Philippine: New plan aims to give HIV-positive Filipino workers abroad easier access to care

Filipino migrant workers living with HIV stand to gain clearer pathways to care and firmer protections under a policy framework that government and international partners began shaping at a roundtable in Manila this week.

The discussion took place on June 15, 2026, at the Department of Migrant Workers (DMW) Central Office. Convened by the DMW together with the Philippine National AIDS Council (PNAC), the gathering drew in other government bodies, civil society groups, and the International Organization for Migration (IOM). Their shared task was to map out how the state can better serve overseas Filipino workers (OFWs) who are coping with HIV while abroad.

At the heart of the talks were the persistent gaps in HIV programs that leave migrant workers without dependable support once they leave the country. The proposed framework is meant to address those weak points, giving affected workers more responsive treatment and a defined route to assistance at every stage of their time overseas. Participants laid out specific policy directions and recommendations geared toward letting workers seek help without shame or hesitation.

A recurring theme during the roundtable was accountability across agencies. Those present argued that without stronger coordination between the offices responsible for migrant welfare, workers living with HIV will continue to struggle to reach the services they are entitled to. The aim, stakeholders said, is to surround these workers with a community of care while safeguarding their rights and overall welfare.

The Philippine response to HIV and AIDS is anchored in Republic Act 11166, the law that reconstituted PNAC and tasked it with steering the country’s prevention and treatment efforts. The council operates as the central planning and policy body on HIV, drawing its membership from national agencies, civil society, and the community of people living with HIV.

For the DMW, the initiative fits within a broader push to ensure that policies serving OFWs account for their health and dignity, not only their employment. The framework discussed this week signals that workers managing a chronic condition far from home remain part of that mandate.

India: Inside India’s highest-migration corridor, HIV treatment follows an uncertain path

For Migrant Workers With HIV, Staying on Treatment Takes More Than Just Medicine

A ground report from the Ganjam-Surat corridor, where migrants with HIV navigate long shifts, travel, and stigma.

When he travelled from Surat back to his village in Odisha’s Ganjam district five years ago for some work, he carried a month’s stock of his daily HIV medicines. But the visit stretched longer than expected. The medicines ran out.

At the time, he did not think much of it. But when he returned to Surat three months later, where he worked in the textile industry, filling and replacing thread bobbins for weaving machines, his body began weakening again.

The work was difficult even otherwise: 12-hour daily shifts inside a room with barely any fans or ventilations, just heat and the constant roar of machines. With a weakened immunity, he couldn’t keep up. Soon, he got jaundice too. It’s not like medicines weren’t available in Odisha. But the hospital was around 80 kilometres away from his house, and Jyotesh had not carried his transfer papers.

“We’re all going to Ganjam for a wedding next week. This time, I have carried medicines worth two months,” he says in late April this year, placing the medicine bottle on the orange-and-blue chattai in his rented house in Surat. Next to it lies a stack of green medical documents carrying his treatment history since his diagnosis. One of the corners has been chewed through—”a rat bit it”, he says with a smile. 

The 41-year-old discovered he and his wife were HIV positive in 2010, when she was pregnant with her first child. By then, he had already spent two decades moving between Ganjam and Surat. His three children don’t have HIV but their lives are still shaped by it: Jyotesh and his wife make sure they don’t eat on the same plate as their kids or share food, and are careful around cuts and wounds. “I know it doesn’t spread that way,” he says. “But in my head, I just want to be careful.”

India’s HIV programme provides free antiretroviral therapy (ART) through government-run ART centres across the country. In theory, a person can access treatment in any part of the country. But in practice, for lakhs of migrant workers like Jyotesh, continuity of treatment is shaped as much by access to medicines as it is by train journeys between villages and work destinations, the informal nature of work, fear of disclosure, crowded housing, changing shifts, interrupted treatment, missed doses, temporary addresses, and constant calculations.
 
Nowhere is that challenge more visible than in the Ganjam-Surat migration corridor, which sees large-scale movement to the city’s textile hubs.

The National AIDS Control Organisation (NACO) identifies interstate migrant workers as “bridge population” for HIV, due to the social and work environment that increases their vulnerability to infection. The term refers to the role migration can play in linking different communities. Studies cited by NACO have found that in high-migration districts like Ganjam, migrant men were up to four times more likely to be living with HIV than non-migrant men in the same districts. 

The Quint tracked migrant workers living with HIV on the Ganjam to Surat corridor to investigate how they live with the constant risk of becoming “lost to follow up.”

BETWEEN THE LOOM AND THE PILL

The sound of the loom never really leaves you in Surat.

A few lanes away from where Jyotesh rents his room, Ranjan*, a textile worker from Ganjam, who has been living with HIV for the past three years, rides his cycle towards the noise after his lunch break on a blazing April afternoon. He stops his cycle in a lane where every building looks like the other. If the sound of the loom sounded like a distant train earlier, now it feels like he is at the railway station.

Three floors up, inside the weaving unit, he starts the 12 machines, one by one. As soon as he is done starting all, the first one shuts again. The process repeats itself for 12 hours, every day. Thread becomes fabric and sweat becomes a hard day’s money.

He is used to it all, now. The noise, the hours, even, to an extent, the heat. What he is not used to is the HIV pill he must take at 9 pm every night, which, he says, makes him sleepy. So for 14 days a month, when his shift changes from day to night, he faces a dilemma: to skip the HIV medicine or to risk the chance of falling asleep at work.

“For 14 days, I take the medicines. For the other 14 days, I don’t,” he says, matter-of-factly. “They make me sleepy and if I fall asleep, I’ll get into trouble. Twice I slept and my seth (boss) yelled at me. I couldn’t even tell him what the medicine was for.”

It is medically recommended to have the medicines every day at the same time — generally after a meal — to ensure that the virus stays suppressed. Repeated interruptions can risk increasing the viral load and weakening immunity. Healthcare workers generally prescribe it for night time after dinner, so that it doesn’t interrupt work day and the minimal side effects can be managed. They encourage patients to discuss the schedules with them before changing the timing on their own, but Ranjan has not had the time to do that yet.

He was asymptomatic when he was diagnosed five years ago along with his wife, during her pregnancy. His family lives in Ganjam; he moves between the two places whenever he can. He has just returned from a few months in Tamil Nadu, where he was trying to work in the fibre industry.

“I did not understand the language or culture there, so I came back here. Surat has so many people from my village now that it has become another Ganjam only,” he says. “But the heat has become so bad these days, the hot air from the machine blows like fire.”

He says he will ask the doctor in the next visit if he can eat his medicines in the morning instead of at night. “I know I should be eating them regularly, but what can I do? I can’t risk it. I’m here to earn.”

INSIDE THE ART CENTRE

For people living with HIV, the ART centre is their lifeline. It’s where they get their medicines every month, consult with doctors and counsellors, monitor their viral load, and, crucially for migrants, get their transfer letters issued to access medicines from another ART centre, whenever they move. 

When The Quint visited one such centre in Surat, the two doctors’ desks were stacked with transfer letters to sign: transfer-ins and transfer-outs.

“We have around 30-40 transfers per centre every month. It’s a bit more in Surat than other cities as there are more migrants here,” said one of the doctors. There are three ART centres in Surat, which means roughly a hundred transfers moving through the city’s system every month. 

Inside the counsellor’s clinic, patient after patient, a similar pattern plays out. Patients place medicine bottles on the table while the counsellor asks how many pills are left. The bottle is either empty or far too full. Both mean the same thing: doses missed. In almost every case The Quint witnessed, the reason was the same: Was in my village. Medicines ran out/could not be had.

“The main problem is adherence,” says Laxmi Parmar, one of the counsellors in the centre, while making notes in her file. 

India’s HIV programme now allows multi-month dispensing for stable patients, meaning medicines can be provided for more than one month at a time. Counsellors routinely ask workers about upcoming travel plans before deciding how much medication to dispense.

“For us, the main difference between migrants and locals is that migrants don’t usually stay in one place,” said the doctor, who did not want to be named. “They keep moving, so for them to continue this life long treatment is more difficult. They require a lot more counselling. If they go back to the village for a long time, they have to be transferred there so they can get medicines from there.”

In the last two months, migrant workers across states in India, including Surat, have moved back to their villages in large numbers due to the ongoing gas crisis in India, driven by the West Asia conflict. Prices for cooking gas have risen sharply and it has hit migrant workers hardest, who very often don’t have documents for residence proof in the cities they work in, and cannot access subsidised supplies.

MIGRATION AS TRADITION

For over a century, migration has shaped life in Odisha’s Ganjam district. 

