European Parliament Votes for HIV

posted: 09/07/2010

In the run up to the largest and most prestigious International AIDS Conference in Vienna (which begins later this month), HIV campaigners across Europe have won a big a vote in the European Parliament for a human rights based approach to HIV. There is now a list of 25 things that should happen next according to the European Parliament’s resolution.
The vote was 400 for and 166 against.
 

After a list of reasons, on page four the 25 actions that the European Parliament and its institutions should now take begins.  It's a shopping list of actions to do the best that is possible to deal with the HIV epidemic for people within Europe and the rest of the world. 

What they voted for

It calls for a human rights approach to dealing with HIV and lists a whole range of things to make this happen - such as decriminalising HIV transmission, and providing healthcare to all, because this is now part of the universal declaration of human rights.

Here is the full Resolution which has just been voted through
You can find the whole debate here – video and printed versions
 

‘Health Tourism’ Mischief

posted: 08/06/2010

Sunday Times deputy editor Isabel Oakeshott has written an ignorant and mischief-making scare story about people from abroad using NHS money. People with HIV were included among those the NHS ‘counter-fraud unit’ listed as responsible.
 

The story calls it health tourism. The Department of Health has published no evidence that people with HIV come here as tourists deliberately to get HIV treatment. The only evidence there is (a snapshot survey by George House Trust and Terrence Higgins Trust) shows people do not know they have HIV when they travel here (to seek asylum, to start a university course, or to work, or visit family …. ).
 

Legal rights ignored
Most people from abroad who do have HIV treatment have every legal right to this. The few who are chargeable under the legal rules usually only find out they have HIV months or years after arrival, and their HIV diagnosis is always a big shock.

The NHS charging rules worsen public health in the UK by discouraging people from taking (always free) HIV tests. Untested and untreated people with HIV are likely to be much more infectious and lead to more HIV infections in the UK. Testing and HIV treatment can make people with HIV almost uninfectious, and that can save the NHS a lot more money than not treating everyone who needs this. HIV is the only sexually transmitted infection that can be left untreated because of these charging rules.
 

The Times report says that in eight-months last year, hospitals reported £24m in “bad debts”, 'most linked to patients from abroad'. The article suggests hospitals recover some of the cash later, but not much. The report says ‘According to the NHS’s counter-fraud unit, health tourism has a particularly heavy impact on maternity services, HIV care and cancer and heart units’.
 

Wrong about pregnant women, cancer, serious heart disease, HIV rights
The newspaper report is mischievous and malicious. The law and official guidance to NHS hospitals tells hospitals they must provide ‘immediately necessary’ or ‘urgent’ treatment.

Who would or could refuse a pregnant woman emergency care, or someone with life-threatening heart conditions, cancer, HIV?
 

Accident and Emergency – wrong again
It claims, without quoting any evidence, that “thousands of foreigners have been diagnosed in their own countries who cannot afford treatment there simply turn up at accident and emergency units in British hospitals and demand to be seen”.

Again this completely ignores the law and official NHS guidance – anyone needing accident and emergency care is always entitled to it without any charge. We get and would expect this if we are abroad and need emergency care.
“6.7 Some NHS services provided in NHS trusts are free to everyone regardless of the status of the patient. This Regulation says what these services are. The current list includes: a. treatment given in an accident and emergency department or casualty department......”
 

Doctors opposed
It correctly reports that most doctors dislike the charging system because medical ethics and the Hippocratic oath mean it is unethical to turn away patients who need urgent medical help.
 

Blame the Irish and Welsh – wrong
It also falsely blames people from the Irish Republic. Irish Citizens have always had the right to come and go freely and live here and use UK services. Brits can do the same in Ireland.

It seeks to create divisions within the UK by blaming people living in Wales for using NHS services in England, although the Welsh pay UK taxes just like everyone else. The Welsh are not foreign or migrants.
 

The Department of Health is already reviewing its policy on foreign patients.
 

Times article
 

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Working Life and New Rights

posted: 05/05/2010

The Equalities Act squeezed through Parliament just before the election. In October it will be law that you can use. What difference might it make to the world of work for people with HIV?
 

