RS & Ors v The Secretary of State for the Home Department

1. These are the appeals of three female Zimbabwean nationals born in June 1977, 24 September 1964 and 16 November 1957 respectively. They all claim to have a well founded fear of persecution if returned to Zimbabwe as they would be unable to demonstrate loyalty to ZANU PF, their removal would breach their human rights (Articles 3, 8 and 14) and their rights under section 21 D and 21E of the Disability Discrimination Act 1995 would be breached. All three appellants are HIV positive and are receiving NHS treatment. RS

2. This appellant was born in Chigutu. She was educated in Gokwe and last lived in Dema Seke, about an hour’s journey from Harare. She arrived at Gatwick airport on 21 February 2001 to visit her husband who was a student here at that time (although in her subsequent asylum interview in October 2006, she claimed that he had returned to Zimbabwe in the year 2000). He had entered the UK as a visitor in February 2000 and thereafter remained as a student, with leave. The appellant was admitted as a visitor for six months and subsequently commenced Bible studies here as a result of which she was granted 12 months’ leave as a student (until 30 September 2002). Their children remained living in Zimbabwe and were cared for by relatives in Dema. In August 2001 both she and her husband were diagnosed as HIV-positive and both commenced anti-retroviral treatment (ART). Her husband was said to have returned to Zimbabwe following the death of his father in 2002.

3. On 25 September 2002, before the expiry of her leave to enter, the appellant made an application to remain for a limited period to undergo private medical treatment. However, a letter from her former representatives accompanying her application form indicated that she was entitled to benefit from NHS treatment and the application was treated by the Secretary of State as having been made to receive free medical treatment for an indefinite period. The appellant stated on her application form that she intended to leave the UK in October 2005 and that she received £600 every month from a relative or friend. A letter dated 16 September 2002 from her consultant, Mr Derrick Evans of Southend Hospital, confirmed that although she had been diagnosed with HIV in August 2001, she had probably had the disease for approximately seven or eight years.

4. The application was refused on 5 January 2004. The Secretary of State balanced the compassionate aspects against the need to maintain immigration control. He considered that the resources of the NHS were limited and that it would be unrealistic to expect the NHS to treat everyone who could not obtain treatment of a similar standard in their own country. He considered that the medical evidence indicated that the appellant was fit to travel, and that she had been working for a long period of time. He noted that medical treatment was available in Zimbabwe and that the appellant's husband, three children and other family members lived there. He noted that the appellant’s studies had been funded by her sisters-in-law, P (in the USA) and M (in the UK), and that funds were said to be available for the cost of private treatment in the UK. He considered there was no reason why these funds could not be provided to the appellant in Zimbabwe particularly as treatment would be cheaper there than in the UK. He concluded that the immigration rules made no provision for leave to be granted for the purpose sought and that under the applicable policy, this was not a case where exceptional leave should be granted.

5. An appeal was lodged against that decision and came before Mr Gillespie, sitting as an adjudicator at Hatton Cross on 21 October 2004. In support of her appeal, the appellant provided a statement dated 11 October 2004. She maintained that she had been born in Chigutu, a rural district about 110 km south-west of Harare. Her parents were alive and lived in Gokwe, several hundred kilometres west of Harare. They moved there in 1990. She claimed to have one sister and four brothers; a fifth brother had died the previous year. Her sister, J, was married and had four children. Her brother L was also married with two children. These siblings lived with their families in Gokwe. Her three younger brothers were unmarried and lived with their parents. Two of them were still at school. The rest of her siblings were unemployed. The appellant stated that she had lived in Gokwe until 1995 when she was married and went to live in Dema. She has two children. They are currently looked after by her sister-in-law, F. The appellant claimed that she and her family had always been MDC supporters. This had caused problems with food distribution in the village. When food arrived it was distributed according to a list drawn up by regional ZANU PF supporters who were able to identify the families who did not regularly attend their meetings. They were then put last on the list. She maintained that in August 2004 her brother-in-law was killed and his house was burnt down. The hospital refused to treat him because he was an MDC supporter and he died of his injuries. She stated that her husband had come here to visit his sister and had subsequently obtained a student visa to study English on a three-year course. He stayed with his sister M, with whom the appellant also lived after her arrival. M was recognised as a refugee in 2002. The appellant stated that her husband returned to Zimbabwe in August 2002 following the death of his father and was not receiving any treatment as there was none available in his area.

6. The Adjudicator found that the appellant would not have access to consistent and adequate ART in Zimbabwe and that her family was not affluent and could not guarantee financial assistance. He noted that the appellant’s mother-in-law was said to have fallen seriously ill while visiting P in the USA and the appellant maintained that the claim in her application form that she received £600 a month had been fabricated by her previous representatives. He found that on return to Zimbabwe it was likely that the appellant would live in circumstances of privation. He found that she would be unable to access private treatment. He considered there would be a rapid decline in the appellant's health on return and that life expectancy would be no more than one or two years at most as against a possible 10 years on her present regimen. He found that the appellant's husband lived in poverty and was unable to obtain medical treatment without production of a ZANU PF card. He lived in fear of threats of political intimidation. His brother had been killed the previous month and his house had been destroyed. He concluded that in the “peculiar circumstances” of this case the Article 3 threshold had been met and allowed the appeal. The determination was promulgated on 29 October 2004.

7. On 3 November 2004, the respondent applied for permission to appeal. It was argued that the adjudicator had failed to take into account the jurisprudence of the higher courts and that he had failed to reason how the appellant would fall into the exceptional category as outlined in N v Secretary of State for the Home Department [2003] EWCA Civ 1369 , given that she had family in Zimbabwe and that medical treatment, whilst expensive, would be available. Permission to appeal was granted on 25 January 2005. When the appeal came before Senior Immigration Judge Warr on 12 July 2006, he found with the consent of the parties that following the decision of the Tribunal in JM* Liberia [2006] UKAIT 00009 , the Tribunal was without jurisdiction as the appellant's removal was not imminent, this being a variation appeal.