Migration runs so deep in this coastal district, that people often joke that every household in Ganjam has at least one person working in Surat. Researchers trace the roots of migration in the region to the Na’Anka famine of 1866, which wiped out almost one-third of the state’s population.

It was initially limited to the northern states, like Uttar Pradesh and Jammu & Kashmir, but shifted to West Bengal after Independence due to the language, food, and cultural similarities and conveniences. Majority of Ganjam’s migrants worked in the jute mills here, and some in coal mines in present-day Jharkhand. Since they could not go to Southern states due to the language barriers, they began going to Mumbai and the industrial areas of Gujarat. Mumbai’s labour politics made the city less accessible and Surat became the destination.

Over time, farmers became textile workers, and it became a skill that was inherited by generations. 

“Migration first became a livelihood for survival and then tradition for the people of Odisha and the rural infrastructure completely changed because of it,”said Lokanath Mishra, co-founder of Association for Rural Upliftment and National Allegiance (ARUNA) NGO, which was started in Odisha in the 1990s to prevent HIV transmission among migrant populations.

“There are trains that are filled with migrant workers everyday, mostly to work in the textile industry,” he said.

Ganjam features among the 17 districts with the highest male out-migration across state borders in India, according to the Working Group on Migration report, published by the then Ministry of Housing and Urban Poverty Alleviation in 2017. While there is no official data available, experts and field workers estimate that there are at least fifteen lakh migrants from Ganjam in Surat, forming a bulk of the labourers for the textile industries.  

The same migration corridor also, over decades, has shaped the district’s HIV epidemic. Ganjam currently ranks eighth among India’s AIDS-prone districts, and has consistently figured in the top ten list.

“In Ganjam, migration is circular. Young boys leave home from the age of 13 or 14. They travel alone, live in crowded rooms, earn cash wages, and stay away from families for long periods. This increases the likelihood of seeking new partners or transactional sex. Services exist across state boundaries. But many migrants only begin treatment after returning home. The asymptomatic period is very dangerous because people feel fine and delay care. The gap between people living with HIV and people currently in treatment is severe. The challenge with the system is that migration is difficult to track. People keep moving.”
Lokhanth Mishra, founder of ARUNA NGO
 
Mishra estimates that of roughly 19,000 people believed to be living with HIV in Ganjam, only around 7,000 are currently under treatment.

A study by the Population Council in 2011, conducted in collaboration with NACO and the United Nations Development Programme (UNDP), made some relevant findings:

  • In Odisha, 43 percent of all HIV-infected persons in Odisha were from Ganjam alone. 
  • HIV prevalence was four times higher among migrants than non-migrant men, even after controlling for age, education, source of referral and other possible confounding factors. 
  • The likelihood of being HIV-positive for returned migrants compared to non-migrants was over sevenfold.
  • Migrant men were up to eight times more likely to be living with HIV than non-migrant men in Ganjam district.
  • Selected indicators of socioeconomic vulnerability such as literacy, agricultural land/property ownership and employment were associated with HIV infection.

The latest data from Odisha’s National AIDS Control Programme shows that a cumulative 66,121 HIV-positive cases have been identified in the state. 

A senior official from the Odisha State AIDS Control Society told The Quint that the overall HIV caseload in the state had remained relatively stable in recent years.

“Even if the numbers appear high, that is partly because more people are getting tested and diagnosed earlier, instead of remaining undetected for long periods,” the official said, requesting anonymity. “Ganjam remains a priority district because of its long history and scale of out-migration. We conduct awareness and testing activities around festive seasons when many workers return home. There are outreach camps, nukkad nataks (street plays), messages at billboards and behind tickets. But because people keep moving states and change phone numbers, preventing patients from becoming lost to follow up remains a big challenge.”

LOST TO FOLLOW UP

Inside ART centres, NGOs, and healthcare systems, there’s a term routinely used: ‘LTFU’, which stands for Lost to Follow Up. It is used in medical forms and discussions to describe patients who stop returning for treatment.

“Sometimes, migrants say they are going to their villages for two months but if they don’t come back for medicine refills by then, we contact them,” said a doctor at the ART centre. “If we manage to speak with them, we remind them to visit the nearest ART centre. If we can’t get in touch, we contact the NGOs in the village to reach them.”

But a lot of times, ‘LTFU’ happens simply because people living with HIV— migrants or not—have a hard time to accept the diagnosis, or to manage medicines alongside work, or to keep it hidden. Sometimes, especially when asymptomatic, they believe they can simply outlast it without treatment. Outreach workers are tasked with tracing them.

The Quint accompanied Bhadraben, an outreach worker with the Gujarat State Network of People Living with HIV/AIDS (GSNP+), a community organisation supporting people living with HIV, on one such follow-up visit. As we walked through narrow lanes towards a colony where several clients lived, she said to put away the notebook and pen so as not to alert anyone to the nature of the visit.

“Migrants usually stay in crowded colonies. They give an address but it’s not complete or it’s vague. A house has several rooms and several people in one room. We go to find them, and if we can’t get through on the phone, we have to ask neighbours for them by name. People get curious and ask why we are looking. We have to lie and say we are from LIC, or a bank, so as to not disclose, because in most cases no one else knows about the diagnosis.”
Bhadraben, outreach worker

Some patients, she says, give wrong phone numbers and addresses altogether.

Dr V Sam Prasad, Country Programme Director at AHF-AIDS Healthcare Foundation, acknowledged that one of the biggest challenges in HIV care among migrant populations is retention.

“The first challenge is that we tend to lose people after identifying them,” he says. “People are not keen on getting treatment in unfamiliar cities. The current system requires manually getting a transfer letter to access medicines in another city. That needs to change. Even if someone has no art centre in the vicinity, if they want to access meds, local medical stores should be able to get it. The behavioural change will be immediate.”

STIGMA, DISCLOSURE, AND WHAT CITIES OFFER

Ever since he was diagnosed less than six months ago, Ashok* has been consumed with anxieties and fears. What if someone finds out in my village? What if someone finds out here? Will my condition get better? What vegetables can I eat? What if the one ASHA didi who knows tells someone? Will my child eventually get it too? Will my life ever be the same?

The anxieties of the diagnosis sit visibly on him, along with exhaustion of the night shift. 

“Only my wife, me, and the ASHA didi know. Parents don’t keep well and don’t want to worry them more. I used to feel weak and uneasy but since I have started taking medicines it’s better. I just can’t stop overthinking,” he says, speaking softly so as to not be overheard in the temple compound where we sit.

He started his treatment in Ganjam and is now in Surat for two months, where he has worked as a textile worker for the last 10 years. 

“The centre closest to my village is 50 kilometres away in Bharampur. I go by bus or bike but it takes almost the whole day  to get medicines. There is also always a huge line. I prefer it here, the centre is a fifteen-minute walk from my house,” he says, turning his bicycle keys over in his hands.

The calculations that he has just begun to make have been Pooja’s* reality for over a decade, accompanied by something else: guilt. 

A migrant from Odisha, she found out she was HIV positive during her second pregnancy, tested at a government hospital in Surat. She had been married once before when she was very young; she suspects her first husband had the virus though she never knew for certain and he died soon after. Her second husband was diagnosed alongside her, followed by her daughter and son.

 “My son does not know what medicine I gave him every night. He keeps asking, and I keep deflecting. I tell him it’s for strength.”
Pooja
Her daughter, she says, used to blame her for it and ask her why she hadn’t killed her rather than giving her this. Her husband initially blamed her too. For about twelve years, she balanced HIV treatment, an abusive household, and work – sticking diamond stones onto sarees.

“If I didn’t find time to finish it in the day, I would complete it at night,” she says. 

Her worst fears came true in 2019 when her then-landlord found out about her diagnosis and kicked them out of the house. According to her, the information was given to him by someone from the medical community who had treated her. Her husband was severely ill with TB at the time and could not be moved back to Ganjam easily. They rented a one-bedroom apartment for fifteen days, till he got a bit better, and returned to Ganjam for a few months after that.

“I usually go once every few months to collect medicines for my full family. Our vitals are good so they give for a few months,” she says. “It’s so much better to do that here rather than in Ganjam. Even though the hospital is far away and I go secretly, people come to know. They wonder, Kiski bahu hai? Kiske liye dawai le rahi hai? (Whose daughter-in-law is she? Who is she taking these medicines for?) So I don’t go to get medicines when I’m there, I have to make sure I come back before my medicines get over. No one knows where you’re coming from and where you’re going, here.” 

BEYOND MEDICINES

“HIV is complex and when you add migration to it, it’s another challenge,” says Daxa Patel, co-founder and Project Director of GSNP+.

