The HIV/AIDS pandemic is exacerbated by conditions of violence and instability, which increases the risk of exposure to the disease through large movements of people, widespread uncertainty over conditions, and reduced access to medical care … If unchecked, the HIV/AIDS pandemic may pose a risk to stability and security. (UN Security Council Resolution 1308, 17 July 2000)
Forced migration and HIV/AIDS are two of the crucial social issues facing the world today and can be seen as a ‘double emergency’ in some countries. Over twenty million people have died of AIDS-related illnesses over the past two decades, and there are an estimated thirty-eight million people living with HIV/AIDS around the world. There are also some seventeen million displaced persons globally. The association between HIV/AIDS and forced migration predictably appears particularly strong in sub-Saharan Africa with its large number of high intensity conflicts, its large and diverse population of displaced persons, and its overall HIV/AIDS prevalence rates estimated at somewhere between 7.5 per cent and 8.5 per cent ( UNAIDS/WHO 2003 ). According to a paper presented to UNHCR, ‘within years, the mortality [from HIV/AIDS] is expected to double in the refugee camps. The ravages of the HIV epidemic in the camps in terms of social and medical consequences and its death toll outweigh those of any other single disease’ ( UNHCR, 15 February 2001 ).
The links between HIV/AIDS, conflict and forced migration are at a relatively early stage of being explored and researched. Three key elements are central to the issue of forced migration and HIV/AIDS. Firstly, the correlation between conflict, forced migration, and the spread of HIV/AIDS. Secondly, the way in which forced migration can increase vulnerability to becoming infected with HIV/AIDS and its effects. Thirdly, the way in which HIV/AIDS could be a causal factor in humanitarian crisis and forced migration. After a brief definition of the key terms involved, these three issues are addressed in turn. This is followed by an overview and analysis of the key international legal instruments of relevance to the subject, and the guidelines that have been developed by the main actors involved. A summary of the main challenges that are faced when trying to tackle HIV/AIDS in situations of conflict and forced migration are then presented.
The International Association for the Study of Forced Migration (IASFM) describes forced migration as ‘a general term that refers to the movement of refugees and internally displaced people (those displaced by conflicts) as well as people displaced by natural or environmental disasters, chemical or nuclear disasters, famine, or development projects’. The main causes of involuntary displacement are wars and armed conflicts, although natural disasters and development projects are also factors. According to the United Nations High Commissioner for Refugees (UNHCR), there are some fifty million uprooted people around the world, including both refugees and internally displaced persons (IDPs), of whom around 75 to 80 per cent are women and children.
The legal definition of a ‘refugee’ is a person residing outside his or her country of nationality, who is unable or unwilling to return because of a ‘well-founded fear of persecution on account of race, religion, nationality, membership in a political social group, or political opinion’ (Article 1 of the 1951 United Nations Convention Relating to the Status of Refugees). The most widely used definition of IDPs is one presented in a 1992 report of the Secretary-General of the United Nations (UN), which identifies them as ‘persons who have been forced to flee their homes suddenly or unexpectedly in large numbers, as a result of armed conflict, internal strife, systematic violations of human rights or natural or man-made disasters, and who are within the territory of their own country’.
- International Association for the Study of Forced Migration (IASFM) - http://www.iasfm.org/pages/1/index.htm
- UNAIDS - http://www.unaids.org
- UNAIDS (2004 report) - http://www.unaids.org/bangkok2004/report.html
- UNHCR (legal documents): http://www.unhcr.org/cgi-bin/texis/vtx/basics
- UNHCR (statistics) - http://www.unhcr.org/cgi-bin/texis/vtx/statistics
- UNAIDS/WHO (‘Aids Epidemic Update’ December 2003 - http://www.unaids.org/Unaids/EN/Resources/Publications/corporate+publications/aids+epidemic+update+-+december+2003.asp
- WHO (HIV/AIDS) - http://www.who.int/hiv/en/