Illegal migrants 'should be tested' for HIV on arrival

Illegal migrants should be tested for HIV on arrival and if found to have the disease they should be given treatment accordingly, the Labour Party spokesman for social affairs, Michael Farrugia said yesterday.

He was quick to add, however, that Malta should not shoulder the responsibility alone and other EU countries should share the burden holistically, not just with funding but also by providing medical treatment and taking on a portion of those immigrants granted protection.

Dr Farrugia was reacting to an article in The Sunday Times which said that half of the HIV cases being treated in Malta involved African immigrants and that the number of HIV cases had quadrupled over the past two years, from between seven and 10 cases a year to 30 - 40. The figures, however, could not be telling the whole picture because immigrants are not screened for HIV on arrival.

"I am not surprised by the figures. It is well known that HIV is rampant in the countries that most of these immigrants come from," Dr Farrugia said.

He said the problem had to be tackled from all angles and that this should also come up during the parliamentary debate on illegal immigration the opposition had demanded.

Dr Farrugia, a doctor by profession, explained that the increase in HIV needed to be tackled first and foremost through education that discouraged casual sex and one-night-stands, not only with illegal immigrants but with foreigners and locals alike.

"Before getting involved with someone sexually, you should make sure you know the person well, including whether they are HIV positive, and this is something that we need to stress," he said.

But another problem was that if immigrants were given treatment they might not be able to comply with the strictly-timed regime and would develop resistant strains. But, even for this, he said, education was the key.

"You cannot force someone to comply with the treatment but then not everyone will respond in the same way. Yet, those who want to be treated, and are educated accordingly, they will be able to comply as best as possible."

He stressed that another important factor was to teach infected people not to infect others by taking extra precautions and not hiding their disease from their partners. "They have a legal responsibility to do this," he warned.

When asked whether all foreigners should be checked for HIV, he made it clear that it would be impractical to give a blood-test to everyone entering the country, so there was a limit to what could be done. However, when it came to illegal immigrants, because of where the migrants were coming from, the conditions of how they arrived and the fact that they would be processed by a large number of professional personnel, all tests necessary should be carried out.

If they were found to be HIV positive, then treatment must be provided, he said.

"Our responsibility to take care of them doesn't end when one of them gets sick. Just as we provide shelter, food and water, we must provide medical treatment but we cannot do it alone," he added, calling for stronger burden-sharing agreements.

"Burden-sharing cannot be seen simply as a question of how many immigrants are arriving or how big the country is. There's the question of resources and the strain on the various institutions, including the hospital, for instance. The EU must contribute holistically to help us overcome this challenge."

Christopher Barbara, Malta's only virologist in service and chairman of Mater Dei Hospital's Pathology Department, told The Sunday Times that, although screening was not expensive, treating an HIV-positive patient would cost about €500 a month for the rest of their lives.

"If the test is positive we have to offer treatment. Otherwise, why are we screening them in the first place? And it would be ethically incorrect to screen somebody selfishly, just so that we can label them HIV-positive."

He explained that if infected immigrants did not take the treatment properly, they might become resistant to the drugs and develop untreatable strains of the virus.

"I'm still not convinced screening is the solution. Initially, I thought we should help these people and treat them. Today, the more I study the situation the more convinced I am that we shouldn't," he said.

When contacted, the Parliamentary Secretary for Health, Joe Cassar said the government was addressing the matter and taking advice from consultants on the best way forward.

The Ministry for Justice and Home Affairs refused to comment, saying this was a public health issue not an immigration one.

The debate of whether or not to test illegal immigrants on arrival for infectious diseases such as HIV and Tuberculosis has been going on around Europe for a while but so far no ideal or practical solution has been found.

The problem will get worse once certain Eastern European countries, which tend to have high rates of HIV, join the EU and their citizens would, of course, have the freedom to move anywhere around Europe.

cperegin@timesofmalta.com