Patel says that one of the initial challenges is disclosure, especially when the partner is staying away. Government guidelines mandate  that once you are diagnosed, your partner should be tested too. 

“We try to get the testing done when they go back to their villages but it doesn’t always happen as they often don’t disclose it to their families. If they are unmarried, then even index 2 testing should happen, which means all their sexual partners, which is yet another challenge,” she says. 

According to her, conversations around condoms or safe sex can themselves trigger suspicion inside marriages where the diagnosis has not been disclosed.

“Along with medicines, nutrition, mental health, housing conditions, and healthcare all affect treatment. Even family support is of utmost importance. In Surat, migrants often stay in rooms which are shared between a large number of people who alternate sleeping in the room as per their shifts. Immunity is already compromised. Crowded living increases chances of airborne infections and co-morbidities.”
Daxa Patel, co-founder and Project Director of GSNP+
 
NACO continues to list migrant workers as a bridge population who are vulnerable to HIV and require Targeted Interventions (TI) for HIV prevention and care. Jogendra Upadhyay, at the Gujarat AIDS awareness and Prevention (GAP) unit, has held HIV awareness sessions and testing drives and camps in Gujarat in collaboration with NACO and International Labour Organisation.

Between 2021 and 2025, they ran testing camps across 48 workplaces in eight districts of Gujarat, reaching 48,000 workers. 138 people were found positive. 

“93 percent of whom were being tested for HIV for the first time in their lives. What’s interesting is that over 90 percent of them were asymptomatic. After their test results, we link them to the nearest government centre,” he tells The Quint. “It’s such a big, unorganised sector that reaching everyone is difficult.”

LEARNING TO LIVE WITH IT

Some of the Ganjam migrants who arrived decades ago have figured out how to live, and work, with HIV in a different city; the alarm clock on their phone is their best friend.

Akka has been in Surat for 40 years and has watched it transform from a small town to an industrial hub. She is part of the transgender community, that NACO recognises as high risk, and among roughly a thousand hijras from Ganjam now living in Surat.

“I used to take medicines from a private practice for the first 6-7 years after diagnosis, before switching to the government. For a few years, I used to keep going back to Odisha to collect my medicines every two-three years before I finally transferred to Surat.”

She is different from most of the people who spoke to The Quint in one significant way. “I don’t hide that I have HIV,” she says. “I tell people. Why should I lie?”

The virus has worn Shivsagar* down differently. He has lived and worked with it for twenty years, but now he can only do the former. He came to Surat three decades ago to work in textile factories and now runs a small food stall near his house. 

“I could lift 100 kilos earlier and now I struggle with 20. I don’t have too much strength anymore and my legs give me trouble. I think I will return back to my village soon” he says, sitting in his one-room apartment with his wife Laxmi, whose yellow saree matches the bandhani cloth hanging in the room.

Through the walls, you can hear the loom from the mill next door. They have lived here for fifteen years, yet, nobody knows about their positive status. During the lockdown, he was stranded in his village without medicines and documents. Now, he carries stock whenever he goes.

But he wishes he didn’t have to.

“I heard injections are coming now instead of daily tablets,” he says, speaking of Lenacapavir, the world’s first twice-yearly HIV injection that has recently launched and has sparked questions and hope among many living with HIV. “When will that happen? Will I be allowed to take it? I’m tired of carrying medicines and documents everywhere.”

*All names of people living with HIV have been changed to protect privacy.

(This content received support from the Thomson Reuters Foundation as part of its global programme aiming to strengthen free, fair and informed societies. Any financial assistance or support provided to the journalist has no editorial influence. The content of this article belongs solely to the author and is not endorsed by or associated with the Thomson Reuters Foundation, Thomson Reuters, Reuters, nor any other affiliates)

 

Europe’s HIV response cannot succeed without migrant health equity

Europe debates migration, but ignores migrant health

By Tamara Prinsenberg & Daniel Reijer – AHF Europe

Migration dominates political debate across the continent. Governments argue about borders, asylum systems, returns, integration, and security. Election campaigns are built around it. Entire ministries are dedicated to it. Yet one issue remains largely absent: access to healthcare.

This is no marginal issue. Many migrants in Europe still struggle to access even the most basic HIV and STI services.

At AIDS Healthcare Foundation (AHF) Europe, we work with migrants, refugees, undocumented people, labour migrants, international students, and other vulnerable communities across several European countries.

Every day, our teams and partners provide frontline HIV and STI services designed to reach people who would otherwise be excluded. Many of these services are multilingual, community based, anonymous, and specifically designed to reduce fear and stigma. In 2025, AHF Europe provided HIV prevention, testing and linkage-to-care services to more than 28,000 migrants.

For many migrants, accessing healthcare in Europe is far from straightforward. Some do not understand the language used in clinics or hospitals. Others are unsure whether they are legally entitled to care. Some fear that seeking healthcare could negatively affect their migration status. Others simply do not know where services exist or how to navigate an healthcare system that can already be difficult for citizens themselves.

From a public health perspective, this simply makes no sense. Viruses do not care about residency permits or asylum procedures. HIV does not distinguish between documented and undocumented people. If people are pushed away from prevention, testing, and treatment services, infections are diagnosed later, transmission risks increase, and healthcare systems ultimately face higher costs.

Excluding migrants from healthcare does not protect public health; it undermines it. And yet, across Europe, barriers remain everywhere.

The scale of the issue is reflected in the latest ECDC data. In 2024, migrants accounted for more than 55% of new HIV diagnoses in the EU/EEA, up from 38.3% in 2015. Many migrants also acquire HIV after arriving in Europe, highlighting the need for accessible testing and prevention.

AHF Europe recently conducted a comparative analysis of migrants’ access to HIV and STI services across the nine European countries where AHF operates, including countries in both the EU and Eastern Europe. None fully guaranteed comprehensive access to care, and practical barriers including language, stigma, administrative requirements, and lack of information were identified across all countries reviewed.

Some countries have relatively strong legal frameworks on paper. But reality looks very different once someone tries to navigate the system. Can you access testing without health insurance? What documents do you need? Is interpretation available? Will seeking care affect your migration process? Can undocumented people safely access treatment? Who explains any of this?

These questions matter enormously in practice, and what we see repeatedly is that community organisations often become the bridge between migrants and healthcare systems that are difficult to navigate, even for citizens.

Across Europe, AHF supports community based and low threshold services, including checkpoints, multilingual testing, and outreach programmes that help migrants access care. These approaches are essential because healthcare is not only about services, but about trust. And right now, that trust is fragile.

That fragility risks becoming even worse under parts of the EU’s increasingly punitive migration agenda. Proposed changes to EU return and migration policies risk creating an environment where undocumented migrants become even more afraid to access healthcare services because of fears around surveillance, detention, deportation, or data sharing between institutions.

This is not a theoretical concern: when healthcare systems become entangled with migration enforcement, people disappear from care. Fear of detection pushes people further underground, weakening public health and eroding trust in healthcare systems, while placing healthcare workers in situations where medical ethics risk colliding with migration enforcement priorities. This is not just a migrant issue; it is a public health issue.

Taken together, this exposes a deeper contradiction in Europe’s current political direction. Since COVID-19, European leaders have repeatedly emphasised preparedness, resilience, and health security, highlighting the importance of early detection, strong public health systems, and rapid responses to infectious diseases. The EU has invested heavily in strengthening its health security architecture and improving preparedness for future pandemics. At the same time, however, parts of Europe’s migration policies risk pushing vulnerable communities further away from healthcare systems altogether.

Europe cannot claim to prioritise early detection and prevention while supporting policies that make people afraid to seek care. You cannot build resilient health systems while creating environments where undocumented people fear that visiting a clinic could expose them to detention or deportation. Europe should have learned this lesson already during COVID-19: health systems are only effective when people trust them enough to use them. If migrants avoid testing or treatment because healthcare systems are perceived as connected to migration enforcement, everyone becomes more vulnerable.

Across Europe, migration is increasingly discussed through the language of crisis and control. Health easily disappears in that political climate. Migrants are often portrayed as a burden on healthcare systems, even though excluding people from early prevention and care almost always creates worse health outcomes and higher long-term costs.

The solutions themselves are not particularly complex. We know what works: multilingual services, low threshold community testing, peer outreach, culturally competent care, and partnerships with civil society organisations. But these approaches require political commitment and sustained funding, not temporary pilot projects that disappear after two years.

The European Union has previously played an important role in coordinating HIV responses and setting common public health priorities. Renewing a strong EU HIV Action Plan, with a serious focus on migrant access and health equity, would be an important step forward.