What’s new? 
In work situations the main new disability rights are:

• A ban on most health related questions until after a job offer is made - so asking if you have HIV or details of any health problems and absences will be barred - until they have offered the job. There are some exemptions- for example they will be able to ask if you require any adjustments to be able to carry out a task during your job selection / interview, or to ask if you are a ‘disabled person’ on a simple equality monitoring form.
• Introduction of ‘protected characteristics’ – ‘disability ‘ is one of these . Protected characteristics are the groups and situations where people have legal protection from discrimination. Protected from discrimination are people with disabilities (this includes everyone with HIV), sexuality, gender, race, age, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, and religion or belief.
• Discrimination by Association. This protects people from discrimination when they are associated with a person with protected characteristics – eg the HIV negative / untested partner of someone with HIV will also be protected. So refusing a job to a HIV negative (or untested) gay man for fear that he might have HIV and need time off work, would be illegal disability discrimination.
• Discrimination by Perception. Someone may mistakenly believe you are a disabled person and discriminate against you because of this. This is now illegal too.
• Combined Discrimination. People can now claim direct discrimination for up to 2 protected characteristics – so you could claim discrimination both about HIV and race, or HIV and gender, or HIV and sexuality – or any other combination. 
• Detriment Arising from Disability. This gives back the legal right not to face ‘less favourable treatment’ – court decisions made this difficult to win. For example sacking someone for taking reasonable time off for a HIV clinic appointment is wrong – it is an impairment-related absence. The employer would have to prove the dismissal was a proportionate means of achieving a legitimate aim.
• Duty to make reasonable adjustments – this is now a little better - employers now have to provide auxiliary aids or services to remove any disadvantage the person experiences.
• There’s a broader definition of disability to include more people, but everyone with HIV is already protected as ‘ disabled.’ This therefore helps some people who don’t have HIV. People now only have to show that any impairment they may have has a “substantial and long term effect on a person’s ability to carry out normal day-to-day activities”.

More Information

For more background, and for an easy read summary of the Act, visit the Equalities Office website

Eversheds (they are lawyers) Guide to the Act for Employers
Equality and Human Rights Commission:
HR Magazine article

Source - Breakthrough UK

HIV, Human and Sexual Health Rights

posted: 15/04/2010

A groundbreaking guide Advancing the Sexual and Reproductive Health and Human Rights of People Living with HIV has been produced by UNAIDS. Now, policy makers, programme managers, health professionals, donors and advocates have an important tool to better support the sexual and reproductive health and rights of people living with HIV.
 

Networks of people with HIV worldwide contributed to this guide, which explains what people involved in advocacy, health systems, policy making and law can do to support and advance the sexual and reproductive health of people living with HIV, and why these issues matter.

