that any HIV vulnerability related to mobility is not just about tourists and migrants, it is also about nationals, entering, departing and re-entering. If governments really want to reduce HIV vulnerability related to mobility they should ensure that all mobile people benefit from appropriate HIV programmes and services. In the era of Universal Access and increasing globalization, no comprehensive AIDS response should leave out people on the move,” she said.

Restrictions on the entry, stay and residence of people living with HIV will be highlighted during a Special Session at the International AIDS Conference in Mexico this August, as well as the Global Forum on Migration and Development in the Philippines in October. The final recommendations of the Task Team will be presented in a report at the next meeting of UNAIDS Programme Coordinating Board in December 2008 and to the board of the Global Fund of Fight AIDS, TB and Malaria in November.

Since the beginning of the HIV epidemic, governments and the private sector have implemented travel restrictions with regard to HIV positive people wishing to enter or remain in a country for a short stay (e.g. business, personal visits, tourism) or for longer periods (e.g. asylum, employment, immigration, refugee resettlement, or study).

UNAIDS has set up an international task team to heighten attention to the issue of HIV-related travel restrictions (both short-term and long-term) on international and national agendas and move towards their elimination.

The international task team met for the first time in Geneva on 25-26 February. The meeting, co-chaired by UNAIDS and the Government of Norway, brought together representatives of governments, inter-governmental organizations and civil society, including the private sector and networks of people living with HIV.

According to data collected by the European AIDS Treatment Group, a total of 74 countries have some form of HIV-specific travel restrictions, 12 of which ban HIV positive people from entering for any reason or length of time. The most common reasons used are to protect public health and to avoid possible costs associated with care, support and treatment of people living with HIV.

Whatever the reason, HIV-related travel restrictions raise fundamental issues regarding the human rights of non-discrimination and freedom of movement of people living with HIV in today’s highly mobile world.

In the year 2000, the World Tourist Organization estimated that there were 698 million international arrivals world-wide. The majority of these people are travelling for short periods of time, e.g. for tourism, business, conferences, family visits. With regard to longer-term mobility, the International Organization for Migration (IOM) estimates that some 175 million migrants currently live and work outside their country of citizenship, i.e., 2.9 per cent of the world’s population.

HIV -related travel restrictions usually take the form of a law or administrative instruction that requires people to indicate their HIV-free status before entering or remaining in a country. Some countries require people to undergo an HIV test whereas others require an HIV-free certificate or simply that people declare their HIV status.

Testing under such circumstances is akin to mandatory testing, and in many instances is done without appropriate pre and post-test counselling or safeguards of confidentiality. Any HIV testing should be done voluntarily and on the basis of informed consent.

The personal impact of HIV-related travel restrictions can be devastating for the individual seeking to immigrate, to gain asylum, to visit family, to attend meetings, to study, or to do business. The candidate immigrant, refugee, student or other traveller may simultaneously learn that s/he is infected with HIV, that s/he may not be allowed to travel, and possibly that his/her status has become known to government officials, or to family, community, and employer, exposing the individual to possibly serious discrimination and stigma.

For those already in a receiving country, they may face summary deportation without due process of law and protection of confidentiality. Under such circumstances, there is every incentive to hide or deny one’s HIV status and to avoid contact with immigration authorities and health care workers. Both immigration controls and public health efforts are thereby undermined, while individuals are cut off from prevention, assistance and, perhaps, needed health services.

“Travel restrictions based on HIV status again highlight the exceptionality of AIDS, especially short-term restrictions," said UNAIDS Executive Director Dr Peter Piot. "No other condition prevents people from entering countries for business, tourism, or to attend meetings. No other condition has people afraid of having their baggage searched for medication at the border, with the result that they are denied entry or worse, detained and then deported back to their country", he added.

While recognizing that control of a country’s borders and matters of immigration fall under the sovereign power of individual States, national laws and regulations should ensure that people living with HIV are not discriminated against in their ability to participate equally in international travel, in seeking entry or stay in a country that is not their own. The International Guidelines on HIV/AIDS and Human Rights state that any restriction on liberty of movement or choice of residence based on suspected or real HIV status alone, including HIV screening of international travellers, is discriminatory.