8. Despite the agreement of the parties, the appellant's representatives sought permission to appeal to the Court of Appeal against that decision. It was submitted that JM was wrongly decided and the Tribunal had erred in concluding that on an appeal against a refusal to vary leave, the question of the compatibility with human rights of a hypothetical return was not justiciable. That application was refused by Senior Immigration Judge Jordan on 7 August 2006. A renewed application was made to the Court of Appeal on 27 August 2006. It was argued that as permission to appeal had been granted in the case of JM and was listed for hearing by the Court of Appeal, that the application in the instant case should have been stayed until judgment was issued in JM or should have been granted pending judgment. On 29 December 2006 Laws LJ ordered that the court was satisfied that the appeal should be allowed and remitted to the AIT for reconsideration before a differently constituted Tribunal on the basis of the statement of reasons which had been agreed by the parties. The statement said that following the Court of Appeal’s decision to overturn JM , the determination of the AIT in the appellant's case should no longer stand. The nature of the reconsideration was left open to the AIT.

9. Meanwhile, on 6 March 2006, the appellant claimed asylum. At her asylum interview conducted on 4 October 2006, she claimed to have been active with the MDC since its formation in 1999. She claimed that husband was also involved as were her family members. Her husband was known to the authorities as an MDC member as were his sisters. She maintained that she had attended rallies, distributed T-shirts, bandanas and leaflets and sold cards. She claimed to have been arrested three times. The first occasion was in 2000 when she had been selling T-shirts in Dema. She was taken to the police station and beaten with ropes and questioned for about two hours after which she was released. Her sister-in-law and some seven others had been arrested with her. She was told not to sell T-shirts in the future. The second arrest also took place in Dema in 2000. On that occasion she was attending a rally and she was one of many that were arrested. No further details were provided of this arrest or of the third. The appellant claimed that she had relatives here who were granted asylum in 2003 or 2004.

10. The asylum application was refused on 10 October 2006. An appeal was lodged against the decision and on 3 November 2006 the appellant prepared a statement, presumably in anticipation of her hearing. In that statement she gave the month of her birth as May, rather than June (this is corrected in the third witness statement). She also maintained that her student leave was given until the 30 November 2002 rather than 30 September 2002 which was previously claimed and which was evidenced by the copy of her passport. She also maintained that she was diagnosed as being HIV-positive in August 2002. She maintained that she made a successful application for discretionary leave. In her statements the appellant also maintained that both she and her husband remained active MDC members. Her activities were said to continue in the UK but are limited for financial reasons. She referred to three arrests in Zimbabwe all of which took place in 2000. The first detention lasted some two hours and occurred when she was taken to the police station for selling MDC T-shirts. On the second and third occasions she had been at rallies handing out MDC material. She maintained that she did not come to the UK with the intention of claiming asylum. In 2004 she was advised by her husband not to return because of the dangers she would face.

11. When the appeal came before an immigration judge at Hatton Cross on 8 December 2006 (coincidentally, it was IJ Gillespie who as an adjudicator had determined her human rights appeal), the hearing was adjourned because proceedings with regard to the human rights appeal were still outstanding. The asylum appeal was re-listed for 19 February 2007 so that the two matters could be merged. The February hearing was subsequently adjourned (it is unclear why) and the matter then came before Senior Immigration Judge Gleeson at Field House on 6 June 2007. She found that the adjudicator made a material error of law and that any difficulties the appellant may face in accessing medication did not meet the N threshold. She then proceeded to decide the substantive appeal but appears to have only decided the human rights issue. The appeal was dismissed by way of a determination promulgated on 23 July 2007. The asylum issues have never been determined.

12. On 3 August 2007 the appellant sought permission to appeal to the Court of Appeal on the basis that no material error of law had been identified. The application was refused by Senior Immigration Judge Batiste but granted on renewal by Sir Henry Brooke on 7 December 2007. The matter then came before Pill, Arden and Longmore LJJ on 18 July 2008. The court found that Senior Immigration Judge Gleeson had correctly identified an error of law by the adjudicator but that her subsequent approach could not be justified as there was material which required analysis. The matter was therefore remitted for a fresh hearing of the Article 3 claim. In so doing Pill LJ criticised the intemperate language used by the adjudicator and advised that a more substantial factual analysis was required to justify it. He stated: “If the general conduct of government is to be condemned in this way, a cogent statement of the factual basis for condemnation is required”. Arden LJ suggested that “great care would have to be taken to determine whether the lack of medical facilities or food is due to the infliction of deliberate harm on the appellants or whether the lack of medical facilities is due to a lack of national resources for this purpose. The Tribunal will also need to determine the level of seriousness of any actual or threatened harm and the cause of such harm. It may also need to determine whether any actual or threatened harm would be a serious if it were not for the appellant's medical condition”.

13. A Case Management Review hearing was then arranged. On 19 August 2009 the respondent was directed to consider this case, along with those of the other two appellants which had been co-listed, in the light of the determination in RN (Returnees) Zimbabwe CG [2008] UKAIT 00083 . This was done and the response from the respondent is dated September 2009. In this appellant's case, the Secretary of State considered that she had failed to establish the facts on which she wished to rely. It was noted that the appellant delayed making a claim for asylum by over seven years and that she had argued her case on medical grounds until the promulgation of RN . He noted that the appellant had lived with her sister-in-law who had successfully claimed asylum and that it was therefore reasonable to assume that she, herself, would have been aware of the option of claiming asylum. The Secretary of State noted the appellant had family in Zimbabwe and they were not subject to political intimidation. The appellant did not have a political profile in her own right; she was not subject to any targeted ill-treatment and would not have any profile with the authorities.

14. A third witness statement has been prepared by the appellant and is dated 19 January 2010. In it, she adopts her previous statements. She maintained that her family moved with her to Gokwe in 1992. She also maintained that she was unable to continue with her studies once they moved there. She mentioned for the first time that both she and her husband were arrested for distributing T-shirts and selling cards and leaflets. They were kept at the police station overnight and her sister-in-law, M, who had also been arrested with them, was raped by the police. The appellant claimed that she was touched by the police officers in a sexual way in front of her husband. Although she explained that she did not mention this in her 2004 statement because that application was only concerned with her ill health, she did not explain why it was omitted from her 2006 statement which was specifically prepared for her asylum appeal. She maintained that at “other times” she was arrested for a few hours when MDC meetings were broken up. Her husband was also arrested on these occasions. On two occasions she and her husband were held overnight. This was not mentioned before. On another occasion they were released in the evening after a few hours of detention.