12 recommendations

1. HIV testing should never be mandatory and always be based on the ‘three Cs’: confidential, based on informed consent, and conducted with counselling. This applies equally to marginalised groups, including sex workers, injecting drug users, prisoners, migrants, refugees, and members of lesbian, gay, bisexual, and transgender and intersex communities.
2. Systems for HIV prevention, treatment, care, and support must be strengthened to deal with increased demand at the same time that HIV testing is scaled up, to ensure that HIV testing results in referral to HIV prevention, treatment, care and support programmes. In particular, pregnant women should not be tested only to prevent transmission from parent to child; they must also be offered prevention, treatment and care services.
3. National laws should be reformed and enforced to ensure that:
   ¤    Laws explicitly ban discrimination based on sexual orientation, gender identity, and HIV status;    ¤    Anal sex, sex work, same-sex relationships, and transgender relationships are decriminalized;    ¤    Disclosure of HIV status is not required by law if a person is practicing safer sex, their HIV status is oherwise known, or there is a well founded fear of harm by the other person;    ¤    HIV transmission is not considered a crime except for rare cases where there is evidence beyond a reasonable doubt that one person deliberately tried to infect another and indeed did so;    ¤    HIV status alone does not affect a person’s right to marry or found a family, is not grounds for divorce, and is not relevant in child custody decisions;    ¤    Young people have the right to confidentiality and do not need parental permission for age-appropriate information and sexual and reproductive health care, even if they are below the age of majority;    ¤    Women’s property rights are ensured and protected, particularly following divorce, abandonment or a spouse’s death;    ¤    Sexual violence, including incest, forced or early marriage, sexual assault or rape (including in the context of sex work or in marriage) is recognised and prosecuted as a crime;    ¤    Injecting drug users are provided with treatment, including opioid substitution therapy, and harm reduction programmes as an alternative to incarceration; and    ¤    Transgender people are legally recognised and clear procedures are in place for changing name and sex on official documents.
4. All people living with HIV – including members of marginalised groups, such as sex workers, injecting drug users, prisoners, migrants, refugees, and members of lesbian, gay, bisexual, transgender and intersex communities – should have access to a full range of sexual and reproductive health services, including:
   ¤    All available contraceptive options and help with dual protection, without coercion toward any method;   ¤    Counselling and support for positive prevention and voluntary disclosure   ¤     Access to safe abortion (where legal) and post-abortion care;    ¤    Counselling and support for safe ways to become pregnant;    ¤    Counselling and practical support for infant feeding, whether breastfeeding or replacement feeding;    ¤    Diagnosis and treatment of STIs;    ¤    Cancer prevention and care;    ¤    Counselling related to violence;    ¤    Sexual dysfunction treatment; and    ¤    Male circumcision for men living with HIV if, when fully informed, they want the procedure.
5. Health workers should receive training in human rights and universal precautions, as well as specific training in sexual and reproductive health care for people living with HIV, including technical skills and stigma reduction. People living with HIV should participate in these programmes as trainers.
6. Health service providers and advocates should support closer linkages between HIV prevention, care, and treatment; comprehensive sexual and reproductive health services; drug substitution therapy; mental health and psychosocial services; and anti-discrimination and antiviolence initiatives.
7. Advocates should ensure that special centres and programmes are developed to deliver information and services to hard-to-reach populations.
8. Governments, international agencies, and NGOs, in collaboration with organizations of young people living with HIV, should develop specific guidelines for counselling, support and care for people born with HIV as they move into adolescence and adulthood.
9. Governments, international agencies, and NGOs should better research and monitor the sexual and reproductive health of people living with HIV, including data disaggregated by gender, age, marital status, geographic location and sexual orientation. This research should be conducted with the input and supervision of people living with HIV.
10. Governments, international agencies, and NGOs should set and monitor concrete targets for involving people living with HIV in all relevant activities, including positive prevention programmes.
11. Governments, international agencies, and NGOs should support income-generating programmes. This includes directly employing people living with HIV, and paying them for their work.
12. Advocates should ensure that programmes to bolster participation of people living with HIV also help build needed skills. In particular, women and young people should be provided with ‘know your rights / laws’ education and advocacy training.
     

• The UNAIDS Guide Advancing the Sexual and Reproductive Health and Human Rights of People Living with HIV  pdf 2.3Mb

Source 

Asylum - Human Rights Ignored

posted: 09/03/2010

A new report for the Equalities and Human Rights Commission lays bare the UK government’s abuse of the human rights of asylum seekers and refugees living here, including many who are living with HIV. People seeking sanctuary in Britain are denied vital healthcare whether they are in detention centres or living in the community, the Equality and Human Rights Commission has found. Hundreds of rape victims, people living with HIV, and traumatised children are missing out on treatment and basic medical help.
 

Institutional failures

The report, from the University of Kent, warns "There is evidence of an institutional failure to address health concerns about asylum seekers in detention. More specifically there are concerns about children's health, mental health, treatment for those with HIV and access to female GPs, especially for women who have suffered rape and sexual violence."
 

Asylum and medical charity workers said the findings confirmed the experience of hundreds of refugees. A spokeswoman for Medical Justice said: "Sadly and unsurprisingly, findings of these failures accord with what our volunteer doctors have been seeing on the hundreds of occasions they have visited immigration detainees and seen their medical notes."
 