Besides being discriminatory, travel restrictions have no public health justification. HIV should not be considered to be a condition that poses a threat to public health in relation to travel because, although it is infectious, the human immunodeficiency virus cannot be transmitted by the mere presence of a person with HIV in a country or by casual contact.

Restrictive measures can in fact run counter to public health interests, since exclusion of HIV-positive non-nationals adds to the climate of stigma and discrimination against people living with HIV, and may thus deter nationals and non-nationals alike from coming forward to utilize HIV prevention and care services. Moreover, travel restrictions may encourage nationals to consider HIV a “foreign problem” that has been dealt with by keeping foreigners outside their borders, so that they feel no need to engage in safe behaviour themselves.

Travel restrictions do not have an economic justification either. People living with HIV can now lead long and productive working lives, a fact that modifies the economic argument underlying blanket restrictions: concern about migrants’ drain on health resources must be weighed with their potential contribution. Furthermore, the continued expansion of treatment programmes towards Universal Access by 2010, and the sustained fall in the cost of treatment in low- and middle-income countries dispels the myth that the travel of a HIV positive person would drive up the cost of health care systems abroad.

The creation of an International Task Team on HIV-related Travel Restrictions is a critical opportunity to heighten attention to the issue of HIV-related travel restrictions on international and national agendas and move toward their elimination.

Developing Specific Recommendations for Positive Change

The International Task Team comprises two working groups which focus on short-term and long-term restrictions, supported and guided by a Steering Committee. The Working Groups and the Steering Committee of the Task Team will meet four times before August 2008, when its final recommendations will be presented at the International AIDS Conference in Mexico. The Task Team will generate concrete recommendations on specific actions that different stakeholders (government, civil society, intergovernmental organizations and the private sector) can take to move towards the elimination of HIV-related travel restrictions. The Task Team will focus on key strategic actions that:

1. Increase attention to the issue of HIV travel restrictions internationally, regionally and nationally
2. Influence governments that have HIV-related travel restrictions relating to entry and short-term stay to remove such restrictions; and
3. Spur longer term action to move towards the elimination of all HIV-specific travel restrictions.

In developing these recommendations, the Steering Committee will be supported by the Working Groups which will be requested to undertake:

1. A critical mapping of the current situation related to the use of short-term and long-term HIV-related travel restrictions
2. An analysis of the obstacles to eliminating the different types of HIV-related travel restrictions and possible actions by various national and international stakeholders to support this elimination, and
3. Recommendations on best practice regarding the entry and stay of people living with HIV in different contexts of mobility and migration.

Recommendations will support the principles of non-discrimination and the Greater Involvement of People Living with HIV and rational HIV-related policies for travellers, migrants and mobile populations in sending and receiving countries – in the context of efforts to achieve universal access to HIV prevention, treatment, care and support, as agreed by governments at the High Level Meeting on AIDS (2006).

The International Task Team on HIV-related Travel Restrictions will hold its next meeting on 31st March – 2nd April in Geneva.

The Haitian civil society organization SEROvie was one of the 10 community-based organizations who won a Red Ribbon Award this week for its work in the prevention of sexual HIV transmission.

During its 14 year existence the group has repeatedly switched strategy. First they cast themselves as HIV educators, raising awareness everywhere from schools to church groups. Gradually they began talking gender, explaining to Haitians how prejudice and power-dynamics upped some people’s HIV risk. This ground-work was necessary to venture where they really wished to work—with the neglected gay, bisexual, sex worker and transgender communities.

“There was nothing for them then,” reflects executive director Steeve Laguerre. “Before we started, the men who have sex with men (MSM) didn’t know where to go to get HIV services. When they went to the usual sites they were not welcome at all so they were afraid to go. They were dying at home, alone.”

SEROvie conducts HIV prevention, health referrals, and psychological and social support, as well as home-based care visits, vocational training and a micro-credit programme. Today, 10% of the organization’s 4 000 beneficiaries are living with HIV and are accessing antiretroviral treatment and connecting with others through support group systems. Over the years SEROvie has fostered relationships with a range of community-friendly services. These are places where MSM and transgender people can get non-judgmental care along with information that is relevant to their lives. For Laguerre the key to serving this hard-to-reach community is, above all else, listening.

