At a time when HIV is still spreading steadily across the globe, we are also witnessing progress in controlling this deadly disease. Responses to the AIDS epidemic have grown and improved considerably over the last few years. The objective of this E-bulletin is to circulate AIDS-related news, publications, literature and research to affiliated unions and others working in this field. It is a part of our new Global HIV/AIDS project, which is targeting ITF affiliates all over the globe. Get involved! For further information and queries please contact Dr. Syed Asif Altaf, Global HIV/AIDS Project Coordinator, Altaf_Asif@itf.org.uk or the Regional Education Coordinator in your ITF region, ITF Education Department: education@itf.org.uk .

This issue of the E-bulletin will look at a story from Tanzania where the Communication & Transport Workers' Union of Tanzania organized workshop to develop workplace policy on HIV/AIDS. The issue will also focus on the formation of international task team and growing momentum to eliminate travel restrictions against people living with HIV.

Communication & Transport Workers' Union of Tanzania organized workshop to develop workplace policy on HIV/AIDS

According to UNAIDS the estimated total HIV positive people in Tanzania is 1.4 million and the adult prevalence rate is 6.5%. But with proactive response from the government and civil society including trade unions, the HIV prevalence rate has started declining in Tanzania. The most recent information shows HIV prevalence rate among antenatal clinic attendees in Zanzibar ranging from 0.7% IN Unguja to 1.4% in Premba, while in mainland Tanzania it was 8.7% dropping from last surveillance figure of 9.6%.  Although the numbers of studies on HIV prevalence among transport workers are very few, the evidence is clear that HIV prevalence is high among several categories of transport personnel. According to a study done in late 90s in the Dar-es-Salaam highway, HIV prevalence was found to be 28 percent for truckers and 56 percent for their female partners.

Communication & Transport Workers' Union, the ITF affiliate in Tanzania has been implementing education programmes for its members for many years but recently they have organized a workshop to develop workplace policy on HIV/AIDS in collaboration with the management of private transport companies. The issues they have included in their policy are:

• Education, awareness and prevention programmes including treatment of sexually transmitted infections, condom promotion and voluntary counselling and testing (VCT)
• No direct or indirect pre-employment testing for HIV
• Protection against victimization
• Managing illness and job security
  

The union has also incorporated the workplace policy on HIV/AIDS in the recently signed collective bargaining agreement.   

Elimination of travel restrictions against people living with HIV:  Momentum builds after formation of international task team on this issue

All people living with HIV face potential obstacles when seeking to travel. Since the beginning of the HIV epidemic, governments and the private sector have implemented travel restrictions with regards to HIV positive people wishing to enter or remain in a country for a short stay (e.g. business, personal visits, tourism) or for longer periods (e.g. asylum, employment, immigration, refugee resettlement, or study). UNAIDS has set up an international task team to heighten awareness of the issue of HIV-related travel restrictions (both short-term and long-term) on international and national agendas and move towards their elimination.


Some countries have no policies regarding the entry of HIV-positive people, as long as they meet eligibility requirements applicable to all individuals. On the other hand, a 1987 United States immigration law defined HIV as a “dangerous contagious disease” and states that all foreign nationals with HIV are “inadmissible” to the United States. At least 75 other countries have similar barriers. A handful of nations, now about 20 have particularly rigid policies requiring proof of HIV-negative status before allowing anyone to enter for any reason. There are indications that such policies are becoming more common and are being enforced more aggressively.

Whatever the reason, HIV-related travel restrictions raise fundamental issues regarding the human rights of non-discrimination and freedom of movement of people living with HIV in today’s highly mobile world. In the year 2000, the World Tourist Organization estimated that there were 698 million international arrivals worldwide. The majority of these people are travelling for short periods of time, e.g. for tourism, business, conferences, family visits. With regard to longer-term mobility, the International Organization for Migration (IOM) estimates that some 175 million migrants currently live and work outside their country of citizenship, i.e., 2.9 per cent of the world’s total population. HIV -related travel restrictions usually take the form of a law or administrative instruction that requires people to indicate their HIV-free status before entering or remaining in a country. Some countries require people to undergo an HIV test whereas others require an HIV-free certificate or simply that people declare their HIV status.

Testing under such circumstances is akin to mandatory testing, and in many instances is done without appropriate pre and post-test counselling or safeguards of confidentiality. Any HIV testing should be done voluntarily and on the basis of informed consent. The personal impact of HIV-related travel restrictions can be devastating for the individual seeking to immigrate, to gain asylum, to visit family, to attend meetings, to study, or to do business. The candidate immigrant, refugee, student or other traveller may simultaneously learn that s/he is infected with HIV, that s/he may not be allowed to travel, and possibly that his/her status has become known to government officials, or to family, community, and employer, exposing the individual to possibly serious discrimination and stigma. While recognizing that control of a country’s borders and matters of immigration fall under the sovereign power of individual States, national laws and regulations should ensure that people living with HIV are not discriminated against in their ability to participate equally in international travel, in seeking entry or stay in a country that is not their own. The International Guidelines on HIV/AIDS and Human Rights state that any restriction on liberty of movement or choice of residence based on perceived or real HIV status alone, including HIV screening of international travellers, is discriminatory.

Besides being discriminatory, travel restrictions have no public health justification. HIV should not be considered to be a condition that poses a threat to public health in relation to travel because, although it is infectious, the human immunodeficiency virus cannot be transmitted by the mere presence of a person with HIV in a country or by casual contact. Restrictive measures can in fact run counter to public health interests, since exclusion of HIV-positive non-nationals adds to the climate of stigma and discrimination against people living with HIV, and may thus deter nationals and non-nationals alike from coming forward to utilize HIV prevention and care services. Moreover, travel restrictions may encourage nationals to consider HIV a “foreign problem” that has been dealt with by keeping foreigners outside their borders, so that they feel no need to engage in safe behaviour themselves.

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

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