Europe cannot seriously claim to pursue health equity while some of the most vulnerable people on the continent still face barriers to basic HIV and STI services. Migrant health is public health. When migrant health is neglected, public health fails us all.

Kazakhstan: Access to HIV treatment in Kazakhstan for citizens and foreigner

In Kazakhstan, HIV treatment is officially free, the state provides patients with antiretroviral therapy (ART). But in practice, access to treatment depends on a person’s status: whether he has citizenship or a residence permit. Kursiv Lifestyle figured out how everything works and what to do in different situations.

How can citizens of Kazakhstan get ART:

  • First you take an HIV test. If the result is positive, you will be referred to an infectious disease specialist or a specialist of the center:
  • Next, you need to contact the AIDS center and report your result. The doctor conducts additional examinations and offers to register;
  • Registration is issued and you officially become a patient of the center;
  • After that, the doctor selects a treatment regimen. Antiretroviral drugs are given free of charge through the center, and the patient begins regular therapy.

Where to get tested for HIV for free and anonymously? You can take the test free of charge at the polyclinic by attachment or at the AIDS Center. Private medical centers also provide this service, but for a fee.

If complete anonymity is important, it is better to go to the AIDS Center or a private laboratory. In case of anonymous contact, no documents are required, you will be assigned a number known only to you.

Another anonymous way is to order a free express home test through the website hivtest.kz. This can be done today in 5 cities: Almaty, Astana, Karaganda, Ust-Kamenogorsk and Pavlodar.

Testing is included in the guaranteed amount of free medical care. This means that it can be passed even without registration or documents.

Where to register? To get therapy, you need to register at the AIDS center, they are in every major city. It is through this system that drugs are prescribed and issued.

This usually happens in the same institutions where testing is carried out – regional centers and polyclinics.

You can find out the address of the AIDS center in your city on the website of the Kazakh Scientific Center of Dermatology and Infectious Diseases.

What should I do if I don’t register in the system? The lack of registration complicates the process, but does not make it impossible. In any case, you can take the test for free and anonymously. Problems begin at the registration stage, as the system usually requires IIN or attachment to a polyclinic.

There are options: temporary attachment to the polyclinic or registration through the AIDS center itself. If there are refusals, it is recommended to apply again or to another center – decisions are often made individually.

What should foreigners do

The situation depends on the status of stay in the country. Foreigners with a residence permit (residence permit) have the same rights as citizens of Kazakhstan. They can get tested, register and receive therapy for free.

If there is no residence permit? If a person is in the country temporarily (under the RWP), he is entitled to free tests and consultations, but free ART is not guaranteed by law. But there is international donor funding and NGOs through which some people receive therapy or emergency support.

Then the person needs to contact the nearest AIDS Center as soon as possible and clarify whether it is possible to get into the donor program. The main source of such assistance is the Global Fund to Fight AIDS, Tuberculosis and Malaria. As of December 9, 2025, 225 people living with HIV in Kazakhstan received ART at the expense of a Global Fund grant.

For help, you can contact NGOs and patient organizations. Community Friends work with HIV migrants in Almaty. They give pre-exposure therapy, put citizens from Central Asia on the remote registration, help and accompany to the AIDS center, where you can get treatment for foreign citizens, advise on adherence to ART, legal and social issues. In emergency cases, you can get a supply of ART for 1-2 months through them. For example, if a person is “stuck” in another country and cannot leave.

We managed to contact Oksana Ibragimova, a senior case manager of the Community friends. She confirmed the information about grants for ART and told about the program for citizens of neighboring countries.

“At the moment, non-citizens of Kazakhstan can apply to any AIDS center and receive therapy on a grant from the Global Fund. In addition, now we have a program for citizens of Uzbekistan, Tajikistan and Kyrgyzstan: they can send their tests to their homeland, they will be registered there and send medicines to Kazakhstan. Thus, the treatment is carried out at the expense of their native country,” says Ibragimova.

For HIV-positive travelers and migrants, Oksana recommended the website vputi.org, where you can find out information about the laws of different countries regarding HIV and access to therapy.

If a person has been denied treatment, there is a risk of interruption of therapy or problems with tests, you can leave an appeal on the Pereboi platform – you will need to fill out a small form on the website to contact the consultant, there are no contact numbers. You can also contact the Kazakhstan Union of People Living with HIV for advice and routing – the contact number and mail are in the “contacts” section of the website itself.

Important clarification: HIV status does not restrict entry into the country and does not prevent obtaining a residence permit, it was excluded from the list of diseases with which it is impossible to enter the country back in 2011.

Где гражданам и иностранцам с ВИЧ получить терапию в Казахстане 

В Казахстане лечение ВИЧ официально бесплатное, государство обеспечивает пациентов антиретровирусной терапией (АРТ). Но на практике доступ к лечению зависит от статуса человека: есть ли гражданство или вид на жительство. Kursiv Lifestyle разобрался, как все устроено и что делать в разных ситуациях.

Как гражданам Казахстана получить АРТ:

  • Сначала вы проходите тест на ВИЧ. Если результат положительный, вас направляют к инфекционисту или специалисту центра:
  • Далее нужно обратиться в СПИД-центр и сообщить о своем результате. Врач проводит дополнительные обследования и предлагает встать на учет;
  • Оформляется постановка на учет и вы официально становитесь пациентом центра;
  • После этого врач подбирает схему лечения. Антиретровирусные препараты выдают бесплатно через центр, и пациент начинает регулярную терапию.

Где пройти тест на ВИЧ бесплатно и анонимно? Сдать тест можно бесплатно в поликлинике по прикреплению или в СПИД-Центре. Частные медицинские центры тоже оказывают эту услугу, но платно.

Если важна полная анонимность, то лучше пойти в СПИД-Центр или частную лабораторию. При анонимном обращении документы не требуются, вам присвоят номер, известный только вам. 

Еще один анонимный способ — заказать бесплатный экспресс-тест на дом через сайтhivtest.kz. Сделать это можно на сегодня в 5 городах: Алматы, Астана, Караганда, Усть-Каменогорск и Павлодар.

Тестирование входит в гарантированный объем бесплатной медицинской помощи. Это означает, что его можно пройти даже без регистрации или документов.

Где встать на учет? Чтобы получить терапию, нужно встать на учет в СПИД-центре, они есть в каждом крупном городе. Именно через эту систему назначают и выдают препараты.

Обычно это происходит в тех же учреждениях, где проводится тестирование — региональных центрах и поликлиниках.

Узнать адрес центра СПИД в вашем городе можно на сайте Казахского научного центра дерматологии и инфекционных заболеваний. 

Что делать, если нет регистрации в системе? Отсутствие регистрации усложняет процесс, но не делает его невозможным. Пройти тест можно в любом случае бесплатно и анонимно. Проблемы начинаются на этапе постановки на учет, так как система обычно требует ИИН или прикрепление к поликлинике.

Возможны варианты: временное прикрепление к поликлинике или оформление через сам СПИД-центр. Если возникают отказы, рекомендуется обращаться повторно или в другой центр — решения часто принимаются индивидуально.

Что делать иностранцам

Ситуация зависит от статуса пребывания в стране. Иностранцы с видом на жительство (ВНЖ) имеют те же права, что и граждане Казахстана. Они могут пройти тестирование, встать на учет и получать терапию бесплатно.

Если ВНЖ нет? Если человек находится в стране временно (по РВП), ему полагаются бесплатные тесты и консультации, но бесплатная АРТ не гарантирована законом. Но есть международное донорское финансирование и НПО, через которые часть людей получает терапию или экстренную поддержку. 

Тогда человеку нужно как можно быстрее обратиться в ближайший Центр СПИД и уточнить, можно ли попасть в донорскую программу. Главный источник такой помощи — Глобальный фонд борьбы со СПИДом, туберкулезом и малярией. На 9 декабря 2025 года 225 людей, живущих с ВИЧ в Казахстане получали АРТ за счет средств гранта Глобального фонда.

За помощью можно обращаться в НПО и пациентские организации. В Алматы с мигрантами с ВИЧ работает Community Friends. Они дают доконтактную терапию, ставят на дистанционный учет граждан из Центральной Азии, помогают и сопровождаем в центр СПИД, где можно получить лечение для иностранных граждан консультируют по приверженности к АРТ, по правовым и социальным вопросам. В экстренных случаях через них можно получить запас АРТ на 1–2 месяца. Например, если человек «застрял» в другой стране и не может выехать.

Нам удалось связаться с Оксаной Ибрагимовой — старшим кейс менеджером ОФ Community friends. Она подтвердила информацию о грантах на АРТ и рассказала о программе для граждан соседних стран.