“We had to learn not to impose activities, interventions and services that we thought were a good idea. You need to listen to the community. Your programme interventions need to come from them and then you will be successful. What we did at first was think to ourselves ‘Let’s have such and such training. I am sure they need it’. Then you are asking yourself why they are not showing up,” Laguerre reasons.

It’s through this approach that the organization came up with its most recent incarnation. Today SEROvie supports the development of a lesbian gay, bisexual and transgender (LGBT) network throughout Haiti while providing MSM with education opportunities and job training. One man might want help to pursue a degree. Another may wish to set up a hairdressing service in his village. Some would like to fix computers, cook or drive cars. More than 500 persons have been trained in this way. But what do hairdressing and driving have to do with HIV?

“We were providing sensitization regarding HIV and sexually transmitted infections (STIs) and then we asked ‘What’s next?’ We asked the men and they said ‘We are not working. We would like to work’,” Laguerre recounts. By empowering the community economically, the men are more empowered about their sexual decision-making as the vulnerabilities MSM face everywhere are intensified by poverty.

Asked what advice he would offer other Caribbean non-governmental organisations (NGOs) on pressing the political class for action on behalf of marginalized and vulnerable groups, Laguerre stresses the importance of obstinate persistence.

“It takes constant work to build a relationship. You need to invite them within the institution so they can see what exactly you are doing. You need to send reports to them. You have to force communication with them,” he says.

That strategy is paying off. Recently Haiti’s Ministry of Health approved funding and asked SEROvie to help them implement activities for the LGBT community and sex workers in ten districts throughout the country.

“That,” Laguerre says with a satisfied smile, “is a first.”

Ten community-based organizations, which have shown exceptional and inspiring action on AIDS were honoured with the 2012 Red Ribbon Award in a special session of the XIX International AIDS Conference (AIDS 2012) on Wednesday. The Red Ribbon Award is the world's leading award for innovative and outstanding community work in the response to the AIDS epidemic.

Since the beginning of the HIV epidemic, governments have prevented people living with HIV from entering or residing in their countries based solely on their HIV status. Such restrictions have stopped HIV positive people from travelling for business, family visits, or tourism; and from entering a country for study, labour migration, and political asylum.

GENEVA, 31 January 2013—The United Nations Joint Programme on HIV/AIDS (UNAIDS) welcomes the recent law reforms in Mongolia that have removed all travel restrictions and other discriminatory provisions for people living with HIV. The reforms which were passed by Mongolia’s Parliament in mid-December of last year took effect on 15 January 2013.

The Law on Prevention of Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome removes all HIV-related restrictions on entry, stay and residence. Foreigners applying for visas to Mongolia are no longer required to disclose or provide documentation of HIV status.

“I commend Mongolia for taking this bold step and I hope this will encourage other countries to follow their example and move the world towards zero HIV-related stigma and discrimination,” said Michel Sidibé, UNAIDS Executive Director.

UNAIDS advocates for the right to freedom of movement—regardless of HIV status. There is no evidence to suggest that restrictions on the entry, stay or residence of people living with HIV protect public health.

Mongolia’s reforms also removed employment restrictions that prevented people living with HIV from undertaking certain jobs, including in the food industry. The new law has also encouraged the creation of a multi-sectorial body comprised of government, civil society and private sector representatives to help put in place the reforms.

With the removal of Mongolia's restrictions, UNAIDS counts 44 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. There are five countries with a complete ban on the entry and stay of people living with HIV and five more countries deny visas even for short-term stays. Nineteen countries deport individuals once their HIV-positive status is discovered.

GENEVA, 22 June 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) applauds the legislative reforms by the Republic of Moldova to lift its restrictions on entry, stay or residence based on HIV status. With these reforms, the Republic of Moldova joins a growing list of countries that are aligning national HIV legislation with international public health and human rights standards.

