A/HRC/23/41 ensure budgetary support for linguistically appropriate health services, interpreters and information and education. 44. Health-seeking behaviour can be influenced by a migrant worker‟s cultural background. Cultural misunderstandings and apprehension of procedures which they are not traditionally and culturally familiar with act as barriers to access.89 Migrant workers may therefore prefer doctors who practise their native traditional systems of medicines and who better understand their diseases, as opposed to the host State‟s health-care providers, who are perceived to lack cultural sensitivity to their health problems and sometimes racist and therefore discriminatory.90 Treatment interruption 45. Ensuring continuous access to treatment and medicines on a non-discriminatory basis is crucial to the right to health framework. Migratory processes and pressures can expose migrant workers to increased risk of contracting communicable diseases particularly HIV.91 There is therefore a need to ensure that continuous treatment is available to these populations throughout the entire process. Treatment interruptions, lack of follow-up and treatment failures are documented at higher rates among migrants than the stationary population.92 Some States have adopted regional frameworks, such as the Ibero-American Social Security Convention,93 and bilateral social security agreements94 to ensure “portability” of social security, including health-care benefits, from sending to receiving States, which allows migrant workers to enjoy such benefits, independent of their immigration status. States are encouraged to adopt such approaches with respect to access to treatment for chronic diseases, such as HIV, in order to maximize adherence rates in both sending and receiving States. D. 3D jobs and occupational health 46. Occupational health is integral to the right to health. States should ensure that occupational health laws and policies address the unique vulnerabilities of migrant workers in dirty, dangerous and degrading (3D) industries and are implemented, monitored and enforced.95 The vulnerability of migrant workers in 3D jobs may be further intensified in cases of irregular migrant workers, who, due to their legal status are in a weaker position to negotiate their rights with employers. 96 Furthermore, lax enforcement of laws and 89 90 91 92 93 94 95 96 14 European Health Management Association, “Barriers to Healthcare Services for Migrants”, Policy Seminar Report (n.d.), available from http://www.ehma.org/files/A2%20report-migrants.pdf. Ibid., pp. 24-26. UNDP and Secretariat of the Pacific Community, Migration, Mobility and HIV: A rapid assessment of risks and vulnerabilities in the Pacific, (April 2010), pp. 10-12. Médecins Sans Frontières, Providing antiretroviral therapy for mobile populations: Lesson learned from cross border ARV Programme in Musina, South Africa (July 2012), p. 6, available from http://www.msfaccess.org/sites/default/files/MSF_assets/HIV_AIDS/Docs/AIDS_report_ARTformob ilepops_ENG_2012.pdf.. The Convention came into force in 2011 following ratification by seven States. Robert Holzmann, Johannes Koettl and Taras Chernetsky, “Portability Regimes of Pension and Health Care Benefits for International Migrants: An Analysis of Issues and Good Practices”, Social Protection Discussion Paper No. 0519, (May 2005), p. 4. See A/HRC/20/15, para. 5. Godfrey Kanyenze, “African migrant labour situation in Southern Africa”, Paper presented at the ICFTU-AFRO conference on Migrant Labour, Nairobi, 15-17 March 2004.

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