About the database



Content


Methodology restrictions database


The database was first created and published on the internet in 1998 by Aids Info Docu Switzerland, the former Swiss AIDS Documentation Centre. The centre published information collected by the Swiss Federal Department of Foreign Affairs, listing restrictions in a number of countries.

In 1999, the German AIDS Federation “DAH” conducted a first survey among German embassies abroad and foreign embassies in Germany. The results were published in a resource book for counselling services by local German AIDS service organisations. The Swiss and the German data was merged, and published by Aids Info Docu on its web site.

A second survey was conducted by DAH in 2008. The questionnaire included the following questions:
  • Are there HIV-specific regulations affecting short or longer term stays in the specific country?
  • Are there compulsory medical examinations or HIV-tests in application processes (visa, work permit, study permit or long term residency permit applications)?
  • Are there any rules or regulations on controlling or deporting people with HIV?
  • Is the importing of antiretroviral medication for personal use possible?
The collected data is completed by information collected by the U.S. Department of State, the Foreign Affairs and International Trade Canada Web site, UNAIDS, EATG and database users (via feedback form).

Only information based on reliable, verifiable sources is published.

The collected data is updated continuously on the dedicated web site. Quick references for dissemination and advocacy are produced and updated annually in ten languages.

The database has informed the International Task Team on HIV-related Travel Restrictions, called by UNAIDS in 2008.


Updated: January 31, 2011 back to top



Mobility: A basic right for people living with HIV


The Unites States of America removed its entry restrictions for people living with HIV in January 2010. The legislative change in the USA and the similar changes announced recently in China received broad media coverage. We very much hope that these examples will have a domino effect, resulting in the revision of legislation in other countries which currently impose entry or living restrictions on people living with HIV (PLHIV).

We must also keep in mind that there are still countries in Europe maintaining restrictions which discriminate against people living with HIV.

For many people, travel is an important aspect of life. Some choose to benefit from the positive quality-of-life effects which come from participating in leisure travel. Others have to stay in foreign countries for long periods due to personal or professional reasons. Our data collection has become a reliable point of reference for PLHIV, providing them with up-to-date information which allows them to decide on the most appropriate behaviour before travel, as well as acting as an indicator of the extent of discrimination against people with HIV face in different parts of the world.

Starting with an initial survey of foreign representatives in Germany and German representatives in foreign countries in 1999, we wanted to document the official legal regulations concerning entry and residence for PLHIV, and also to find out about their implementation in practice. The data collected through our own research was complemented with other available information. In the subsequent years, feedback and information from all over the world was included in the continuous process of updating the data. A new survey of all diplomatic representatives in 2007/2008 aimed to ensure that the data was up to date and gather current, reliable data on 192 countries.1

We currently lack information from 8 out of the 200 countries included in our survey. 66 of the 192 countries on which we have information have special entry regulations for PLHIV. The majority of countries with entry restrictions require obligatory HIV tests from long term visitors and immigrants.

It is a sad fact that so many countries continue to limit the free movement of PLHIV. Although there is a distinction between entry regulations for tourists (tourist visa for a 1–3-month stay) and regulations for longer stays - the positive aspect of which is that tourist visits only rarely become a problem even for PLHIV- the fact that 31 (!) countries are willing to deport PLHIV or ask them to leave the country if HIV is diagnosed is frightening.

Longer stays, for study purposes and for work, for instance, often require special permits from which PLHIV are excluded. In a few cases, there are also regulations for a country’s own citizens when they return from abroad.

Tip of the iceberg

Entry restrictions generally affect people who want to stay in a country for a long period of time. Depending on the duration of the stay, a negative HIV test result must be presented to authorities for approval of the stay. HIV-positive test results generally lead to refusal of entry or to being forced to leave if one is already in the country. Such regulations limit PLHIV in the selection of educational opportunities and places of work. This discrimination cannot be accepted, particularly in view of the change in status of HIV from a fatal to a treatable chronic disease, since PLHIV – just like any other citizens today – need to plan their education and pursue a profession.

