Access to health care for undocumented migrants in Italy.

support for primary health, including AIDS and other disorders. The Commission called for donor support of 0·1% of donor gross national product (roughly US$36 billion in current dollars). 5 Actual donor aid lags at around 0·04% ($12 billion). We are not overspending on AIDS but underspending on the rest. These needed sums are paltry relative to military spending or the bank bailouts. The Global Fund off ers an eff ective fi nancing mechanism. The choice is not between AIDS, health systems, and other Millennium Development Goals. We can and must support them all. We declare that we have no confl icts of interest. Integrating health interventions for women, newborn babies, and children: a framework for action. (not only of the citizen) and statutes free health care for the poor. An amendment to the law concerning public order measures, approved on May 14, 2009, by the Chamber of Deputies and now to be approved by the Senate, introduces the crime of illegal immigration, and consequently obliges by law all civil servants to report undocumented migrants. Public health workers are civil servants. Notwithstanding previous legislation forbidding them to report undocumented migrants, this new legislation risks creating fear among migrants, preventing them from attending health facilities and exposing both migrants and the whole community to higher health hazards. Since 2003, Médecins Sans Frontières has been working in Italy, off ering assistance at landings, and in public health centres for undocumented migrants. Migrants often present with disorders related to the hardships of the journey (trauma, dehydration, etc), the difficult working and living conditions (eg, osteoarticular diseases), and the stress caused by social exclusion, uncertainty of income, and changes in eating habits (gastritis and duodenal ulcers). Women mainly attend for gynaecological problems. Cross-cultural mediation services and outreach activities, aimed among other things at raising awareness about the availability of health care without the risk of being reported, have proven to be key factors for achieving eff ective access to health care. 1 If the Senate approves the current proposal, the obligation for civil servants to report undocumented migrants would undermine any confi dence they might have had in the public health system. This will increase exclusion and worsen their already unacceptable living and working conditions, 2,3 with serious health consequences for the whole community. In line with Giorgio Cometto and colleagues' Comment, 1 we suggest that the Global Fund should open three additional funding windows. …