“This decision by the Republic of Moldova is a concrete win in our global efforts to secure freedom of movement for people living with HIV,” said UNAIDS Executive Director Michel Sidibé. “Restrictions that limit movement based on HIV-positive status alone are discriminatory and violate human rights,” he added.

In addition to removing the country’s travel restrictions, the recent legislative reforms in the Republic of Moldova strengthen prohibitions on HIV-related discrimination in the workplace and remove mandatory HIV testing for non-nationals and for couples before marriage.

After the removal of the Republic of Moldova’s restrictions, UNAIDS counts 46 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. At least 130 countries have no such restrictions.

Fiji latest country to remove entry barriers for people living with HIV

GENEVA, 7 September 2011—The British business pioneer Sir Richard Branson has thrown his support behind a global drive to rid the world finally of the remaining discriminatory laws that keep people from visiting, or living and working in countries solely because they are HIV positive. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has called for the global freedom of movement for people living with HIV.

Sir Richard Branson said, “I applaud UNAIDS' tireless efforts to encourage countries to remove travel restrictions on people living with HIV. Everyone should have the chance to travel freely, and I welcome the opportunity to work together on such an important issue.”

Last month, Fiji became the latest country to lift its restrictions on entry, stay or residence based on HIV status.

“I am very proud to say as the Head of State, that the Fiji Government has taken strides into changing laws that are discriminatory including decriminalizing men who have sex with men and amending legislation on travel related restrictions involving people living with HIV and promoting consultations around creating an enabling environment for sex workers,” the President of Fiji Ratu Epeli Nailatikau stated in his opening address at the International AIDS Congress on AIDS in Asia and the Pacific on Friday 26 August.

Sir Richard Branson said, “Fiji's leadership sends a strong message, and my hope is that other governments will follow their example.”

With the removal of Fiji’s HIV travel restrictions, UNAIDS counts 47 countries, territories and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. At least 128 countries have no such restrictions.

UNAIDS Executive Director Michel Sidibé said, “With the support of tireless advocates such as Sir Richard Branson—we will bring about a new era of equal mobility for people living with HIV.”

Sir Richard Branson is Founder of the Virgin Group of companies. Virgin is one of the world’s most recognized and respected brands and has expanded into many diverse sectors from air and ground travel to telecommunications, health, space travel and renewable energy through more than 200 companies worldwide. In 2005, Branson started Virgin Unite, the Group’s non-profit entrepreneurial foundation, which works with partners to create new  approaches to social and environmental issues. Virgin Unite has also helped to incubate a number of global leadership initiatives, including the Elders, the Carbon War Room, and the Branson Centre of Entrepreneurship.

UNAIDS

UNAIDS, the Joint United Nations Programme on HIV/AIDS, is an innovative United Nations partnership that leads and inspires the world in achieving universal access to HIV prevention, treatment, care and support. Learn more at unaids.org.

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Virgin Unite is the non-profit entrepreneurial foundation of the Virgin Group.  Founded in 2005, Virgin Unite unites people to tackle tough social and environmental problems in an entrepreneurial way, with the aim to help revolutionize the way businesses, government and the social sector work together – driving business as a force for good.  This is based on the belief that this is the only way to tackle the scale and urgency of the challenges facing the world today. For more information please visit www.virginunite.com. 

GENEVA, 26 August 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) applauds a decision by the Government of Fiji to lift its restrictions on entry, stay or residence based on HIV status. With this reform—officially announced today by the President of Fiji at an AIDS conference in South Korea—Fiji joins a growing list of countries that are aligning national HIV legislation with international public health standards.

“This is a clear breakthrough in our efforts to secure the global freedom of movement for people living with HIV,” said UNAIDS Executive Director Michel Sidibé. “Restrictions that limit movement based on HIV-positive status only are discriminatory and violate human rights,” he added.

In Fiji, as elsewhere in the Asia Pacific region, increased action on AIDS is showing results and the AIDS epidemic is stabilizing. However, new HIV infections still outpace the number of people starting treatment, and stigma and discrimination pose serious obstacles to progress.

After the removal of Fiji’s restrictions, UNAIDS counts 47 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. At least, 128 countries have no such restrictions.