PLHIV are at constant risk of losing what they have built up: their job, their financial basis, access to health care, their home, their friends and family, and even their life. In this regard, some countries in Asia and the Middle East set particularly poor examples. We have anecdotal reports of people dying in deportation confinement, denied access to treatment while waiting to return to their homeland. This usually affects migrants who have been confined for deportation when their HIV status is discovered. The excuse of ‘legal problems’ between the authorities is often given. Authorities can even make it harder for their own citizens to return home if it becomes known that they are infected with HIV or have AIDS.

The true extent of the problem is unknown

The true scale of the daily discriminations experienced by PLHIV cannot be described, and the data compiled here can only provide a limited picture of the consequences of statutory regulations. There is currently no system and no organization which centrally collects relevant cases and reports on them. We only have individual, anecdotal reports. Further uncertainty about the true extent of these regulations is created by the fact that existing laws are sometimes not applied or only applied by some officials. The following information provides an overview of the extent of the problem:
  • Approx. 40 million people worldwide are living with HIV. Most of the affected persons live in low and middle-income countries. Many of them have an urgent need for treatment options in order to survive.
  • According to figures from the United Nations World Tourist Organisation (UNWTO), there were approx. 935 million international arrivals worldwide in 2010.
  • Approx. 191 million migrant workers live outside their own countries, according to estimates by the IOM. The refugee commission of the United Nations (UNHCR) assesses the number of refugees and people seeking asylum at 20.8 million worldwide.
  • With respect to the countries with discriminatory entry regulations, more reliable monitoring of actual conditions is required for the future. This is the only way we can show how PLHIV suffer disadvantages and discrimination on a global level.
A heavy burden for PLHIV

Application forms for entry visas often contain questions about general health, such as “Do you suffer from a communicable disease?” Those who decide to answer truthfully can expect entry to be refused. If HIV-positive travellers decide to answer this question untruthfully, they then encounter the subsequent problems of needing to hide any medication they are carrying and needing to give the healthiest possible impression to the border official(s). At border checks, it is the job of officials to look at luggage and/or check completed forms. The checks may also include checks of physical appearance.

If health certification is required when applying for the visa or for entry at the border, the required tests and examinations are frequently carried out by contractual doctors or other official bodies. Only those who subject themselves to these regulations have a chance of entering the chosen country – apart from the option of paying bribes, as anecdotal reports suggest.

Some countries require foreigners to have regular routine examinations which may include an HIV test. The costs for all these tests must naturally be covered by the individual, putting financially weaker groups of people at a disadvantage.

Other checks are performed by agencies whose task it is to hire workers in foreign countries. In applications for healthcare professions (physicians, nurses, etc.) a negative HIV test is a prerequisite for even being invited to an interview. In this manner, for instance, medical personnel is recruited from South Africa to work in the rich north. Other employers and other institutions such as universities also often openly require HIV tests as a prerequisite for employment, allocation of study places, and grants.

In principle, anyone entering a country may find themselves in the position of having to provide information about “suspicious” fellow travellers. An HIV-positive passenger from Japan on his way to China, when China still had its restrictions enforced, was sent back on the next airplane after a fellow passenger on the plane listened in on a conversation about HIV and reported him.

There is a particularly significant strain when a traveller’s physical appearance makes it impossible to hide or deny illness. It is then often at the discretion of the border official to order an examination. People who refuse to subject themselves to this will not have the option to enter the country, as examples from Malaysia and other countries show.

Positive examples are rare

Positive examples are rare, but should give us courage that cooperative commitment can bring about change. There are some countries which have eased or removed their restrictions in recent years. The examples of the USA and China are an important victory in the fight against the global discrimination against PLHIV.

Canadian HIV and human rights activists did good work in advance of the World AIDS Conference in Toronto 2006 and obtained changes in the entry regulations for short-term visas. This made it possible for PLHIV to participate in the conference and of course had longer-term benefits as well.

Following this, in 2007 the International AIDS Society (IAS) re-stated that it would not hold an international AIDS conference in any country which refuses entry to PLHIV.

Pressure by the Global Fund to cancel a working meeting in China, if the Chinese government did not remove questions about HIV from the entry application form, shows that this subject has reached the global HIV community.

The creation of an International Task Team by UNAIDS is another positive sign that the situation regarding entry regulations for PLHIV is changing. Last but not least, the request of the UN general secretary Ban Ki-Moon in June 2008 to end this form of stigmatization has met with worldwide resonance. Let us hope that Ban Ki-Moon’s authority paves the way for the elimination of the harsh restrictions in South Korea, his home country.