15. The appellant said that because of her activities, she, her husband and their children were not included in food distribution. She maintained that her husband was arrested on more occasions than herself, and maintained that when her student leave was completed she saw that the situation in Zimbabwe was deteriorating and in order to find a way of remaining longer in the UK she decided to claim asylum. She maintained that her brother-in-law was killed in a house fire in August 2002 because he was an MDC supporter.

16. In her statement the appellant said that her husband, children, her husband's sister and her children survive on US $10 a month. They were denied food aid due to their MDC connections. In 2004 and 2008 during the time of the elections, ZANU PF thugs came to the house and beat them. Sometimes they had to go into hiding in order to be safe. The appellant was unsure whether her husband has been arrested since his return in 2002. In the last few months he has been bed ridden. The appellant maintained that her father died in 2004 and her mother in 2005. Her mother-in-law is supported by relatives in the USA and does not share the money with the appellant's husband. The appellant expressed concern that her husband is reaching the end of his life and hoped that her children can be reunited with her in the UK in the near future.

17. Dr Day’s medical report of 4 February 2010 confirms that the appellant is on the following regimen; Tenofovir, Zidovudine and Efavirenz. She remains a low grade Hepatitis B chronic carrier at very low risk of future complications. Her latest CD4 count on 1 February 2010 was 623 and she has a fully suppressed HIV viral load of less than 50 copies/ml. Her life expectancy is said to be less than five years if medication is stopped. EC

18. This appellant was born in Gutu; she grew up in Harare where she lived from the age of two with her parents and siblings. She attended school from 1971 until 1984 and left secondary school with seven O-levels. She then attended a secretarial college and obtained a diploma. In 1987 she commenced employment with a bank, remaining with them until December 2001. She separated from her husband in 2000 and he lived in South Africa until his death last year. Her two children remain living in Harare with her mother.

19. In September 2001 the appellant came to the UK for a short holiday to visit her mother's distant cousin, Mr M Manhuna; she refers to him as her uncle. He worked for the Zimbabwe High Commission in London. On 21 December 2001 she returned to visit him for Christmas. She maintains that she fell ill and was diagnosed with pneumonia. Tests were undertaken and she was diagnosed as being HIV positive. She maintains that she had no idea she was ill prior to this. Medical evidence dated 27 May 2002 from Southend Hospital indicates that she would, however, have had the disease for ten years or more. She then went to live with her cousins, Flo and Chipo, daughters of another uncle. She continues to live with Flo. She maintains that her mother is disabled following a stroke, her father is elderly and has limited means, her brother is deaf and cannot work and the family rely on a relative who provides them with maize. Her sister lives with her mother-in-law in a village. There are other distant relatives but they are all struggling to survive. The appellant has not felt able to tell any of her family that she is HIV positive.

20. On 5 June 2002 the appellant applied to remain in the UK in order to receive NHS treatment. Her application was accompanied by a letter from her uncle promising financial support for her studies. That application was refused on 25 June 2003. The Secretary of State considered that there were no provisions under the Immigration Rules to enable an applicant to remain to receive free medical treatment. The policy guidelines introduced on 19 December 2000 were considered. The Secretary of State considered that NHS resources were limited. He noted that the appellant had had the disease for many years, that she was fit to travel and that she had a family in Zimbabwe. He considered it was not suitable to grant exceptional leave in this case. An appeal was lodged on 2 July 2003. Articles 3 and 8 were relied on.

21. In September 2003 the appellant commenced a course of studies. On 6 October 2003 she then made an application to remain as a student. Her cousin, Chipo, undertook to finance her studies and to support her. The Secretary of State noted that section 3 C of the Immigration Act 1971 (as inserted by the Immigration and Asylum Act 1999 ) prevented the appellant from making a fresh application whilst an appeal was pending. However, her student application was treated as a variation of the original application and was then considered. The Secretary of State was not satisfied that the appellant met the requirements of the student rules as her college was not on the DfES register. Furthermore, there was no evidence to show satisfactory progress had been made. As the appellant had previously indicated that she wanted to remain indefinitely in the UK, the Secretary of State was also not satisfied that the appellant would leave the UK at the end of her studies. The application was therefore refused on 29 November 2006. On 6 February 2007 the Secretary of State wrote to clarify the position. He noted that as the student application had been made at a time when the appellant had no leave to be here other than under section 3 C of the Immigration Act 1971 , she could not seek to vary her leave during that period. As the original application had already been decided, it was no longer possible to seek to vary it and so there was no outstanding student application. In any event, the appellant has indicated in her witness statement that she does not wish to pursue this matter.

22. On 21 February 2007 the appellant’s representatives informed the Tribunal that the appellant wished to rely on asylum grounds. They indicated that the appellant’s previous advisers had told her she could only apply on medical grounds.

23. On 12 March 2007 the appeal came before Immigration Judge E B Grant at Hatton Cross. She heard oral evidence from the appellant but dismissed the appeal on asylum and human rights grounds in a determination promulgated on 10 May 2007. She also found that the appellant was not entitled to humanitarian protection. An application for reconsideration was sought and obtained by the appellant on 5 June 2007. The matter was heard on 7 September 2007 by Senior Immigration Judge Jarvis who found a material error of law in Judge Grant’s determination and ordered a second stage reconsideration. That took place before Immigration Judges Neuberger and Dawson at Taylor House on 18 March and 20 May 2008. In a statement prepared on 18 March 2008, the appellant maintains that her former partner has died in South Africa. She maintains that her mother’s cousin (Mr Manhuna) left London in 2005 and she does not know where he is. She believes he has retired. It is noted that she gave evidence to Immigration Judge Grant that his son lived in Northampton and that she had his telephone number and could contact her uncle through him. In a determination promulgated on 2 June 2008, the appeal was dismissed on all grounds.

