By Oluwakemi Agunbiade

After a swift move through the House of Commons, the Illegal Migration Bill has now reached the House of Lords. The Bill, as it stands, will leave many groups vulnerable with its plans to remove anyone who has not reached the UK through ”safe and legal” routes, to third party countries. Beyond our overarching concerns, shared with many, this Bill could lead to catastrophic outcomes for those seeking asylum who are living with HIV and will work in conflict with efforts to engage all people living with HIV in care – vital to end HIV transmissions.

We have been told that this Bill aims to protect asylum seekers by deterring them from making dangerous journeys, especially in small boats. However, that ignores the reality that so many people leave their home countries because they are escaping persecution and are forced by circumstance and a lack of other options to embark on these journeys to the UK.

We have already seen how notices of removal to Rwanda led to higher incidences of poor mental health for asylum seekers. Removal to a third party country for processing will have particular repercussions for those living with HIV in terms of mental and physical health effects. Our 2021 publication HIV and migration found that struggles navigating the asylum and health systems take a huge toll on the mental health of migrants, which often impacts access to care and adherence to treatment for HIV. Making an asylum claim is complex and stressful, with fear of notice of removal a significant further pressure on the individual that will be exacerbated if the proposals make it into law.

In eight of the countries considered safe for removal, homosexuality is deemed a criminal offence worthy of imprisonment. On top of this, while its harder to track transphobia in legislation, within a few of the countries, including Rwanda, there have been reported cases of discrimination against trans women through arbitrary arrests by the police and acts of violence. Many such forms of marginalisation also intersect with and drive further HIV related stigma and prejudice.

Discussions around health inequality and its negative consequences are often rooted in how safe people feel and ease of access to the institutions delivering health services. For example, the choices trans people make around their healthcare are deeply affected and limited by the transphobia they experience in these spaces. Where a person fears persecution, we cannot expect them to feel safe accessing healthcare. The government would not be prioritising the safety or the health of LGBTQIA+ migrants if they continue to propose they are removed to countries where they are more vulnerable to discrimination.

A further pressing concern is the impact on assurances of access to HIV care in third party countries. Transfer of care when someone is removed from the UK is already a critical challenge. We fear that access to care will be dependent on which country a person is removed to and that there won’t be time for appropriate assessments to be made. Variation between access to healthcare services creates the risk of people disengaging with their care as they must rebuild a support system. Health-related considerations are less likely to be factors in removal decisions and there will be even more burden on people living with HIV to try to access the support necessary to maintain their health.

The needs of migrants living with HIV are extremely nuanced. We know that the system is already failing people despite existing duties, with examples of people detained and removed without access to their medication. Alison Thewliss MP’s proposed amendment to the Bill sought to exempt people living with HIV from certain provisions but was unsuccessful. Now as the Bill moves through the House of Lords there is further opportunity to interrogate the Bill and its negative impact on health. The consequences of this Bill threaten to further isolate migrants living with HIV from the support systems they need. It is crucial we rally behind the work in opposition to the Bill and specifically highlight the risks to people living with HIV and to the public health response to HIV.

We have joined 176 other civil organisations to call on Parliamentarians to urge the Government to immediately withdraw the Illegal Migration Bill. In the coming weeks we will see how the Bill stands up to scrutiny in the Lords, and we hope it will be amended to mitigate the harms of the proposed policies. If this does not happen, we will continue to campaign so that the human rights, health, dignity and welfare of asylum seekers living with HIV are seen as central to the immigration policy agenda.