A prerequisite for these positive developments was and is that the scope of the problem must be pointed out again and again. We are glad to see that our data collection has proved to be an extraordinarily strong political instrument in these processes. The examples given above encourage us to keep combating the negative perception of PLHIV (cost factor, virus carriers, source of danger) which are the background of such discriminatory regulations. Clarifying how HIV has changed in recent years and the contribution which PLHIV make to society is an important step against the policy of exclusion.

Even after the legislative changes in the USA, the world at present is still not a very open place for PLHIV. In order to change the situation we need to fight for fundamental human rights, closely connected with the lifesaving ability to secure financial survival and access to treatment and care. To reach these goals, we require your support.


Updated: January 26, 2011 back to top

1 References to “countries” in this document also include territories and areas. Please note that the designations employed and the presentation of the material in this paper do not imply the expression of any opinion whatsoever on the part of the authors concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries



Developments and tendencies in recent years – an overview 2


2011

Indonesia
We receive notice that the Education Department has started enforcing an old requirement that foreign teachers must be free of HIV. 


2010

USA
On 30 October 2009, during a ceremony at the White House, US President Barack Obama announces that all restrictions affecting people with HIV from entering or migrating to the United States will be lifted. The legislation banning entry for PLHIV has been in effect since 1987. The new legislation takes effect on 4 January 2010. This great success is due to the tireless efforts of many NGOs globally. The international cooperation between DAH, IAS, EATG, ILGA, GNP+, UNAIDS and the Global Fund put real pressure on the US.

China
The refusal of entry to the HIV-positive Australian novelist Robert Dessaix to participate in a literature festival in Chengdu and Beijing in March 2010 creates a broad media echo. More than 90 Australian writers join to sign a protest letter condemning China’s discriminatory entry policies.

In April the Chinese government announces the lifting of the 20- year-old entry ban affecting people living with HIV. This is a great step forward, but a number of critical questions remain unanswered: at the time of writing, we have not seen translations of the new entry and residency regulations nor the new visa application forms. It is therefore not clear how the new law will be implemented in practice and how fast this is happening. It is furthermore unclear whether prospective visitors will be asked to declare their HIV status on visa application forms at entry.

Bulgaria
Bulgaria revises its legislation on entry and residence for people with HIV. New rules on HIV testing are effective from March 2010 onwards. Under the old rule, mandatory HIV tests were possible on entry for foreigners suspected of being a danger to public health. Mandatory HIV tests are now only possible for certain groups, like people who need blood dialysis.

Nambia
July 7 2010, Namibian Minister of Home Affairs and Immigration Rosalia Nghidinwa, has formally announced to remove all HIV related immigration barriers for people living with HIV from its Immigration Control Regulation.

Ukraine
The Ukrainian Parliament revises its Law on Prevention of AIDS and Scoial Protection of Population in October 2010. Restrictions on entry of people living with HIV are removed from the law.

India
The Indian Ministry of External Affairs lifts all travel curbs against HIV-positive people.


2009

Czech Republic
The Czech Republic announces in May 2009 that visa applicants from 10 countries must present an HIV test in order to enter the country. The new legislation applied to citizens from Congo, Kenya, Moldova, Mongolia, Nigeria, Pakistan, Tajikistan, Turkmenistan, Ukraine and Vietnam. The discriminatory proposition is withdrawn after mass protest by the HIV community throughout Europe, including an open letter by the EATG (http://www.eatg.org/eatg/Position-statements/Open-letters/Letter- on-Czech-Republic-Visa-Restrictions-for-People-Living-with-HIV). The administration quietly drops the plan.

South Korea
For many years the country has been among the most restrictive in the world. The government may prohibit entry of foreigners who are suspected of carrying HIV any time at its discretion. This applies mainly for long-term stays. In addition, the legislation allows the deportation of HIV-positive foreigners. After protests from human rights experts and a lawsuit in December 2009 which resulted in the deportation of an HIV-positive migrant worker being interrupted, the legislation in South Korea awaits revision. Foreigners residing in the country are currently required to undertake an HIV test once a year.