24. On 17 June 2008 an application for permission to appeal to the Court of Appeal was made on the appellant’s behalf. The application was refused by Senior Immigration Judge Freeman on 26 June 2008. The application was renewed to the Court of Appeal but refused by Laws LJ on 21 August 2008. A further application was made and on 27 October 2008 Rix and Carnwath LJJ granted permission to appeal. On 17 March 2009 Rix LJ ordered by consent that the determination be set aside and the appeal be remitted for second stage reconsideration with all matters open.

25. On 2 September 2009 the Secretary of State responded to directions set at a Case Management Review hearing that the case be looked at in the light of RN . The Secretary of State noted that the appellant had delayed making an asylum claim for five years and had relied on medical grounds until the promulgation of RN . He noted that the appellant had family in Harare and that they were not subject to political intimidation. The appellant had no political profile and had never claimed political interest. There was no evidence to show that she would attract the adverse interest of the authorities on return.

26. A medical report from Dr Day at Southend Hospital dated 12 February 2010 confirms that the appellant has been under the care of that hospital since February 2002 when she requested a sexual health screen. There is no reference to any diagnosis of pneumonia. She was tested positive for HIV with a CD4 count of only 36. She also had seborrhoeic dermatitis and oral candida. She responded well to Efavirenz and Combivir. Her last test showed an HIV viral load count of less than 50 copies/ml and a CD4 count of 597. In April 2009 her medication was simplified and she takes one tablet of Atripla daily; this does not require refrigeration. Alternative drug regimes are expected to be effective in her case and an earlier report in February 2007 from Dr Day indicated that her medication could be adjusted to alternative drugs such as the most affordable ones in Zimbabwe. The cessation of treatment would put her life expectancy at less than three years. BR

27. This appellant is from Chitungwiza Town, an MDC stronghold. She first came to the UK on 16 February 2001 and was admitted as a visitor for six months. She returned to Zimbabwe on 9 March 2001 returning to the UK on 2 December 2001 when she was accompanied by her two grandchildren (children of her daughter S) and claimed to be visiting her other daughter, M, a student nurse. The Immigration Officer was told that S was living in Zimbabwe and had no intention of travelling to Zimbabwe as she could not get time off work. They were all admitted for six months. They all overstayed.

28. On 20 August 2002 the appellant sought to regularise her stay. It is not known what happened to the children. The appellant applied for indefinite leave to remain on compassionate grounds. An accompanying letter from her solicitor stated that she had been diagnosed with advanced HIV infection. In a later letter her solicitors notified the Home Office that the appellant was receiving £100 a fortnight in hardship money from Barnados. The appellant had two daughters in the UK, S in Leeds and M who was studying in Bristol. She had four sisters in Zimbabwe who lived with their families.

29. The application was refused on 14 April 2004. The Secretary of State considered that there were no provisions under the Immigration Rules to enable an applicant to remain to receive free medical treatment under the NHS. NHS resources were limited. The policy guidelines introduced on 19 December 2000 were considered. Overstayers would only be permitted to remain here to access free treatment in exceptional circumstances. The Secretary of State considered that the appellant was fit to travel and had a family in Zimbabwe. He considered that treatment was available in Zimbabwe. He concluded that a grant of exceptional leave was not suitable in this case.

30. As her leave had expired at the time she made her application, the appellant had no right of appeal on immigration grounds. She does not appear to have pursued her human rights claim at that stage. Nothing further was heard from her for over a year. Then on 5 July 2005 she applied for leave to remain as the dependant of a work permit holder (her daughter, M) who had permission to work here until 6 May 2009. The application was refused on 6 February 2007. The Secretary of State noted that only the spouses and children of work permit holders were allowed to remain as their dependants under the Immigration Rules. She could not remain as a dependent parent as her daughter was not settled in the UK. The other daughter was a failed asylum seeker. The appellant’s circumstances were considered under paragraph 395C but were not found to merit a grant of exceptional leave. The appellant’s application was also refused on human rights grounds. On 14 February 2007 the appellant lodged an appeal. Her appeal was heard by Immigration Judge Britton at Newport. Asylum does not appear to have been relied on and the appeal was dismissed on human rights grounds in a determination promulgated on 1 April 2007.

31. On 19 April 2007 an application for reconsideration was made on behalf of the appellant. On 1 May 2007 this was granted by Senior Immigration Judge Freeman who then sat with Senior Immigration Judge Jordan on 22 July 2007 to hear the matter. The panel decided that there was a material error of law in the determination and that the matter should be re-heard. It was conceded by the appellant’s representative that there was no realistic prospect of personal risk to the appellant on the basis of her individual history “outside the lack of favour that might be shown to her in connection with AIDS treatment”. It was flagged up as a possible country guidance case on the issue of the availability and distribution of medical treatment for HIV sufferers.

32. There followed the Case Management Review hearing common to all the appellants on 19 August 2009 following which the appellant’s case was considered under the RN guidelines by the Secretary of State. In a letter dated 2 September 2009 the Secretary of State found that the appellant had waited seven years to claim asylum. She had relied upon her medical condition until after RN had been promulgated. He noted that the appellant could be expected to have known about asylum previously as her daughter had been an asylum seeker. The appellant’s sisters in Zimbabwe did not suffer any form of political intimidation. The appellant had no political profile. It was not accepted that S’s husband had been a local MDC chairman as S’s asylum claim had been found to be a fabrication. The appellant would therefore be able to return safely to Zimbabwe.

33. On 17 February 2010 the appellant prepared a witness statement. She maintained that she lives with her daughter, M, who was a student. S now has indefinite leave to remain (according to the documentary evidence this was granted on 20 March 2008; the basis for this is not known). The appellant stated that she discovered that she was infected in June 2002 and that she then commenced treatment. She stated that two of her sisters in Zimbabwe had died five years earlier in an accident and she did not know whether the other two were alive or dead as they were displaced and she had lost contact with them. She maintained that M travelled to Zimbabwe in 2009 but had been unable to locate them. She stated that she is on new medication as she had developed a resistance to her previous regimen. She is currently taking Raltegravir, Atazanavir, Ritonavir and Truvada (Emtricitabine with Tenofovir). She also suffers from gastroesophageal reflux disease (GERD) and diabetes.

