Humanitarian action to protect public health
Hon Pete Hodgson
Minister of Health
Hon David Cunliffe
Minister of Immigration
30 August 2006 Media Statement
Humanitarian action to protect public health
The government is taking action to protect the health of New Zealanders, and Zimbabweans in New Zealand who have fled the Mugabe regime, Health Minister Pete Hodgson and Immigration Minister David Cunliffe announced today.
Cabinet agreed to a Special Zimbabwe Residence Policy (SRP) in 2005 in response to the humanitarian crisis under Robert Mugabe. About 500 Zimbabweans have been granted residence under the SRP, but many who are eligible have yet to come forward to apply for residence.
It is believed that some of these potential residents are not coming forward because of uncertainty around their HIV status following a policy change to require mandatory HIV screening before approving residence applications.
Zimbabweans here under the SRP will be offered residency regardless of their health status if they apply by next February 28 and meet other standard requirements.
"Under successive governments, New Zealand has been at the forefront of adopting a proactive and pragmatic approach to the management of HIV/AIDS," Pete Hodgson said. "We are now faced with a situation where people may be putting their health, and the health of others, at risk because of a government policy - we cannot accept that.
"We are doing this because it's the right thing to do to protect the health of New Zealanders and of those Zimbabweans seeking to become New Zealanders. When people know about their HIV status, we can be much more successful at containing the spread of the virus."
Cabinet has set a closing date of February 28, 2007 for applications under the Special Residence Policy (SRP), established in July 2005 for Zimbabweans here before October 2004. Temporary permits would be extended to provide time for residence applications to be decided.
"Cabinet also agreed to offer residence to these individuals regardless of their health status as long as they meet other requirements, such as being of good character as shown by police and other checks," Mr Cunliffe said.
"This waiver recognises we expect that some of the people who apply will not meet the acceptable standard of health criteria, particularly given the higher rate of HIV/AIDS in Zimbabwe.
"About 800 people eligible for the SRP have still not applied, and there is anecdotal information that for some of them fear of finding out they have HIV through the health screening immigration policy requires, and then having their applications rejected, is the reason they have not come forward. We have applications on hand for the Special Residence Policy where people have declared they have HIV."
Mr Cunliffe said the decision was made for both public health and humanitarian reasons.
"This is an exceptional case, made for a group of people who might be unable to go home, and who without this decision couldn't stay here lawfully. Without the certainty of the Government decision, people could have gone underground, with negative consequences for them and for New Zealand."
QUESTIONS AND ANSWERS
How many people who came into New Zealand under the Special Residence Policy are likely to have HIV?
Estimating reliably the number of people who are HIV positive is extremely difficult because the group may not be representative of the general population in Zimbabwe in terms of HIV prevalence.
The UNAIDS 2006 Report estimated the prevalence rate of HIV in Zimbabwe was about 20 per cent. On that basis, of the 1300 people who came to New Zealand under the SPR policy 260 could have HIV (20 per cent). But it should be noted of the 500 who have already come forward and been tested only 42 were found to be HIV positive (8.4 per cent).
What is the prevalence rate of HIV in Zimbabwe?
The UNAIDS 2006 Report found the prevalence rate of HIV was on average 20.1 per cent (a range between 13.3 and 27.6 per cent).
How much is it going to cost to treat the people found to have HIV?
On average it costs about $18,000 a year to treat a person using antiretroviral treatment. This includes the cost of the drug treatment regime, clinic visits and associated laboratory tests. In general a person with HIV is likely to visit a clinic and undergo lab testing three to four times a year.
It is estimated that of the 800 Zimbabweans who have yet to apply for residence in New Zealand and be screened, using a prevalence rate of 20 per cent, up to 160 could be infected with HIV. In the unlikely event that all required antiretroviral treatment it could cost about $2.9 million a year.
Where will the money come from?
The Ministry of Health will work with district health boards to more accurately identify the costs involved and incorporate it into the usual budget setting process.
How does a person get tested?
For immigration health screening purposes a person needs to go to a General Practitioner for a medical assessment. The GP will arrange for a number of blood tests to be undertaken, including HIV.
Does New Zealand have the health infrastructure to deal with this many people with HIV?
Yes. Not all people infected with HIV in this group will require antiretroviral treatment when they are diagnosed. People with HIV infection are referred to specialist infectious disease physicians, who care for and monitor their health status on a regular basis.
Will this prevent other New Zealanders with HIV from getting treatment, care and support?
Funding treatment for Zimbabweans, who test HIV positive, will have minimal impact. Not all Zimbabwean people infected with HIV will require antiretroviral treatment when they are diagnosed. Any subsequent treatment will be spread over time.
How can we control the spread of HIV in New Zealanders?
Effective screening, treatment and prevention is in the interests of the whole community. Effective programmes in groups which may be at higher risk help reduce the level of risk in other groups too.
Advice, testing for HIV and referral to services is available through a general practitioner.
In this particular population the Ministry of Health has funded the New Zealand Aids Foundation to work with the African community on a range of programmes aimed at prevention, care and support. The Foundation is running an HIV Prevention Campaign, working with the African community to encourage testing and safer sex practices.
How many people in New Zealand are known to have HIV?
A total of 2474 people had been reported to have HIV infection to the end of December 2005 – it is estimated that less than 2,000 people in New Zealand are currently living with HIV.