«На данный момент неграждане Казахстана могут обратиться в любой СПИД-центр, и по гранту Глобального фонда получить терапию. Кроме того, сейчас у нас действует программа для граждан Узбекистана, Таджикистана и Кыргызстана: они могут выслать свои анализы на Родину, там их поставят на учет и отправят лекарства уже в Казахстан. Таким образом лечение осуществляется за счет их родной страны», — говорит Ибрагимова.

Для ВИЧ-положительных путешественников и мигрантов Оксана порекомендовала сайт vputi.org, где можно узнать информацию о законах разных стран касательно ВИЧ и доступа к терапии.

Если человеку отказали в лечении, есть риск перерыва терапии или проблемы с анализами, можно оставить обращение на платформе Pereboi — нужно будет заполнить небольшую форму на сайте, чтобы связаться с консультантом, контактных номеров нет. Также за консультацией и маршрутизацией можно обращаться в Казахстанский союз людей, живущих с ВИЧ — контактный номер и почта есть в разделе «контакты» на самом сайте.

Важное уточнение: ВИЧ-статус не ограничивает въезд в страну и не мешает получить вид на жительство, его исключили из перечня заболеваний, с которыми нельзя въезжать в страну, еще в 2011.

Spain: Spanish officials warn of HIV treatment barriers for undocumented migrants

There are warnings that undocumented migrants in some autonomous communities are unable to access HIV treatment

Valladolid, 11 May (EFE). – The national director of the National AIDS Plan, Julia del Amo, has pointed out that around 50% of newly diagnosed HIV cases are among people born outside Spain, mostly from Latin America, and has warned that in some regions, particularly Madrid, undocumented migrants face barriers to accessing universal diagnosis and treatment.

Del Amo took part on Monday in Valladolid in the 22nd National Congress on AIDS and STIs, ‘HIV and +: health, equity and sexuality’, organised by the Spanish Interdisciplinary Society on AIDS (SEISIDA), and at a press conference she emphasised that although the virus no longer constitutes a public health emergency in Spain, ‘it remains a public health problem’.

Although the trend in Spain “is improving”, “we must be radical when it comes to infections; if we are not radical and leave pockets where the infection continues to spread, logically, if we do nothing, in five years’ time we will be much worse off than we are now”, warned Julia del Amo.

Currently, “a person who is being treated and has an undetectable viral load cannot transmit the infection”, hence the insistence that everyone should get tested and treated, although “there is a group of men from other countries, in some autonomous communities, who are not accessing universal diagnosis and treatment due to structural barriers within the healthcare system that prevent it”, said the director of the National AIDS Plan.

Data from 2024 show that around 3,300 new cases of HIV were diagnosed in Spain, half of them late-stage – another of the problems –; with 50 per cent born outside Spain, mainly in Latin America, followed by sub-Saharan Africa; with around 60 per cent of cases involving men who have sex with men, with an average age of 35.

The rate stands at 7 cases per 100,000 inhabitants, slightly above the European average, with 3.76 per 100,000 in the case of Castile and León, which recorded 90 new infections in 2024, with Burgos and Valladolid leading the way, although within the region’s low rate, Del Amo noted.

In this regard, one of the main groups at risk is currently the vulnerable population of migrants “who are being denied access due to these barriers within the healthcare system”, primarily in much of the Community of Madrid, but also elsewhere, including Castile and León, and where there is room for improvement, according to the director of the National AIDS Plan.

Julia del Amo emphasised that, nevertheless, there are extraordinary healthcare professionals and community networks of activists who ensure that treatment and diagnosis reach those who need them, albeit with a delay, and “during that delay there are transmissions that we could prevent”.

The president of SEISIDA and co-chair of the Congress, Pablo Ryan, a specialist in internal medicine at the Infanta Leonor University Hospital in Madrid, agreed with these issues regarding access for some migrants, who also lack information, and highlighted the role played by NGOs in facilitating access to treatment for this group, “filling those gaps in the system”.

HIV knows no borders, it knows no administrative barriers; it is a public health issue, both argued, and they recalled that the WHO’s target for 2030 is for 95% of people living with HIV to be diagnosed, for 95% of people living with HIV to be on treatment, and for 95% of those on treatment to be undetectable.

Based on data from 2021/2022, in Spain these targets stood at 92.5%, 97% and 90.5%, Del Amo noted.

In Spain, it is estimated that between 135,000 and 163,000 people are living with HIV; this is not just about a virus or a treatment, but about the conditions in which people live, about equity in treatment and access to testing, and about compassion and empathy, reflected Dr Pablo Ryan.

The rise in sexually transmitted infections was also addressed, which Nuria Espinosa, co-chair of the Congress and a specialist at the Infectious Diseases Unit at Virgen de Rocío in Seville, attributed, in part, to social changes in how people interact, with greater ease in having multiple partners and engaging in riskier sexual behaviour, and highlighted information and condom use as key factors.

Data on these infections show rates of 77 cases per 100,000 in 2024 for gonorrhoea, 24 per 100,000 for syphilis and 86 per 100,000 for chlamydia.

Alertan de que en algunas CCAA los migrantes sin papeles no acceden a tratamientos VIH

Valladolid, 11 may (EFE).- La directora nacional del Plan Nacional sobre el Sida, Julia del Amo, ha recordado que en torno al 50% de los nuevos casos diagnosticados de VIH son de personas nacidas fuera de España, mayoritariamente de América Latina, y ha alertado de que en algunas comunidades, en especial Madrid, los migrantes sin papeles se topan con barreras para acceder al diagnóstico y tratamiento universal.

Del Amo ha participado este lunes en Valladolid en el XXII Congreso Nacional sobre el Sida e ITS «VIH y +: salud, equidad y sexualidad», organizado por la Sociedad Española Interdisciplinaria del Sida (SEISIDA), y en rueda de prensa ha incidido en que aunque ese virus ya no supone problema de emergencia de salud pública en España, “sigue siendo un problema de salud pública”.

Aunque la tendencia en España “es a mejor”, en “las infecciones hay que ser radical y si no eres radical y dejas nichos donde esa infección se sigue transmitiendo, lógicamente si no hacemos nada en cinco años vamos a estar mucho peor de lo que estamos ahora”, ha alertado Julia del Amo.

Actualmente “una persona tratada, con carga viral indetectable, no puede transmitir la infección”, de ahí la insistencia en que todo el mundo se haga la prueba y se trate, aunque “hay un grupo de hombres de otros países, en algunas comunidades autónomas, que no están accediendo al diagnóstico y tratamiento universal por las barreras estructurales del sistema sanitario que lo impiden”, ha trasladado la directora del Plan Nacional sobre el Sida.

Los datos del 2024 recogen que en España se diagnosticaron unos 3.300 casos nuevos de VIH, la mitad tardíos -otro de los problemas-; con un 50 por ciento nacidos fuera de España, América Latina, fundamentalmente, seguida de África Subsahariana; con en torno al 60% de casos de hombres que tienen sexo con otros hombres, con 35 años de edad media.

La tasa es de 7 casos por 100.000 habitantes, un poco por encima de la media europea, con 3,76 por 100.000 en el caso de Castilla y León, que anotó 90 nuevas infecciones en 2024, con Burgos y Valladolid a la cabeza, aunque dentro de la baja tasa de la comunidad, ha referido Del Amo.

En ese sentido, uno de los principales nichos es actualmente esa población vulnerable de personas migrantes “a las que se les está negando el acceso por esas barreras del sistema sanitario”, fudamentalmente en buena parte de la comunidad de Madrid, pero también en el resto, incluida Castilla y León, y donde hay elementos mejorables, ha analizado la directora del Plan Nacional sobre el Sida.

Julia del Amo ha destacado que no obstante hay profesionales sanitarios extraordinarios y hay redes comunitarias de activistas que se aseguran que el tratamiento y el diagnóstico pueda llegar a las personas que los necesitan, pero con retraso, y “durante ese retraso hay transmisiones que podemos evitar”.

El presidente de SEISIDA y copresidente del Congreso, especialista en medicina interna del Hospital Universitario Infanta Leonor de Madrid, Pablo Ryan, ha coincidido en esos problemas de acceso de algunos migrantes, que además carecen de información, y ha destacado el papel que tienen las ONG a la hora de facilitar el acceso a los tratamientos a ese colectivo, “tapando esos huecos del sistema”.

El VIH no entiende de fronteras, no entiende de barreras administrativas, son salud pública, han defendido ambos, y han recordado que el objetivo de la OMS para el 2030 es que el 95% de las personas que tienen VIH estén diagnosticadas, que el 95% de las personas con VIH estén en tratamiento y que el 95% de las personas que están en tratamiento, estén indetectables.