European Commission
The new communication from the European Commission’s Action Plan to combat HIV in Europe 2009–2013 explicitly condemns HIV-related entry restrictions: “HIV/AIDS as an issue of concern for migrants is addressed differently across Europe. Several European countries maintain restrictions on entry, stay and residence based on HIV status. These provisions are discriminatory and do not protect public health”.


2008

Global
In February, UNAIDS sets up an International Task Team on HIV-related entry regulations. The community, NGOs, governments and international bodies such as IOM, ILO, WHO, UNAIDS, UNHCR, etc., are represented. The goal is to put the subject on the political agenda and work out suggestions for solutions.

Europe
The European Parliament asks the European commission to remove HIV-positive Europeans from the Visa Waiver Programme in the visa negotiations between Europe and the USA. Instead, all Europeans are to be treated equally. 309 Parliament representatives vote for this motion, 218 vote against it, and 4 abstain.

Suriname
The Republic of Suriname intensifies regulations regarding the entry of PLHIV from specific regions. Incoming persons requiring visas and coming from Africa, Asia and Eastern Europe must, in addition to health insurance, also show a health certificate which proves that neither leprosy nor sexually transmitted diseases, Hepatitis B, TB or HIV are present.

Global
In the context of the UNGASS meeting in New York, the subject of entry regulations plays an important role. In open letters, representatives of the community point out the hypocrisy that the top-level HIV meeting is taking place in a country which grossly discriminates against PLHIV. It is emphasized that there cannot be “Universal Access” as long as PLHIV are excluded by restrictions. A letter signed by 345 organizations referring to the results of our work is passed on to the ambassadors of the countries with restrictive entry regulations.

United Nations – New York
On 11 June, the General Secretary of the United Nations, Ban Ki- Moon, asks the countries of the world to waive HIV-related entry conditions. He defines these regulations as an affront against humanity. Discrimination like this, he says, will drive the virus underground, where it will spread in the darkness.

Europe
The EU Civil Society Forum on HIV adopts a policy paper to request a change of legislation by those countries in Europe that still have discriminatory restrictions in place. This is to happen by the time of the International AIDS Conference in Vienna in 2010. The paper requests NGOs and intergovernmental bodies like UNAIDS, WHO Europe and IOM to concentrate their efforts to change the situation in Europe.


2007

Australia
In advance of the 4th International Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2007) which is taking place in Sydney, Australia’s prime minister John Howard explains that PLHIV should be better monitored, since they are a public health risk. In the context of the conference, this leads to massive protests by the global HIV community.

Norway
Norway’s foreign ministry, together with activists from the HIV community, announces a two-day conference in Oslo in October at which the various facets of discriminatory entry regulations – particularly with reference to migrants – will be discussed.

China
The Global Fund negotiates with the Chinese government on a change in regulations so that international meetings can continue to take place in China in the future.

Global
The International AIDS Society authors a statement which again confirms that major HIV conferences will, in future, only be held in countries that do not require disclosure of HIV at entry.

Norway, Sweden, Denmark
The foreign ministers of Norway, Sweden and Denmark address their American colleague Condoleezza Rice with an open letter requesting reconsideration of the regulations directed against PLHIV. This is the first time that the dispute is taken to the state level. The foreign ministers have not yet received a response.


2006

Canada
In advance of the World AIDS Conference in Toronto, the effective lobbying work of Canadian activists is able to change restrictions for short-term stays. In the future, Canada will not require the disclosure of HIV infections for short-term stays.

France
Activists around the openly HIV-positive representative Jean-Luc Romero launch a media offensive to draw attention to the discriminatory entry regulations of the USA.

USA
On 1 December, the American president George W. Bush announces plans to change the entry regulations for short-term tourism visas and business trips.


2004

New Zealand
Immigration services confirm that from 2005 immigrants will be tested for HIV. A quota regulation will be implemented: a maximum of 20 HIV-positive persons will be accepted per year.

El Salvador
The country decides to remove its existing entry and residence regulations.

Switzerland
According to press reports, the authorities responsible for public healthcare plan to introduce mandatory HIV tests in people seeking asylum. After protests by the press and experts, the test remains voluntary.

Global
IOM/UNAIDS publishes a joint position statement about entry regulations. The document vehemently opposes mandatory HIV testing and HIV-related discrimination.

United Kingdom
The government decides against mandatory HIV testing of people seeking asylum.

