HIV, migration and urban food security: exploring the linkages - South Africa Report

Since the end of apartheid, patterns of migration into South Africa have shifted, and South Africa has become adestination for people from across the African continent and beyond a small but important number of whom arerefugees and asylum seekers. While South Africa has a protective, integrative, urban refugee policy, many ofthese individuals struggle to access the rights to which they are entitled, including healthcare. In addition, manylower-skilled international migrants are unable to legalise their stay in South Africa. As a result, internationalmigrants often become part of the group of ‘urban poor,’ falling within the periphery of health and social welfareprovision and relying on survivalist livelihoods within the informal economy. The health and wellbeing of anindividual impacts greatly on their ability to maintain a secure livelihood, and this becomes more difficult in thecontext of an HIV epidemic. This paper presents findings from a case study situated in the City of Johannesburg.The research made use of 1) 2006 survey data on migrant livelihood strategies in Johannesburg, 2) a studyinvestigating non-citizens’ access to antiretroviral treatment (ART) in the inner city, which included 3) a set ofinterviews conducted with migrant ART clients who were working in the city’s informal economy. The findingsindicate (a) the importance of the informal economy for migrants to Johannesburg; (b) the challenges that non-citizens face in accessing ART in the public sector in South Africa; and (c) the linkages between urban migrants’access to ART and their ability to maintain a survivalist livelihood. The paper argues that upholding people’s rightto ART for all who need it within South Africa will enable international migrants (including refugees and asylumseekers) to maintain an otherwise fragile survivalist livelihood, and this in turn will assist their self-reliance andintegration into urban life. Recommendations are made to ensure that the right to healthcare is upheld for all inSouth Africa.