Con datos del 2021/2022, en España esos objetivos estaban en el 92,5, 97 y 90,5 por ciento, ha analizado Del Amo.

En España, se estima que entre 135.000 y 163.000 personas viven con VIH, que no es solo un virus o un tratamiento, sino de las condiciones en las que viven las personas, de equidad en los tratamientos y acceso a las pruebas, de cercanía y empatía, ha reflexionado el doctor Pablo Ryan.

También se ha abordado el aumento de las infecciones de transmisión sexual, que la copresidenta del Congreso y especialista de la Unidad de Enfermedades Infecciosas de Virgen de Rocío de Sevilla, Nuria Espinosa, ha atribuido, en parte, al cambio social a la hora de relacionarse, con facilidades para tener más parejas y más relaciones de riesgo, y la información y el uso del preservativo como elementos clave.

Los datos de esas infecciones dejan tasas de 77 casos por 100.000 en 2024 en gonorrea, con 24 por 100.000 en sífilis y 86 por 100.000 en clamidea.

Latin America: Access to HIV Care for migrants hindered by exclusionary policies

Migration and HIV: challenges to overcome barriers

Economic and political setbacks hinder access to public health services for the HIV-positive migrant population. .

“In many countries, access to HIV prevention and treatment services for trans women is impossible due to their immigration status, and this widens the health gap ” Latin American and Caribbean Network of Trans Women , speaking on the UNAIDS podcast Latin American Dialogues: Intersectionality in the HIV Response.”The network is an organization dedicated to defending the human rights of trans women, sex workers, and trans people in situations of human mobility and migration in Latin America and the Caribbean.

What Vidal says is a summary of the times. According to the UNAIDS program, it is estimated that between 30,000 and 40,000 people in transit in the region are living with HIV. The unprecedented social and economic crisis on the continent has generated the largest flow of refugees and migrants in history. In addition to their immigration status, they face high levels of stigma, xenophobia, and racism, and limited access to healthcare.

“We’ve had to receive colleagues who come with a diagnosis, a month of antiretroviral treatment, and when it ends, we practically have to force the health authorities to support us,” Vidal continues. “And what often happens is that because they don’t have identification, they can’t access treatment so easily. Sometimes adherence is lost because we’re talking about a month, a month and a half of waiting for treatment.”.

What’s missing

Bureaucracy, especially the requirement of identity documents in the health systems of host countries, acts as a tool of exclusion that prevents access to antiretroviral therapies and viral suppression controls.

The activists consulted for this article agree: the impact of HIV on people on the move is often exacerbated by institutional mistreatment, abandonment by families, and lack of support during transit, weakening their health . But they warn, “the response to HIV is weak for the entire population. It is not exclusive to the migrant population .

Deaths from advanced infection continue to be recorded in the region, where health systems are already strained. Barriers to accessing comprehensive and sustainable care exist. There is a lack of prevention models and medication shortages. All of this contributes to the virus not being detected in time.

Setbacks in the region

Countries like Costa Rica and Argentina, which historically led the LGBT+ rights agenda, are showing signs of regression in public policy. In Costa Rica, the withdrawal of the OAS LGBT working group and the halting of sexuality protocols in schools demonstrate this setback. Despite the existence of protective laws, their lack of regulation and a climate of discrimination persist. For example, a gender identity law is still lacking, and the restrictions faced by people with HIV, despite existing laws, do not fully protect them .

In Argentina, the National Front Against HIV, Hepatitis, and Tuberculosis reported a 76% reduction in funding allocated to HIV, hepatitis, tuberculosis, and STIs. The national government transferred the responsibility for purchasing antiretroviral drugs to the provinces without providing the necessary resources or logistical support, leading to medication shortages.

“The Milei government has cut the health budget specifically for everything related to HIV prevention and treatment. There are zero prevention campaigns and zero treatment campaigns. And shortages have begun. Before, the national government provided the medication to the different districts; now, the provision has become the responsibility of each district. Sometimes, districts find that these medications weren’t included in their budget allocations or that they lack the logistical capacity to purchase them; so they run out,” explains Mariano Ruiz, executive director of Human Rights and Diversity .

She adds: “The refugees we receive are mostly Russians or people from countries that were part of the Soviet bloc. The main reason they come to us is because they ran out of HIV medication . We help them by providing guidance before they arrive in the country because they are planning their departure from Russia, where life there is unsustainable. We ask them to find out their HIV status and to start treatment if they are positive. For these refugees, the biggest challenge in accessing healthcare is the language barrier,” she explains.

Barriers to access to health

The dismantling of public systems affects the migrant population. 27% of those seeking treatment arrive in an advanced stage of HIV . Furthermore, those in an irregular situation are 70% less likely to achieve viral suppression, according to UNAIDS data

In Mexico, the transition to the IMSS-Bienestar model (a program to provide free medical care to people without social security) has created administrative barriers that violate the right to life of both migrants and internally displaced persons. The requirement of the CURP (a national identification document) is the main obstacle to accessing medications at CAPASITS (Outpatient Centers for the Prevention and Care of AIDS and Sexually Transmitted Infections, which are free, specialized health units in Mexico).

Brigitte Baltazar Lujano, coordinator of the LGBTQ+ community program at the organization Al Otro Lado in Tijuana, points out the seriousness of these omissions.

“It’s not only the external migrant population that is suffering these devastating effects. The involuntary migrant community, internally displaced persons, are also affected. Recently, there have been many changes in how the government handles health issues. It is more difficult for internally displaced persons to access their HIV medication. For people from other countries, it is twice as difficult to access these medications. This represents a very serious lack of attention from our country in this sector. The right to access medication or any other type of medical care that any human being may have is being violated.”

PrEP is not guaranteed for migrant populations

Pre-exposure prophylaxis (PrEP) is a vital prevention tool for migrant populations. However, access to PrEP and emergency post-exposure prophylaxis (PEP) is limited by bureaucratic barriers and discrimination.

In Tijuana, access for migrants is practically nonexistent because the medication is strictly controlled by the Ambulatory Centers for the Prevention and Care of AIDS and Sexually Transmitted Infections (CAPASITS), and identification is required to obtain it, explains Brigitte Baltazar. This same requirement for identification exists in Costa Rica.

“If a migrant arrives after being sexually abused, the health system’s response is usually, ‘Wait three months, get tested, and if you test positive, then we’ll start antiretroviral medication.’ This adds to all the bureaucracy involved in starting treatment. In other words, there is no emergency PEP available for undocumented people, and that leaves them at absolute risk ,” Brigitte explains.

In Argentina, the situation is similar for both asylum seekers and Argentinians seeking emergency medication. “The main obstacle for asylum seekers is the language barrier. Then there are all the same challenges faced by Argentinians: the lack of medication, and sometimes refusal from healthcare staff who are trying to conserve resources. It’s left to the doctor’s discretion whether they consider the person seeking it to have risky behaviors, even though, according to legislation, PrEP is a prevention strategy available only at the person’s request,” explains Mariano Ruiz.

Lack of funding and anti-immigrant policies

The region is also facing cuts in international cooperation. The withdrawal of funding from USAID , the Global Fund, and the closure of UNAIDS offices have left civil society organizations working on HIV, migration, LGBT+ rights, and other issues in a precarious situation.

“I find it so irresponsible and also very perverse that these cuts are eliminating programs when we know they did produce results and did save lives. This continues to be alarming and worrying,” says Dennis Castillo, executive director of the Institute on LGBT Migration and Refugees for Central America (IRCA Casabierta), an organization based in San José, Costa Rica.

Adding to the financial hardship are anti-immigrant rhetoric and policies. Mario Campos explains that migrants living with HIV in the United States fear deportation when seeking healthcare, and that is reason enough not to seek medical attention.

In everyday life, the stigma also manifests itself in the mistreatment by administrative and security staff in hospitals, even before they receive care. “From the moment migrants arrive at the hospital, it’s the security guard who asks which department they’re going to or their medical condition. People already feel uncomfortable and vulnerable. Once, someone told me that the guard said, ‘That’s why you have to be careful, that’s why you shouldn’t be having reckless sex.’ The stigma and discrimination that migrants suffer is serious, but if you add living with HIV, it’s extremely serious ,” says Brigitte Baltazar from Tijuana.

The community response in Mexico, Costa Rica, Argentina and the United States

Faced with the abandonment by States, grassroots organizations and independent activists have assumed the responsibility of guaranteeing services that governments omit, such as prevention campaigns, screening tests and the supply of medication.