34. The appellant’s daughter, M, also provided a written statement on 17 February 2010. She confirmed that the appellant lives with her and her family, that she (M) works as a nurse and has a work permit valid until August 2010, that she will be able to apply for indefinite leave to remain in May 2010, and that her husband is also in employment. She stated that she returned with her husband and children to Zimbabwe for two weeks in 2009 to attend her husband’s grandfather’s memorial service. They stayed in a hotel apart from two days spent in her husband’s home village when they had to take food and water with them. She confirmed electricity blackouts and sewage problems. She stated that she went to look for her maternal aunts in Mbare but could not locate them. She maintained that she is responsible for her mother’s finance and accommodation and additionally provides her with £50 a week.

35. The medical evidence submitted in respect of the appellant shows that she has been treated for tuberculosis. She is making good response to ART. Different prognoses are made of her life expectancy if treatment were to be stopped. The letter of 13 August 2002 from Dr Stanley suggests it would be less than two years; his letter of 9 October 2003 suggests 3-4 years. A report from Dr Minton of 9 October 2009 states that the appellant is on a daily tablet of Truvada with Efavirenz at night. According to his 11 January 2010 report, the appellant has a resistance to the two main classes of HIV medication commonly used, particularly Lamivudine and Efavirenz. Her regimen was therefore changed to a complex one consisting of Raltegravir twice daily, Atazanavir once a day, Ritonavir once a day and Truvada once a day. At her last test on 29 December 2009, her HIV viral load was not detected and her CD4 count was 388. In his report of 25 February 2010 Dr Minton suggests that the only other alternative available to the appellant because of drug resistance would be Enfurvitide which is taken by injection and which he did not expect would be available in Zimbabwe. Case Management Review Hearing

36. A further Case Management review hearing for all three appellants was held on 19 October 2009. Following that hearing directions were sent out by Senior Immigration Judge Lane. It was noted therein that both the appellant and respondent took the view that the hearings were unsuitable for giving general country guidance (if necessary, updating RN ) in relation to returnees to Zimbabwe who were not HIV-positive. The hearings, originally set for 7-9 December 2009 were adjourned owing to the unavailability of expert witnesses and re-listed for 1-3 March 2010 when they came before this Tribunal. Appeal Hearing

37. We heard oral evidence from RS and EC on the first day of the hearing. RS gave her evidence in Shona through a court interpreter and EC gave evidence in English. Evidence of RS

38. The appellant confirmed that the contents of her three appeal statements were true and accurate and adopted them as her evidence. She was then tendered for cross-examination.

39. In response to questions put by Mr Thomann, the appellant confirmed that she had been born in Chigutu and that she had lived in Gokwe since 1990. She had a sister and four brothers all of whom lived in Gokwe. She had two uncles as well. Her parents had died. She was asked to explain the conflict in her written evidence as to which parent had died first. She stated that she had made a mistake with the dates. She clarified that she shared the same mother with her sister but that they had different fathers. She was asked to clarify the reference to stepsisters in the plural in her witness statement; she replied that she only had one. She confirmed that her husband had seven sisters and four brothers. Two of his brothers had died but the rest of his siblings were alive. Of his seven sisters, M lived in the UK and P lived in the USA. Her husband had stayed with M when he came to the UK and so had she. P used to support her financially so that she could attend college but no longer did so. She was referred to her application form in which she mentioned that her sister-in-law would assist her to obtain private treatment. The appellant stated that the lawyer who helped her with that application made a mistake when completing the form. M also assisted her with her studies but no longer provided any financial support because she had her own family and could not afford it.

40. The appellant confirmed that her husband had returned to Zimbabwe following the death of his father as he wanted to attend the funeral and pay his respects. He had family members he wanted to be with at the time. The appellant agreed that funds were sent by her sister-in-law to her mother-in-law in Zimbabwe but maintained that they were insufficient to help to support the appellant’s husband. Occasionally her mother-in-law might assist in supporting the appellant's children. She agreed that her mother-in-law had travelled abroad to visit her daughters but maintained that these were not luxury trips and she had only been abroad twice. Her daughters had funded the visits. She denied that there were people in Dema and Gokwe who were able to support her in Zimbabwe. She maintained, in fact, that as she was in the UK she was expected to help them. She agreed that if it were possible, the community provided support generally.

41. The appellant was referred to the determination of her appeal in 2002. She was reminded that she had claimed that her husband was not politically active or targeted for persecution. Her attention was drawn to a later statement where she claimed that she and her family had always been supporters of the MDC. She was asked to explain why she had not mentioned this in the context of her earlier human rights claim. The appellant explained that she had been dealing with her medical claim the first time and that she raised asylum when she made her second claim. She stated she could not remember being asked in the context of her first appeal whether her husband had any political involvement.

42. The appellant was asked why she made no mention in her first witness statement of being detained. She replied that she had not been asked about that. The appellant was asked to explain the apparent contradiction in her written evidence as to the duration of her detention in 2000 when she claimed she was beaten with ropes. She maintained that she had been arrested three times. She said one of those detentions lasted two hours and another was overnight. She said that she may have mixed up the dates. She could not recall whether the first detention lasted two hours or all night. She denied that she was providing more detail as time went by and explained that the accounts would be different as one was based on medical reasons and the other on asylum.

43. The appellant was shown a letter dated 14 April 2001 signed by the Provincial Youth Secretary and the Secretary of the MDC for Chitungwiza province. She explained that she used to attend youth meetings with her cousin and so was able to obtain this letter. She agreed with the contents of the letter which indicated that she had been victimised, arrested, tortured, had her home and property destroyed and was being hunted by ZANU PF so that she had to leave. She stated, however, that when she arrived here her intention had been to visit. The appellant was asked why there was no mention of the destruction of her home and property in any of her other evidence. She maintained that she had mentioned that the house she had lived in was destroyed. Reference was made to her witness statement in which it is recorded that her brother-in-law's house was destroyed in 2004. She maintained that that was the incident she had been referring to and that as she also lived in the same house, she considered it as hers as well. The appellant was asked to explain why she had made no mention in her statements of being hunted by ZANU PF officials. She replied that when she had been distributing leaflets she had been told that she would be arrested if caught again. That is what was meant. It was put to her that she had only been arrested when selling T-shirts or attending rallies. She denied that, maintaining that it was not only on those occasions. It was put to the appellant that she had not left Zimbabwe because of the actions of state agents. She replied that was not true. The appellant was referred to her asylum application form and reminded that she had been requested to provide full details for her departure. She was asked to explain why she had maintained at that time that her intention had been to visit the UK and why there had been no mention of being hunted by state agents. The appellant replied that the situation had deteriorated and she realised she could not return.

