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Why does the inclusion of migrant populations and ethnic groups make sense? Lisbon, 7 june 2007

Why does the inclusion of migrant populations and ethnic groups make sense? Lisbon, 7 june 2007. Dr Srdan Matic, Regional Adviser STI/HIV & AIDS, WHO Regional Office for Europe. ”I am a migrant and member of an ethnic minority”. Evidence.

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Why does the inclusion of migrant populations and ethnic groups make sense? Lisbon, 7 june 2007

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  1. Why does the inclusion of migrant populations and ethnic groups make sense? Lisbon, 7 june 2007 Dr Srdan Matic, Regional Adviser STI/HIV & AIDS, WHO Regional Office for Europe

  2. ”I am a migrant and member of an ethnic minority”

  3. Evidence • There is limited direct scientific evidence from research demonstrating benefit, or lack of benefit of interventions specifically provided to migrants or ethnic minorities • There is plenty of evidence that universal access/coverage has a beneficial impact on health outcomes

  4. Annual number of newly reported cases – all WHO EURO countries, 31/12/06 WHO/UNAIDS estimates, end of 2005: PLWHA: 2,320,000 (1.56 – 3.19m) Estimated prevalence: 0.51% (range: 0.26-0.75%) Number of cases reported to WHO EURO (31/12/06): New HIV infections: 1 015 247 New AIDS cases: 328 978 New AIDS deaths: 189 959 *Preliminary and incomplete data

  5. HIV cases by country of origin, 2005

  6. Impact of HAART on prevention • Positive effect (decreased morbidity and mortality; increased survival) of HAART continues, including a lower average amount of circulating virus per infected individual since the introduction of HAART • A virus concentration below the detection limit is reached in an increasing number of patients on HAART • The HIV transmission probability in the population has decreased as a result of the lower amount of HIV circulating Source: HIV Monitoring Foundation, Amsterdam

  7. Principles of good public health • Social justice – giving a just treatment and a just share of societal benefits to all groups and individuals • Civil and human rights of individuals (right to life, to health, to education, ....) • Health as human, social and economic right • Principle of non-dicrimination based on race, ethnicity, origin, etc.

  8. Right or wrong? We should do what is right European countries committed to Universal access to HIV prevention, treatment and care (Dublin, Vilnius, Bremen)

  9. Conclusions • Exclusion is directly opposed to the objectives of public health approaches to HIV and STI prevention, treatment and care and undermine public health messages • It increases stigma and discrimination of people vulnerable to HIV • It increases stigma and discrimination of migrants and ethnic minorities • It creates disincentives for HIV and STI testing and counselling, and people die as consequence • It increases vulnerability and creates incentives for unsafe behaviour • It violates fundamental principles of international human rights law • Exclusion is not evidence based

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