Author: Oksana Maklakova, Russia
The government of the Russian Federation is planning to increase the country’s population by 5-10 million people, by attracting migrants from Ukraine, Kazakhstan, Uzbekistan and Moldova. This is what Russian policy-makers say. However, Russia is the only country in the Council of Europe which still deports foreign citizens living with HIV. Anastasia Pokrovskaya, senior research associate of the Federal AIDS Centre, says that introducing amendments to the relevant regulations could protect the health of many people and contribute to their decriminalization. As part of the Partnership Program, she was involved in drafting an expert report for a project to ensure migrant access to HIV treatment and abolish the provision on deportation of foreigners living with HIV who enter the Russian Federation.
– How many migrants come to Russia and what is the rate of HIV prevalence among them?
– According to the Ministry of Internal Affairs, in 2018 Russia issued 1,671,706 labour patents to migrants. Those are people who enter the country legally and are officially registered with the relevant authorities. To get a labour patent or a permit to stay in the country for a period exceeding three months, medical examinations, including HIV testing, are mandatory. HIV prevalence is about 100 cases per 100,000 people tested. However, this number does not reflect the real HIV prevalence as some migrants, anticipating possible test results, avoid health check-ups. They come to the country illegally, get short-term visas without getting any patents, buy fake health certificates or send another person to be tested in their place. This law on deportation of foreigners with HIV creates many opportunities for illegal activity, both among migrants and among Russian organizations which offer migrants illegal services to help them get round the law.
– Is this typical only for Russia? What’s the situation in other countries?
– Initially about 60 countries applied the rule: if you fall ill or cross the border with HIV, you have to leave the country. However, there are now only nine countries, including Russia, where such regulations still exist. Other countries, such as the United States, Armenia and Ukraine, abolished such legislation in the last 5-10 years.
– What is the goal of your project?
– Our goal is to show why this approach should be changed in the first place; to demonstrate the demographic and epidemiological premises for abolishing deportation provisions. We have developed a document providing medical and legal justifications why we need to amend the legislation. We state that this provision should be repealed because it does not bring any benefits. Firstly, it is clear that it will not help us to end the HIV epidemic. In terms of new HIV cases we are ahead of many neighbouring countries from which migrants come to Russia. Secondly, in reality this law does not work anyway. People stay in the country, but go underground and continue living in the ‘grey zone’. As a result, they remain sick and infect others while their disease progresses, as they have no access to treatment. Meanwhile, they cannot go back to their home countries to get treatment because they are afraid they will not be able to return.
– What is the current response to such challenges?
– There are some NGOs which help deliver services to such people. According to the law, we are not able to ensure comprehensive medical check-ups or provide relevant health assistance to migrants. The biggest challenge is that we are not able to provide them with antiretroviral therapy (ART). This is the biggest issue. Russian citizens can access ART free of charge. However, our government is not ready to allocate funding to treat foreigners, for obvious reasons.
– So there are economic reasons for not abolishing the regulations?
– Probably. There are concerns about financial and administrative consequences. International agreements should be signed between governments. It is difficult for us to use the experience of other countries in addressing the issues of HIV and migrants, as the Global Fund to Fight AIDS, Tuberculosis and Malaria and other international charities which could take over some functions in this regard do not operate in Russia. Even if the country abolishes the regulation on deportation of foreigners living with HIV and such people get the right to stay in our country legally, they could still receive ART at home. All AIDS centres in neighbouring countries accept migrants who are registered for HIV care, and provide them with ART medications for several months. However, to get registered for HIV care, people have to leave Russia and then come back, which is currently not possible due to the travel ban on foreigners living with HIV. Thus, we will have to find our own solutions to this situation. There are some options currently being discussed, but it needs time. The final decision should be made by policy-makers, but unless they are informed about this issue they will not resolve it. We have to speak about it and suggest possible solutions. Only then could the laws be revised. I am sure that in our society there will be people who oppose such amendments, as they think migrants are bad for our country. However, those people often forget that migrants are a unique labour resource and in a way a demographic resource which modern Russia really needs.