44. The appellant confirmed that her husband remained in Zimbabwe. She said he was not politically active because he was ill. She stated that she would be of interest to the authorities because of her asylum claim and the length of her residence in the UK. She stated that at the moment they had no interest in him because he was ill.

45. The appellant confirmed that Dema was an MDC stronghold. She was asked why, in those circumstances, there would be any need for someone to target her. She replied that there were still people around who supported ZANU PF.

46. The appellant confirmed that there were hospitals in Dema and Chitungwiza. She agreed that her children had been born in a hospital. She stated that Chitungwiza was about 40-45 kilometres from Dema and that it took about two hours by bus.

47. The appellant maintained that her case was that she would not receive medical treatment if she returned to Zimbabwe because she could not show support for ZANU PF. It was put to her that medical aid was distributed and controlled by NGOs. She agreed that could be the case but stated that it had to go through the healthcare system and hence the government. She expressed awareness that the health minister was with the MDC but stated that they had no control. It was put to the appellant that she had a choice of hospitals to which she could go if returned to Zimbabwe. She maintained that it was not possible to travel for treatment and gave the example of being unable to travel from Southend to Scotland for treatment. She maintained that if she was unable to receive treatment from Dema Hospital, she could not expect to obtain it in Chitungwiza. She maintained that some hospitals in Harare were closed because they had no medicine. That completed cross-examination.

48. In re-examination the appellant stated that her husband was not receiving any medical treatment and was very unwell. She explained that her first witness statement was made in support of her medical claim, the second in support of her asylum application and the third was a consolidated statement for this appeal. She stated that there was nobody who would be able to provide her with financial support in Zimbabwe. She was asked about the cost of travelling from Harare to Dema. She replied that she no longer knew what it would cost as she had been away for such a long time. That completed re-examination.

49. In response to questions from the bench, the appellant confirmed that her husband had not received any treatment since returning to Zimbabwe. She was asked to explain what had prompted her asylum application in 2006. She replied that when she thought about the beatings she had experienced and saw the news she was fearful of returning. She stated that her husband had returned to Zimbabwe in 2002. He had been able to grow vegetables for the first few years as he still had “medicine in his system” . In 2006 or 2007 his sister began to help him. When he left the UK he had a student visa but it expired during the time he was in Zimbabwe. He had no problems on his return because of his visa. She explained that she had not realised that she could make a joint claim on asylum and medical grounds; additionally she had thought the situation in Zimbabwe would improve. With regard to her third detention, she stated it was during the day. She was ill treated on all three occasions. Evidence of EC

50. This appellant gave evidence in English. She too adopted her three witness statements and was tendered for cross-examination.

51. She confirmed that she had arrived in the UK in December 2001 and that she had met the costs of the ticket herself. She had worked as a secretary. She came to visit her uncle who worked in the Zimbabwe High Commission in London. She did not know whether he had been appointed by the government. She had stayed with him when she came here and he provided her with financial support. She maintained that she had completed the application form of June 2002 herself. She said her uncle assisted her with the student application. He had returned to Zimbabwe in 2005. They were no longer in touch. He had retired and gone to his village. She had not really tried to make contact with him but had a cousin in Harare who was his niece and whom she could contact about him.

52. The appellant stated that she had a sister in Zimbabwe who lived in Chivu with her family. Her relatives received maize from a distant cousin who was involved with farming. She stated that she had two children who were both studying and were supported by their paternal grandmother ever since their father had died. She confirmed that she attended church in the UK but there was nobody there who would be able to assist her. She stated that she used to live with a cousin but now lived with a friend from church.

53. In re-examination the appellant stated that her sister was a widow. Evidence of Professor Barnett

54. Professor Anthony Spencer Barnett gave his professional address as the London School of Economics on Houghton Street. He confirmed that he had prepared two reports and that he understood his duties as an expert. He confirmed that the reports were true and continued to reflect his view although he had two amendments to make. The first was with regard to the availability of antiretroviral drugs in the private sector. Although he maintained in his report that such drugs were available he had discovered by way of a telephone conversation made on 18 February 2010 that in most cases such medication was not available. The second amendment was that he was no longer certain that medical staff were on strike as funds had now been made available to them. He stated that he had first travelled to Africa as a volunteer when he was 17 years old. He had trained in social sciences to PhD level. He developed an interest in AIDS in 1986 and had continued his work in infectious diseases since that time.

55. Professor Barnett explained that the National AIDS Council was set up by President Mugabe in 2003 with a view to distributing funds obtained through an AIDS levy providing care and treatment; a detailed description was provided in the report prepared for EC. The Chair of the Board was appointed by the President and although the former could then select members, the President could impose his will in the selection process and could appoint individuals who had not been recommended by the Committee. Appointees were likely to toe the political line. Further, the situation at national level had a direct influence on what happened at village level. The structure was such that the wards charged with co-ordinating activity as regards treatment and care at ground level, were influenced by the line taken at national level.

56. Professor Barnett was asked whether there were any constraints on the co-operation of NGOs in Zimbabwe. He replied that one should not assume that international organisations had the best information. For example, the World Health Organisation (WHO) worked on the basis of reports from the field and sometimes that evidence was anecdotal. He stated that when he had contact with the Red Cross recently, he received different responses from staff in Zimbabwe as opposed to those in South Africa. His informed guess was that this was because such organisations were concerned about their own existence and constrained by the niceties of diplomacy. He said that his own information came from a variety of sources ranging from people on the street to heads of organisations.