In Mexico, the organization Al Otro Lado combats the exclusion caused by the CURP requirement by providing legal support and a physical presence in hospitals to ensure that migrants and internally displaced persons living with HIV can access services and are not discriminated against. They also manage online registrations, provide transportation, and have established partnerships with the AHF Healthcare Foundationto obtain emergency doses of medication when the government denies them.

“The Mexican State must provide what is rightfully theirs, which is access to healthcare for all people. It is a historical debt that the government owes to the migrant population to receive them and provide them with the services they are legally entitled to,” Brigitte Baltazar reiterates.

In Costa Rica, IRCA Casabierta offers a comprehensive approach that includes legal and psychological assistance, a food bank, and a computer lab for the digital regularization of migrants. Faced with cuts in international funding, the organization manages state resources to purchase preventative supplies that the health system does not provide to uninsured individuals. Dennis Castillo, executive director of IRCA Casabierta, denounces the Costa Rican government for abandoning prevention efforts, delegating this task to civil society.

In Argentina, the organization Human Rights and Diversity runs an integration center for LGBTQ+ refugees, most of whom come from Russia, Belarus, and Georgia. Due to a lack of government support to overcome administrative and language barriers, they use “social interpreters”—former beneficiaries who speak the language—to accompany patients to their medical appointments.

Activist Mario Campos connects people on the move with free clinics in Mexico, the United States, Canada, and Spain. His work focuses on combating the knowledge gap caused by the lack of comprehensive sex education, especially among migrants from Central American countries, primarily Guatemala, El Salvador, and Honduras. Mario believes that misinformation and the lack of comprehensive sex education are critical barriers that increase the vulnerability of people living with HIV.

US: Idaho push to identify immigration status of HIV patients sparks alarm

Idaho lawmakers seek immigration status of HIV patients using state resources

The Department of Health and Welfare would be required to report the immigration status of people using state HIV prevention services under a proposed public health budget.

The move comes after Idaho lawmakers in 2025 passed a measure to prevent some immigrants from accessing services such as soup kitchens, prenatal care and crisis counseling.

Just days before that law was set to take effect, the American Civil Liberties Union of Idaho announced a lawsuit against part of the law that would prevent some immigrants from accessing HIV medication.

The plaintiffs argued that the immigrants couldn’t receive the medication otherwise, and the people needing those meds could face severe health issues or even death, while Idaho risked an HIV spread. A judge agreed and blocked that portion of the law from going into effect while litigation is ongoing.

On Tuesday, during a meeting of the state’s powerful budget committee, lawmakers voted 14-4 to include the immigration report language in a Health and Welfare budget.

The budget committee’s co-chair, Rep. Josh Tanner, R-Eagle, told the Idaho Statesman that someone in DHW told him that there was an increase in HIV among undocumented immigrants. He said he would not share the source.

The report was important to help the state figure out how to get ahead of any increases, he said.

“It’s important to understand,” Tanner said.

AJ McWhorter, a spokesperson with the Idaho Department of Health and Welfare, said there hasn’t been a trend in HIV cases for the past five years, but there have been regional increases “here and there.”

HIV cases have increased in the eastern and southeastern parts of the state in 2026, according to East Idaho News, with seven cases diagnosed in the first three months of the year — matching the typical yearly average.

The number of cases in that part of the state was “unexpected,” McWhorter said.

“As for what is causing the increase in Eastern and Southeastern Idaho, we don’t see a single determining factor,” McWhorter wrote in an email. “Increases can occur due to changes in testing patterns, partner networks, or a variety of other community factors.”

During Monday’s meeting, Tanner refused to let Sen. Melissa Wintrow, D-Boise, talk about the motion, instead repeatedly calling for a vote to be taken. But she managed to slip a word in:

“I need to say I think it’s really important that we are not discriminating against people based on a disease and an infection,” Wintrow said. “Disease knows no immigration status.”

New WHO report shows encouraging gains in migrant health inclusion, but gaps persist

Encouraging progress in inclusive health policies for refugees and migrants

The World Health Organization (WHO) reports a major shift in how countries are responding to the health needs of refugees and migrants, with new data showing more than 60 countries – two thirds of those surveyed – now include them in their national health policies and laws.

Drawing on data from 93 Member States, the report establishes the first global baseline for tracking progress toward inclusive, migrant-responsive health systems.

Human migration is a defining feature of our shared history, driving cultural, social and economic developments across generations. Today, over 1 billion people – over 1 in 8 globally – live as refugees or migrants.

Reasons for moving range from conflict and disasters, to economic opportunity, education or family needs. Yet many refugees and migrants face barriers to accessing care, heightened risks of infectious and chronic diseases, mental-health challenges, and unsafe living or working conditions.

“Refugees and migrants are not just recipients of care, they are also health workers, caregivers and community leaders,” said Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “Health systems are only truly universal when they serve everyone. WHO’s new report on the health of migrants and refugee shows that inclusion benefits whole societies and strengthens preparedness for future health challenges.”

Investment in refugee and migrant health deliver far-reaching dividends. They support better social and economic integration, strengthen the resilience of health systems and reinforce global health security. Inclusive, migrant-responsive health systems also reduce long-term costs by enabling healthy, well-integrated populations to contribute fully to the societies in which they live.

The new “World report on promoting the health of refugees and migrants: monitoring progress on the WHO global action plan” shows that even in politically sensitive contexts, countries are increasingly relying on evidence, data, science, and established norms and standards to guide how migration and health are addressed within national health systems.

Case studies from all six WHO regions illustrate how progress can be achieved in practice – from expanded migrant health insurance coverage in Thailand, to the use of cross-cultural communication mediators in Belgium, and the inclusion of migrant community representatives in decision-making on primary health care delivery in Chile.

Gaps remain

Despite progress, the report highlights persisting gaps:

  • only 37% of responding countries routinely collect, analyze and disseminate migration-related health data as part of national health information systems;
  • just 42% include refugees and migrants in emergency preparedness, disaster risk reduction or response plans;
  • fewer than 40% report training health workers in culturally responsive care for refugees and migrants;
  • only 30% have implemented communication campaigns to counter misperceptions and discrimination related to refugee and migrant health;
  • access remains uneven: while refugees are generally more likely to access health services, migrants in irregular situations, internally displaced persons, migrant workers, and international students are far less consistently covered; and
  • participation in governance is limited: refugees and migrants remain under-represented in health governance and decision-making processes in most countries.

The way forward

WHO welcomes the progress made and urges governments, partners and donors to accelerate progress by:

  • embedding refugees and migrants in all national health policies, strategies and plans;
  • strengthening the collection and use of routine, disaggregated migration health data for planning and accountability;
  • coordinating across sectors spanning health, housing, education, employment and social protection;
  • tailoring strategies to the specific needs of different migrant subgroups, including those in irregular situations;
  • meaningfully engaging refugees and migrants in planning, governance and service design and delivery;
  • training health workers on providing equitable, culturally-sensitive care;
  • tackling misinformation and discrimination through evidence-informed action; and
  • protecting and expanding financing to safeguard progress for all.

WHO will continue to support Member States to translate commitments into action, by strengthening evidence, promoting culturally responsive care and integrating refugees and migrants into resilient national health systems. At global, regional and country levels, WHO will also continue working closely with partners, including the International Organization for Migration, the United Nations High Commissioner for Refugees and the World Bank to advance coordinated, rights-based approaches to refugee and migrant health.

The IOM became the first international organization to onboard onto the Global Digital Health Certification Network (GDHCN), a WHO-hosted digital public infrastructure that enables the verification of health documents across countries. The new collaboration is expected to further enhance efforts to help migrants securely access verifiable health records wherever they go, supporting continuity of care across borders.

By becoming the first international organization to join the GDHCN, IOM underscores WHO’s leadership in leading the public health aspects of refugee and migrant health and in fostering trusted, interoperable digital health systems that protect and empower people globally.

Canada: Petition urges Canadians to oppose moves to restrict refugee health coverage

Media Briefing Note: Conservative motion and Liberal changes to refugee health care – Fact Check and Context

THE SITUATION IN BRIEF

The Conservative Party of Canada has tabled a motion today to drastically restrict health care coverage for asylum seekers under the Interim Federal Health Program (IFHP). Conservative leader Pierre Poilievre released a video yesterday making a series of claims about the program that are factually incorrect or misleading.

Importantly: the Liberal government has already introduced cuts to the same program. Starting May 1, 2026, refugees will be forced to pay out-of-pocket co-payments for medications, dental care, mental health counseling, and vision care. The Conservative motion would go further – stripping nearly all non-emergency coverage entirely.

