The real cost of denying people living with HIV permanent residency

by Jonathan Meddings | Policy Analyst, Thorne Harbour Health

Everyone over the age of 15 who applies for a permanent or provisional visa in Australia must have a HIV test to determine if they meet the ‘health requirement’ to be granted a visa. For people living with HIV (PLHIV) this requirement presents a seemingly insurmountable hurdle.

Recently I spoke with several community members and clients of Thorne Harbour Health who were trying to secure partner visas for partners from overseas who are living with HIV. All of them had their initial applications rejected and were awaiting appeal. While it is not unheard of for some such appeals to be successful, none were hopeful that theirs would be.

The reason for the rejection was always the same, a Medical Officer of the Commonwealth decided they didn’t meet the health requirement, and that they fail to meet the criteria for a health waiver.

The health waiver requires that one not “result in a significant cost to the Australian community”. The manner in which this cost assessment for PLHIV is made is quite crude. The number of years an individual is expected to live is calculated based on their age and average life expectancy, then multiplied by the estimated annual cost of antiretroviral medications, although the assumed treatment regimen is always an expensive one and the calculation does not factor in things such as price reductions built into the Pharmaceutical Benefits Scheme. An arbitrary threshold of $40,000 is deemed to be a significant cost; and is easily exceeded by such crude calculations.

Indeed, the actual cost is of no consequence. One client informed me that his antiretroviral medication was made freely available to him by post courtesy of the Malaysian Government, and that he could continue to access his medication this way even were he to also be a permanent resident of Australia, meaning there would be no cost to the Australian taxpayer. This argument didn’t help his case. Australian immigration officials are only concerned about the potential cost, and someone having Medicare eligibility means they could potentially incur a cost on the health system.

While cost is rightly a consideration, for a wealthy country like Australia it should not be a concern.

People wishing to be permanent Australian residents, who happen to live with HIV, are not the burden the Department of Home Affairs assumes them to be. Most will benefit the Australian economy through taxes paid and goods and services consumed. And the several to tens of thousands of dollars people are forced to spend seeking permanent residency in a system stacked against them would undoubtedly be better spent starting their new life in Australia.

The real cost to Australia is not the cost of allowing PLHIV to become permanent residents, but rather the cost of losing skilled prospective and current working Australians to overseas countries due to archaic and discriminatory rules that bar them from becoming permanent residents, or force their partners to choose between the person they love and their home country. This is not a choice anyone should have to make, nor is it a choice that an immigration official should make for them based on dodgy accounting.

We are a wealthy country, but we are poorer for denying people living with HIV permanent residency.