57. Professor Barnett stated that the Global Fund, based in Switzerland, raised money to distribute throughout the world with the purpose of combating killer diseases. It found that a large amount of money allocated to Zimbabwe had been misappropriated by the government. Although the funds were repaid after international pressure, they were now channelled through the UN Development Programme (UNDP) rather than the Bank of Zimbabwe. The Global Fund was a major donor of funds used to purchase antiretroviral drugs. It also provided drugs and trained staff. Although there was some procurement of drugs through the government program, most came from the Fund.

58. With respect to the evidence from the respondent regarding waiting lists, Professor Barnett stated that he understood waiting time to be longer than six months and indeed likely to be up to a year depending on what kind of treatment was sought. If it was first line treatment, then six to twelve months was reasonable. It depended on one's place of residence as well. If second line treatment was sought then the wait could be longer. He was asked whether people already receiving treatment were prioritised for the purpose of obtaining medication. He stated he found this question difficult to answer. He had discussed it with “someone who should know” but they did not know. He had looked at the WHO position and although they confirmed there was such priority, he was not convinced that this happened as no mechanism for that priority to operate existed.

59. Professor Barnett confirmed that he had made recent enquiries of pharmacists in the private sector in Zimbabwe about the availability of drugs taken by the appellants. He had spoken to someone called Benjamin at the Cameron Pharmacy and to someone called Tenda at Avondale Pharmacy. He had enquired as to whether the medication could be obtained within the next two or three days and he had received the following information. RS’s medication of Tenofovir was not available, Zidovudine was available, and Efavirenz was available at one pharmacy but not at the other. EC took Atripla which was a combination of three drugs: Efavirenz, Emtricitabine and Tenofovir. Efavirenz was available but the other two were not. For BR, Atazanir, Truvada and Ritonavir were not available. Raltegravir was a newly introduced drug which was extremely expensive and not available anywhere in Africa according to his enquiries. He confirmed that the cost of medication had not altered significantly since the preparation of his report.

60. Professor Barnett was asked for his view on whether political support affected the distribution of medication. He indicated that in the March 2008 elections, 52.5% had voted for the MDC and 47.5% for ZANU PF. One would therefore expect to see a 50-50 distribution. The evidence from the respondent, however, indicated that the ratio was somewhat higher in provinces that voted in favour of ZANU PF, such as Central Province, Mashonaland East and West.

61. He confirmed that he had read the report prepared by Dr Naomi Mujuru-Mvere and that he agreed with what she had said about local political control over the processes by which people get to see doctors or NGOs and about the unhealthy nature of life in Zimbabwe.

62. Professor Barnett was then asked about the oral evidence of RS with respect to the claimed destruction of her home. He stated that he had studied the anthropology of this area many years ago and that it was common for land and property to be jointly owned by a group or lineage. Therefore although the appellant described the property as being owned by her uncle (sic), it would have been owned by the entire lineage. That completed his examination in chief.

63. Professor Barnett was then cross-examined by Ms Grey. He confirmed that the Global Fund targeted remote regions of Zimbabwe. It was put to him, that in those circumstances, to suggest the imbalance between the distribution of medical treatment between MDC and ZANU PF areas was due to political allegiance was an unsophisticated method of analysis given that the criterion for funding was the remoteness of the district. Professor Barnett stood by his analysis. He maintained that there was an imbalance of aid and that he had considered voting and population density.

64. Professor Barnett agreed that his evidence was obtained from discussions with people and visits made to South Africa. He confirmed that he had not been in Zimbabwe since the year 2000. He had some important contacts, someone who spoke directly with the president but whose identity he could not reveal, and officials working in international agencies, NGOs in Zimbabwe and personal friends. He also met with Zimbabweans in South Africa, both professionals and refugees, and he met Zimbabweans in the UK.

65. He agreed that he had no medical qualifications but anyone who had worked in the AIDS field for as long as he had done, was aware that if a patient's CD4 count dropped below 250, there was a greater risk of opportunistic infections, particularly if they had been suffered in the past. When it was put to him that Dr Day did not suggest in his report that EC was at an elevated risk of ill health because she had contracted opportunistic infections in the past, he contended that Ms Grey had no understanding of an AIDS diagnosis. He explained that in many African countries people had witnessed friends and relatives dying of AIDS and had a good understanding of what conditions such as candida and dermatitis could lead to.

66. Professor Barnett agreed that at the time he prepared his report, the drugs were available. He had used the same definition of availability at that time as he did now. He did not make enquiries about any other drugs that might be available. He also made no enquiries about the availability of drugs during a different timescale. He explained, however, that his evidence showed the volatility of supply. He had no doubt that some drugs might be available today, however the point was that someone seeking treatment could not be sure that they would always be available. He confirmed he had had a single conversation with each pharmacist on 18 February 2010. The information based on his report regarding the availability of drugs was also based on a single conversation. He accepted that the respondent's evidence indicated that on 11 February 2010 Truvada was available. He confirmed that he had no disagreement with the cost analysis set out by the respondent. With respect to the new drug taken by BR, he indicated that it could not be imported to Zimbabwe as it had not been approved for importation as yet. He agreed that he had not specifically made enquiries about the drug and its licence, but he had been told it was not available in Africa. He questioned the definition of availability used by the Ministry of Health in the documentary evidence provided by the respondent. He stated he had no doubt that these drugs would be obtained but he did not know what ‘available’ meant. He agreed that by a volatile supply, he meant that drugs were available erratically. He agreed it would be reasonable to assume that whilst some drugs may not be available in some pharmacies in Harare, they could be available in others. He stated, however, that one could not be sure.

67. Professor Barnett was asked whether it was fair to say that there were some improvements in the economic situation. He agreed that there was improvement but pointed out that it was uneven. Although businesses had picked up and salaries were being paid, there was no improvement for those who were unemployed, and four or five million were dependent on food aid. He agreed that wages were now paid to public sector employees and that they had increased from $100 a month to $150 a month.