USA
On 10 July 2004, Senator Kerry promises that HIV-related entry restrictions will be lifted if he is elected as president. The re-election of George W. Bush temporarily removes the subject from the agenda.


2003

United Kingdom
The government suggests that people seeking asylum should receive mandatory HIV testing. The Terence Higgins Trust successfully pursues a comprehensive campaign against the planned measures.


2002

Canada
Introduction of mandatory HIV tests for all foreigners who want to stay in Canada for more than 6 months. Stays not approved for the majority of HIV-positive foreigners.

Australia
Drastically restrictive entry regulations are introduced. Introduction of individual cost assessment based on life expectancy, treatment costs and total expenses for medical treatment. PLHIV are increasingly being denied immigration.


2001

Global
Finalisation of the UNGASS Declaration: “By the year 2003, we obligate ourselves to introduce, affirm and enforce suitable laws and other measures which are suited to eliminating any form of discrimination to which PLHIV and members of other vulnerable groups are exposed and to provide them with full access to all fundamental human rights and freedoms.”


Updated: January 26, 2011 back to top


2 Compiled by Peter Wiessner and David H. U. Haerry




HIV related restrictions on entry and residence: indicator of stigma and discrimination - EATG activities at International AIDS Conference 2010, Vienna


More than 60 countries are currently restricting freedom of movement for people living with HIV/AIDS (PLWHA). Among these countries are 15 states from the WHO Europe Region. 31 countries do not stand back to deport PLWHA on the ground of their HIV status. These restrictions are a clear indication of stigma and discrimination at governmental level.

Deutsche AIDS-Hilfe (DAH), European AIDS Treatment Group (EATG), the Global Network of People Living with HIV (GNP+) and the International AIDS Society (IAS) jointly organised various activities during the International AIDS Conference in Vienna 2010.

We live in a globalised world, where travelling from one place to another is for many people a routine or necessity. People cross countries for leisure or work, to attend conferences, to study, for an internship or as migrant workers.

To restrict the freedom of PLWHA to stay for a certain time in another country would mean to limit their fundamental rights with very negative consequences for their health, their career and to make their living. In the weeks prior to the conference, we updated the database on HIV related restrictions at www.hivrestrictions.org. Any new information we have received and collected from governments or feedback from users is now available online.

We published the 9th edition of the Quick Reference, a booklet with a brief overview of all restrictions. This particular effort was supported by the Deutsche AIDS-Hilfe. This edition was available at the conference in 10 languages. The booklets are useful for advocacy purposes, download is possible from www.hivrestrictions.org and at www.eatg.org/eatg/Publications/Other-newsletters/Quick-Reference-2010-2011-Entry-and-Residence-Regulation-for-people-living-with-HIV. This work could not have been achieved without the great support by dear friends and activists. Many thanks to everybody for your generous help and support!

The partner organisations submitted two abstracts to the conference, proposed an activity at the Human Rights Networking Zone and co-organised a workshop. Our abstract on deportation of HIV-positive migrants and impact on health and human rights, delivered in collaboration with Human Rights Watch, was accepted as oral presentation for the session on "Refugees and Asylum Seekers and HIV: Deportation and Human Rights Violations", co-chaired by Anna Zakowicz and Frank Amort. We presented latest data on countries deporting PLWHA and findings from the report "Returned to Risk", commissioned together with HRW, the African Policy Network and Deutsche AIDS-Hilfe (www.hrw.org/en/node/85610). A major problem we are facing is access to treatment for PLWHA who are deported back to their country of origin and lack of data and information about their fate. States and intergovernmental organisations are reluctant to publish the data they have. Deportation can result in death and violates human rights, if treatment and care in the home country is not guaranteed. The PowerPoint slides are available at: www.eatg.org/eatg/Projects/Past-projects/AIDS-2010-Vienna-XVIII-International-AIDS-Conference-July-18-23-2010.

The abstract "HIV-specific restrictions on entry and residence in Europe: a source of discrimination and a challenge to demonstrate political leadership" reflects the situation in European countries and the efforts of the HIV/AIDS Civil Society Forum, an informal advisory body to the European Commission, to address this issue at a policy level. 15 European countries still have some restrictions in place; the call for a European response to remove restrictions by 2010 was unsuccessful www.hivtravel.org/Web/WebContentEATG/File/Call%20for%20European%20response%20to%20remove%20HIV%20travel%20restrictions%20in%20Europe%20by%202010.pdf.