Both developments require scrutiny.

Click here to sign a petition against cuts to refugee healthcare. 

QUOTE

“The people being targeted by these cuts survived war, torture, and persecution. They came to Canada because we told the world we were a country that offered refuge. Now both political parties are competing to see who can take more away from them – and they are doing it by lying to Canadians. The IFHP is not out of control. Refugees are not the reason you can’t find a family doctor and stripping sick people of basic medications will not reduce your wait time by a single day. We are asking Canadians: don’t let politicians use vulnerable people as a punching bag to score points. Learn the facts. Reject the division. Speak up for refugee healthcare.” – Syed Hussan, Spokesperson, Migrant Rights Network

CLAIM-BY-CLAIM FACT CHECK

(1) CLAIM: “Cutting refugee health care saves money”
VERDICT: False — Liberal co-payments policy shift costs to the most expensive part of the system

The government still covers 100% of emergency visits. When a refugee cannot afford a $4 insulin prescription and ends up in the ICU for diabetic ketoacidosis, that hospitalization costs an average of $7,826. When untreated hypertension leads to a stroke, costs run into the tens of thousands — all downloaded onto provincial systems.

The evidence is unambiguous: multiple peer-reviewed studies, including a randomized controlled trial that found removing a small $5 co-payment reduced hospitalizations by over 60% for chronic disease patients, confirm that co-payments cause low-income patients to forgo medications and end up in emergency rooms. A Canadian study of patients with rheumatoid arthritis found that during co-payment periods, hospital admissions rose while prescription fills fell. TheCollege of Family Physicians of Canada warns the $4 fee will result in deferred care and worse outcomes. Co-payments do not reduce costs — they move them.

(2) CLAIM: “The IFHP costs over a billion dollars and has grown 1,000%”
VERDICT: Misleading and partly false

The IFHP costs a fraction of what Canadians cost the healthcare system. The IFHP represents approximately 0.2% of Canada’s total health spending of $399 billion. Put another way, Canada spends $9,626 a year on healthcare per Canadian, versus just $1,645 a year per refugee claimant. The “1,000%” growth claim is simply false: costs grew from $211 million in 2020–21 to $896 million in 2024–25 — an increase of approximately 325%, not 1,000%. Costs grew because asylum claim volumes increased and processing backlogs extended the amount of time claimants had to wait for a decision on their case – not because benefits expanded. Asylum claim referrals have already dropped over 43% from 2024 to 2025 — from 190,483 to 108,060. The Parliamentary Budget Officer projects annual cost growth of the IFHP will slow from 33.7% to 11.2% going forward – without any cuts to coverage.

(3) CLAIM: “The IFHP provides deluxe benefits that Canadians don’t get”
VERDICT: False

IRCC’s own program description states IFHP supplemental coverage is comparable to benefits available to low-income Canadians on provincial social assistance — the same level of dental, vision, and prescription coverage as someone on Ontario Works. The claim that asylum seekers receive better care than Canadians lacks any defined comparator and is contradicted by IRCC’s program design. Canada recently launched a national dental care plan precisely because gaps in supplemental coverage hurt low-income Canadians – the answer to that gap is expanding access, not stripping it from refugees.

(4) CLAIM: “Money is being diverted from Canadian health care to refugees”
VERDICT: False

The IFHP is federally funded and entirely separate from provincial health budgets. Cutting it does not free up a single dollar for family doctors or specialist care. What it does do is shift costs — when refugees forgo preventive care and end up in emergency rooms, those costs download onto the very provincial health systems the Conservatives claim to be protecting.

(5) CLAIM: “6 million Canadians can’t find a family doctor because of asylum seekers”
VERDICT: False – causation not established

The OurCare Survey 2025, conducted by St. Michael’s Hospital in partnership with the Canadian Medical Association, found 5.9 million Canadians lack access to a regular primary care provider – but asylum seekers are not the cause. The Canadian Medical Association has documented a deficit of 22,823 family physicians driven by decades of underfunding and inadequate workforce planning. The IFHP is a separate federal program with no connection to provincial budgets that fund family doctors. Asylum seekers make up less than 1% of Canada’s population. Cutting their health care will not free up a single spot on a patient waitlist.

(6) CLAIM: “It takes 30 weeks for the average Canadian to see a specialist”
VERDICT: Mischaracterized metric

The widely cited figure measures median wait time from GP referral all the way to treatment completion — not time to see a specialist. The most recent data puts this figure at 28.6 weeks for 2025. More importantly, this has no relationship whatsoever to refugee health coverage. The IFHP is federally funded and is entirely separate from provincial health budgets. Cutting it will not reduce wait times by a single day.

(7) CLAIM: “Most asylum claimants are bogus”
VERDICT: False

In 2025, 63% of finalized refugee claims were accepted by Canada’s own legal system. Nearly a third of appeals at the Refugee Appeal Division are granted — meaning the system itself regularly finds that initial rejections were wrong.

(8) CLAIM: “Rejected claimants unfairly continue receiving benefits”
VERDICT: Misleading

Rejected claimants remain covered only while exhausting their legal right to appeal – a right that exists because the system makes errors that require correction, as evidenced by the high number of appeals that are successful. There are currently approximately 300,000 pending claims before the IRB. Both the PBO and IRCC identify this backlog as a primary cost driver. The solution is faster, fairer processing – not stripping health care while people wait increasingly longer to get a decision.

(9) CLAIM: “Asylum seekers have never paid taxes”
VERDICT: False

Asylum seekers have work permits and those that work pay income tax, HST, and payroll deductions – the same as any Canadian worker. All refugee claimants pay HST on every purchase.

(10) ON THE PROVIDER BILLING CLAIM

Some Conservative messaging has claimed providers charge up to five times provincial rates under the IFHP. This claim is disputed in Parliamentary committee testimony – IRCC officials state the IFHP uses fee schedules aligned with provincial rates. Where billing irregularities exist, the appropriate response is targeted audits of those providing care, not punishing the people receiving care.

(11) CUTS WILL COST MORE, NOT LESS

Creating financial barriers to treatment for communicable diseases — including tuberculosis, HIV, and hepatitis — poses risks beyond refugee communities. As the HIV Legal Network and HIV & AIDS Legal Clinic Ontario have warned, reduced treatment uptake increases transmission and the likelihood of outbreaks, undermining public health for all Canadians.

(12) THE LEGAL PRECEDENT

In 2012, the Harper government made similar cuts to the IFHP. A peer-reviewed study documented increased emergency room costs as hospitals absorbed care that had been withdrawn. The Federal Court struck the cuts down as “cruel and unusual treatment” — a violation of the Charter of Rights and Freedoms. The cuts were reversed. The current co-payment policy faces the same constitutional vulnerability.

India: Kerala Health Authorities plan large-scale HIV awareness drive and medical camp

Campaign to address health concerns among migrant workers

A recent spike in reported HIV cases in and around Perumbavoor in Ernakulam district has drawn renewed attention to healthcare challenges among migrant workers. As many as 15 people tested HIV-positive in the area over the past few months.

While the workers who tested HIV-positive are currently undergoing treatment, the emergence of these cases has highlighted the urgent need to address broader healthcare gaps within the migrant community.

In an effort to address the emerging concerns, the Health department, along with the Kerala State AIDS Control Society (KSACS), is jointly organising a mega awareness programme and medical camp on February 22, 2026.

The day will also mark the launch of Niramaya Pravas 2026, a campaign spearheaded by the KSACS in collaboration with various government departments. The initiative focuses on promoting the overall health and well-being of migrant workers across the State.

According to Reshmi Madhavan, joint director, KSACS, health challenges continue to remain a matter of concern among the migrant community. “It is observed that their priority is employment. Health figures as an area of least priority. We need to bring them into the ambit of healthcare with due diligence,” Ms. Madhavan said. According to her, the focus should be on empowering the community to seek medical help when faced with an illness, be it a sexually transmitted disease or any other disease.

“The focus is on creating awareness among the community, getting them medical help and preventing the spread of diseases. Hence, we are planning intensive campaigns across the State targeting the community,” said Ms. Madhavan.

One of the main challenges faced by the department is keeping track of members of the migrant community, officials said. “It has been observed that their focus is on staying employed. So even when diagnosed with a disease, they do not return for follow-up treatment. When we try to track them, they would have moved to other locations for work. The absence of proper registers and documentation is proving to be a challenge,” said Dr. Rosamma P.S., Medical Superintendent, Government Taluk Hospital, Perumbavoor.

Perumbavoor municipal chairperson K.N. Sangeetha said that regular medical camps would also be held to address the healthcare challenges of the region.