Conference on Travel Medicine and Global Health: Speech

Ladies and gentlemen,

I am very happy to join you here this afternoon. When I flew into Vienna four years ago to attend the 18th International AIDS Conference, the crew on the aircraft made an announcement that touched me deeply: They wished those of us onboard who were to attend the conference, all the best – and addressed the importance of the ongoing work to fight the disease and to eliminate stigma.

The fact that this message was conveyed in the air, felt somehow groundbreaking – as so many of my HIV positive friends all over the world have been living with travel restrictions because of their positive status. That was an optimistic entry to the International AIDS Conference that particular year…

Travel medicine tends to focus on what the traveler will encounter when crossing borders - in terms of the risk of the journey itself as well as the exposure to special health challenges that are different from those at home.

With HIV/AIDS it is different. HIV has already crossed borders. The virus itself has no preferences in terms of social class, ethnic group or sexual orientation. HIV thrives wherever it is allowed to enter the human body - in Norway as anywhere else.

There is a steady increase in the flow of people across borders. Globalization offers tremendous new opportunities for new relationships and new understanding. People are on the move – as tourists, as seasonal migrants and as workers seeking employment abroad.

In terms of HIV, travelers need to take necessary action to prevent transmission of the virus – by not putting people they meet at risk, and by avoiding getting exposed to the virus themselves.

People take HIV along across borders of various reasons:

- Some may not know they are infected.
- Some may lack adequate treatment.
- Others may undertake a risky sexual behavior – and/or don’t respect the sexual limits of people they interact with.

In principle it should be easy to prevent HIV from spreading across borders. In practice it is often difficult.

Stigma is a barrier. HIV is associated with shame and fear. Therefore it is hard to disclose and difficult to engage with, both for health personnel and for people on the move.

Travel restrictions for people living with HIV have now been lifted in many countries, while some still remain. Legal measures like this aim to stop the traveler, but don’t succeed in stopping the virus.

At the same time, sexual violence, human trafficking and narcotic drugs are closely associated with exposure to HIV transmission. These issues must be addressed in ways that respect international law and that protects and promotes human rights.

So what can we expect from travel medicine?

Stronger and broader engagement is necessary for information and mobilization against HIV. Stigma and silence must be overcome, with more active engagement in providing safe spaces for dialogue and reality orientation of travelers.

Travel medicine can’t just deal with HIV as a matter of providing measures for protecting the traveler against risk to acquire HIV. Travel medicine should also address the risk of causing vulnerability to others.

In the context of global health, travel medicine should contribute to a discussion of rights based prevention, treatment and support for those affected by HIV when moving across borders. Equally important is ensuring access to medicines and continuity in treatment during travel.

I think one of the solutions would be to consider youth as travelers and partners a special focus for travel medicine.

Why?

Young people travel. Young people are a force for change. And young people all over the world are already engaged in ensuring access to health care as a human right for all.

Thank you!