The poster includes a world map showing the current restriction status of all countries, it can be downloaded at: www.eatg.org/eatg/Projects/Past-projects/AIDS-2010-Vienna-XVIII-International-AIDS-Conference-July-18-23-2010.

Peter Wiessner, EATG member and freelance social scientist on behalf of Deutsche AIDS-Hilfe, was invited to participate in the session on "Barriers to Migrants and Mobile Populations in Accessing Comprehensive HIV Services and Treatment". HIV-positive migrant workers are often denied access to health care services, which increases their vulnerability to HIV. This happens quite often despite the fact that migrant workers significantly contribute to the economic growth of the host countries. The PowerPoint presentation on HIV related entry and residence regulations and Human Rights is available at www.eatg.org/eatg/Projects/Past-projects/AIDS-2010-Vienna-XVIII-International-AIDS-Conference-July-18-23-2010. The session video with all the other speakers involved can be viewed at http://globalhealth.kff.org/AIDS2010/July-20/Barriers-to-Migrants.aspx.

Based on our experience in advocating for removal of restrictions, a workshop on how to advocate for the removal of HIV-specific restrictions was carried out at the first conference day. The question is, if and how the recent positive legal changes in the USA, China, Namibia and Bulgaria can have an impact on those countries that still discriminate against the rights of PLWHA. .

The aim of the event was to:
  • Mobilise activism towards the removal of HIV related restrictions on entry stay and residence
  • Build in-country capacity to engage in and lobby for HIV-sensitive migration and immigration policies;
  • Explore, through country case studies, strategies to influence government to initiate policy changes;
  • Build coalitions between international and in-country activists for active engagement;
Nancy Ordover from the Coalition to Lift the Bar in the U.S., Michaela Clayton, AIDS & Rights Alliance for Southern Africa, Ron McInnis from the International AIDS Society and Rosalyn Bolyne from the International Organisation for Migration delivered key notes and discussed possible strategies for removing restrictions in countries that still discriminate with participants.

Another activity, proposed by David Haerry and Peter Wiessner, to further discuss Human Rights issues in relation to entry residence regulations and the criminalisation of HIV transmissions took place in the Human Rights Networking Zone. A very special thank you to Nancy Ordover, Ferenc Bagyinszky from the Hungarian Civil Liberties Union and Dominik Bachmann from the Swiss AIDS Federation for their valuable input to the session! Nancy discussed the changes in U.S. law, Dominik elaborated on the advocacy efforts in the area of criminalisation of HIV transmission in Switzerland. Ferenc talked about the legal situation in Hungary and on the difficulties to lobby for legislative changes.

2010 was an incredibly productive year for all travel restrictions advocates. DAH, EATG, GNP+ and UNAIDS organised a well attended press conference with key note speeches by Michel Sidibé, UNAIDS Executive Director, Kevin Moody from GNP+, one representative from the Government in Namibia and one journalist from China. The global community interest about the topic is still high. We hope that other countries will follow the positive moves by Bulgaria, China, the U. S., Namibia and Georgia. These changes are the result of tireless efforts by a large number of Civil Society advocates. www.eatg.org/eatg/Press/Press-Releases/66-countries-discriminate-against-people-living-with-HIV-HIV-related-entry-and-residence-regulations.


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Impressum


© Deutsche AIDS-Hilfe e.V. / German AIDS Federation & European AIDS Treatment Group EATG

Editor

Karl Lemmen, Bundesgeschäftstelle der Deutschen AIDS-Hilfe e.V. / German AIDS Federation

Authors

Peter Wiessner, EATG, co-author (peter.wiessner (at) eatg.org)
David H.-U. Haerry, EATG, online edition (david (at) haerry.org)

Publisher

International AIDS Society (IAS)

Thanks to
  • The Global Network of People living with HIV/AIDS GNP+, for dissemination and advocacy support
  • The International Lesbian and Gay Association (ILGA) and Stephen Barris for dissemination and advocacy support
  • UNAIDS and the International Task Team on HIV-related Travel Restrictions
Logotypes

DAH, EATG, GNP+, IAS, UNAIDS


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