’First Wave’ research on ’migration’ and HIV has failed us — Here comes the Second Wave

GENEVA, 8 September 1998 (MAHA) — Third World people are seen today as international carriers of disease. The first wave of liberal research on migration and HIV has been driven, both explicitly and implicitly, by the concern to respond to racist ideology and practice in public health.

Liberal AIDS social research on ’migration and HIV’ is being transformed by a small but growing group of ’second-wave’ researchers who believe that current approaches lack the analytical tools and methods to build powerful responses to the equation of Third World people with disease.

Put history back into ’migration’

The positivist tendency of technical classification schemes and over-generalisation has reduced the term of ’migrant’ to an abstract « umbrella category » in which all meaningful political distinctions - of race, social class, gender, geography, and so on - are collapsed. First, we must disaggregate this category to reveal social groupings (defined by race, social class, gender, geography ) with drastically different power and access to resources. Second, we must historicise migration. The ’first-wave’ history says that a small group of public health specialists began HIV prevention for migrants in Europe in the late 1980s.

Yet work had started several years earlier - hidden from the gaze of mainstream public health - to survive the epidemic in the poor inner cities, estates and banlieues of Europe’s biggest cities.... Grassroots education, mobilization for AIDS prevention, and better care for people facing AIDS came onto the agenda of lovers, friends, and families. This early AIDS organising is part of the broader history of Third World organising for racial equality and social justice in Fortress Europe.

This history is significant for at least three reasons. First, it highlights the fact that the health gap between the "white population" and the rest of us was there long before AIDS burst onto the scene. AIDS research must take into account the historic nature of this gap. Second, the context for research must be our struggles as peoples of the Third World diasporas. Third, we believe that this early history is in fact the missing half of the history of AIDS organising and research which have secured the rights and treatment of the white, middle-class minority of the North.

In all of the rich countries of the North where data is available, Third World people are now, disproportionately, the last in line for testing and, for those who are HIV+, for care and medications. It has been a fight to force the acknowledgement of this reality, but this can hardly be called a victory.

Demand access based on need, not status

The demand for free access to the best available treatment and care (including combination therapy) is not a utopic one. There are medical centres and clinics, like the Centre du Moulin Joly (in Paris, France), or the Free Clinic in Brescia Italy, which offer care and treatment based on need - without asking about immigration status or economic status - all over Europe and probably all over the world.

However, people living with HIV are facing the consequences of the attack on the welfare state in the 1980s which zeroed in on the poorest and most disenfranchised people living in the rich countries of the North. Immigration controls have become a key component of welfare, and accelerated the trend to total denial of care and treatment by writing the undocumented out of social security and health insurance schemes.

Second-wave AIDS social research on migration must contribute to the arguments and analytical tools to oppose immigration controls and welfare cutbacks because these policies have a disparate impact on survival (’vulnerability to HIV,’ if you prefer) — according to ’race’ and immigration status.

Support Mister M: Deportation = Death

Deportation, for people facing HIV, is the last stop in a long chain from discrimination to denial of treatment. Deportation is torture. It is the negation of human rights. For Third World people facing HIV, deportation is a death sentence.

The Swiss government is trying to deport Mister Mfumu, a Congolese man living with HIV. HIV is not a crime, yet in 1996 Mister Mfumu was jailed by the unjust Swiss law which criminalises HIV transmission. Now government have stated they will force him on the plane with a small suitcase with 12 months combination therapy. Prison followed by deportation is a Double Punishment - no Swiss will ever face deportation.

Mister Mfumu wants to stay. He has not been back to his home country of the Democratic Republic of Congo for 18 years. All of his ties are here, in Switzerland. He is very much part of this society - his life is here. We are fighting Mister Mfumu’s deportation because he is telling us that the prospect of deportation is driving him mad and making him sick.

Some have said that Mister Mfumu is only one insignificant case in the global AIDS equation. However, Mister Mfumu’s case brings the theme of this Conference back to the on-the-ground reality of AIDS today. Now more than ever, we need global AIDS research and activism to build on such insignificant individual cases, turning them into issues, issues into causes, and causes into a movement with the power to pressure governments into respecting the rights of Third World people like Mister Mfumu, who have been pushed to the front lines of today’s struggles against HIV.