Time for action

This EHRC report sets out problems of poor treatment of refugees and asylum seekers in the UK. There are some serious failings. We’ll be checking to see what action the Commission now takes to end the government’s mistreatment and denial of people’s human rights.

HIV, health and social care
Inadequate HIV healthcare is one of the points highlighted in the healthcare section of the report. There are specific concerns around vulnerable groups. For women asylum seekers and refugees there is evidence of poor antenatal care and pregnancy outcomes. There is little evidence of the commissioning of services for disabled asylum seekers (such as everyone with HIV) and no clear guidance exists on local authority responsibilities towards asylum seekers with care needs. Mental health problems including post-traumatic stress disorder, depression and anxiety are prevalent among asylum seekers and refugees, and the provision of mental health services for survivors of torture and organised violence is widely regarded as inadequate.
 

The vulnerability and ill health of asylum-seeking and refugee children is an area of particular concern, as are the health needs of older refugees. There are also concerns around the provision of healthcare to asylum seekers in detention with communicable diseases and with HIV/AIDS.
 

Poverty, destitution and access to accommodation and financial support
Asylum seekers are vulnerable to poverty and destitution (defined as not having adequate accommodation or support for themselves and their dependants for the next 14 days) as a result of a number of factors. These include: the circumstances in which they and their dependants arrive in the UK (often without money or accommodation), the complexity of the rules for entitlement to financial and other support for asylum seekers and those refused asylum, the occurrence of administrative and casework errors, and the fact that the vast majority of asylum seekers do not have permission to work.

Evidence indicates that refused asylum seekers are the most disadvantaged group and evidence of destitution appears to run counter to Section 11 of Chapter 42 of the Human Rights Act 1988 and Council Directive 2003/9/EC.
 

Care needs gaps
Asylum seekers with care needs are particularly vulnerable to poverty and to falling through the gaps between Home Office and social services support. Other vulnerable groups include single women and those with children.
 

There are concerns about the specific requirements that asylum seekers must meet when lodging a claim in order to be eligible for support. The incompatibility of the Section 55 and 9 provisions with Articles 3 and 8 of the European Convention on Human Rights (ECHR) remains a key concern, as do the conditions that asylum seekers must comply with in order to receive Section 4 support. Complex issues surround the provision of support for unaccompanied asylum-seeking children, and there are doubts as to whether the UK’s responsibilities under domestic legislation and international human rights principles are being fulfilled.
 

Key issues for action now by the Equalities and Human Rights Commission
There is an ongoing tension between policies relating to immigration control and those concerned with welfare. This lies at the heart of many of the concerns regarding the equality and human rights of asylum seekers and refugees.

• Processes for removal involving detention and deportation have been the subject of sustained criticism on human rights grounds.
• Living conditions and support received by asylum seekers and refugees in the UK also cause concern. There are general inefficiencies within the system: many people do not know or understand the process, and receive different and conflicting advice from different agencies. On accommodation and support, the impact of the Section 55 and Section 9 provisions has been of considerable concern and, despite various clarifications and revisions by the government, may continue to have an adverse impact on asylum seekers. The quality of housing remains problematic and in some instances appears to conflict with the respect for family and home required by Article 8 of the ECHR.
• There is evidence of problems of access to healthcare. There is a serious lack of clarity with respect to the healthcare entitlements of asylum seekers and this feeds into confusion at ground level.
• Policies and practices within the asylum system covering the seven equality areas, as well as the treatment of vulnerable groups, also cause concern. The provisions put in place by UKBA in order to meet its legal requirements to take gender, race and disability into account have been criticised, and there is clearly a need for more rigorous and widespread equality impact assessments of the various aspects of the asylum system. Furthermore, less consideration is given to those equality areas not subject to the current equality duties. Ideally, the introduction of a new single equality duty covering all seven strands should help to initiate consideration of the issues affecting gay, lesbian, bisexual and trans asylum seekers, as well as those of different ages and with different religion or beliefs.

EHRC report (pdf) - Refugees and asylum seekers : a review from an equality and human rights perspective

Source 
Equality and Human Rights Commission
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