Amsterdam 2015
Amsterdam 2015
Abstract book - Abstract - 2251
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Abstract #2251  -  Migration and HIV
Session:
  22.6: Migration and HIV (Parallel) on Wednesday @ 16.30-18.00 in C002 Chaired by Christiana Noestlinger,
Dolores Albarracin

Authors:
  Presenting Author:   Ms Adeline Toullier - AIDES, France
 
  Additional Authors:   
Aim:
In France, migrants suffering from serious illnesses who cannot receive health care in their country of origin are protected against deportation measures and their situation is stabilised by a law stating that they may obtain residence rights for medical reasons. This legislation was acquired as a result of the advocacy work conducted by patient associations, such as Act Up-Paris and organisations defending the rights of migrants and patients. These organisations are now grouped together in an inter-associative organisation called ODSE (Observatoire du Droit à la Santé des Etrangers, or the Monitoring Committee for Migrants’ Rights to Health). To guarantee confidentiality, the assessment of medical criteria is carried out by public health medical inspectors (and not by immigration officials), who are controlled by the regional public health authority (ARS). This is a regional administration in charge of public health. According to the latest figures published by the government, the number of foreigners benefiting from a residence permit in relation to their state of health is stable: around 35, 000 people.
 
Method / Issue:
The ODSE has made an inventory of difficulties faced by immigrants in accessing residence permits and protection against deportation. According to field data and observations, the ODSE records the rules that govern the drafting of assessments for a residence permit by ARS doctors.
 
Results / Comments:
Since a legislative reform in 2011, public health medical inspectors’ working conditions have deteriorated which in turn has consequences on access to resident permits for migrants with HIV. For instance, pressure from the top of the chain of command to pronounce more negative evaluations of people living with HIV (5 refusals in 2011 vs 14 from January 2014 to March 2015), parallel medical investigations, bypassing procedures by immigration officials, encroachments on medical confidentiality, (0 cases in 2011 vs 54 in January 2014 to March 2015), medical assessment poorly respected by administration (7% in 2013 vs 60% in 2014, and non-respect of medical confidentiality in administrations (0 cases in 2011 vs 15 2012-2014). (Source: ODSE) The number of first residence permits issued fell by 18% during the 14 months subsequent to the legislative reform (official administration report, 2013). The number of first residence permits issued ped by 6% in 2013 (Health Ministry report).
 
Discussion:
The next legislative reform plans to transfer medical assessments to the French agency in charge of immigration and integration (OFII) which is a public institution under the exclusive control of the Interior Ministry. Its role is to manage and control migration flow. The ODSE would like to set up a collegiate body within the ARS, under the exclusive control of the Health Ministry, in order to ensure independent exercise of public health medicine.
 
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