68. Professor Barnett maintained that food distribution was restricted to supporters of ZANU PF. Although he acknowledged that the food programme was under the control of international agencies and NGOs, and therefore contrasted with the situation in 2008, he stated that food had to be distributed through the local structure and that was when political influence came to bear. He stated that a document from local administration was needed to obtain a supply of food. Sometimes, party allegiances and interpersonal relationships impacted on the ability to obtain such authorisation. Professor Barnett was asked to explain how that meshed with his claim in his report that NGOs operated effectively. He indicated that was not what he meant. He stated that there was less bias in the urban areas. It was put to him that EC would be returning to Harare and so would be unlikely to face any substantial bias regarding food aid. He agreed that was a reasonable conclusion if vouchers were to be relied on. With regard to BR's return to Chitungwiza, he replied that he had never been there and could not help. It was pointed out that Chitungwiza was an MDC seat and that there would be people willing to identify supporters of the MDC for the purposes of obtaining an authorisation document for food aid. He replied that may be the case but one could not be sure that the town hall or village council had altered its complexion and it may be that the administration or local authority was different to the political seat of the area. As to whether it was reasonable to assume that there would be an MDC MP or someone else to turn to for assistance, he was unable to say.

69. Reference was made to the comment of the Minister of Agriculture who threatened to ban NGOs. The point was made that this had not yet happened. Professor Barnett agreed but stated that it indicated the kind of environment in which NGOs were operating. By threatening their work, the minister was moderating what they had to say. He agreed that nevertheless NGOs had to show transparency and effectiveness in their work if they were to maintain international integrity. He agreed that that might justify an employee's reluctance to identify himself.

70. Ms Grey suggested that there was little reason to suppose that those operating in health centres necessarily had political allegiance to ZANU PF. Professor Barnett disagreed and stated that the further out one went in the structure, the more likely it was that one would find ZANU PF supporters, whereas those closer to the Minister were more likely to be from the MDC. He said there was no conflict between individuals supporting President Mugabe but striking because they had not been paid. When it was put to him again that there was no real evidence that health workers favoured ZANU PF supporters over the MDC when it came to access for treatment, Professor Barnett stated that people working in the Town Hall may be fossils of the old regime. He described the situation as being akin to Belfast in 1987 when the Catholics complained about discrimination. He agreed that about a third of those requiring treatment were now receiving it and that the situation was probably improving but he maintained that the estimates of the Global Fund were based on a mathematical model and one did not know the reality of the situation. He also wondered how the figures provided by the Ministry of Health had been compiled.

71. It was put to Professor Barnett that his objections to the prioritisation of patients already on ART appeared to be based on the lack of information he had about how that could operate and that he could not therefore say with any certainty that the information from the respondent was not true. Professor Barnett replied that if he was not in a position to know, neither was the Secretary of State.

72. He agreed that the funds misused by the government were returned to the Global Fund following international pressure and that the UNDP had taken over control of distribution but he maintained that the government could not be trusted and that it would not take kindly to having part of its economic system re-colonised.

73. Professor Barnett was referred to a claim in his report that supplies of available drugs may be diverted by ZANU PF personnel. He confirmed that the source of that claim was information from people in South Africa and also from Zimbabweans in the UK and some news reports. He maintained that medical personnel were stealing and selling drugs and that radio stations and the press were inflaming feelings. It was pointed out to him that he had maintained in his report that such incidents occurred in rural areas and therefore did not apply to the situation of the appellants. He disagreed. He stated that such events also happened in urban areas. When asked for evidence of that, he stated that he had received such reports from people. It was pointed out to him that in his report he had repeatedly referred only to rural areas. He replied that that did not mean it did not happen in urban areas.

74. Professor Barnett agreed that many Zimbabweans had fled their country for economic reasons. He was asked why they should not be assumed to be economic migrants on return. He stated that the Mugabe regime thought of those who fled as traitors and opponents of the regime. He agreed he had little independent knowledge or expertise on the issue of political violence. That completed cross-examination.

75. In re-examination Professor Barnett confirmed that he had attended AIDS conferences, had written a book on the subject, had contact with leading scientists and had studied the science of HIV. He agreed that he did not have knowledge on other aspects of medicine. He confirmed that about 40% of opportunistic infections in Africa were tuberculosis cases. He explained that if medication were to be interrupted, there would be an explosion of resistant strains of the virus. This would happen if a patient missed more than two days a month. However, if a longer period of medication were to be missed, then the patient could return to the situation he was in when he first commenced treatment. He stated that Efavirenz was not suitable for those of African heritage as they became really ill and that when it was taken here, they could be supervised. He pointed out that in the information from the Ministry of Health, there was an attempt to maintain that CD4 counting machines were not needed. With regard to NGOs, Professor Barnett stated that they walked a fine line; balancing threats by ministers with the need to provide a service to the society in which they worked.

76. In reply to questions from the bench, Professor Barnett explained that it would take between four and six weeks for drugs to leave the patient's system if medication were to be stopped. He expressed surprise at the fact that RS’s husband was still alive. He agreed that it was possible that some of the informants he obtained information from may have their own agenda. He stated that he did not ask for their political allegiance and they may be critics of the government.

77. He confirmed in response to a question then put by Ms Monaghan, that the existence of an agenda on the part of his informants did not impact on his judgement. He stated that he asked questions about the sources of their information. Evidence of Andrew Jones

78. The last witness we heard from was Andrew Jones, First Secretary for Migration at the British Embassy in Harare, called as a witness by the respondent. Mr Jones gave oral evidence via video link from Harare. He confirmed he had responsibility for policy issues in Zimbabwe and South Africa and that he had prepared two reports, both of which he relied upon. He agreed that he had no direct involvement in the health care system in Zimbabwe. He confirmed that all the interviews which had been summarised in his report were conducted in person except for one which was carried out by e-mail. He then collated the information which was agreed with his informants and prepared his report. He had selected his sources as being those whom he assessed to be able to provide the most information. He confirmed that four organisations did not want their identity or the name of the informant to be released. He confirmed that the contents of his report were true to the best of his belief. He confirmed that he had visited the Avenues Clinic in Harare. He had been taken to the store room and was shown the stock of medication. He stated that it was possible to obtain a fairly wide variety of drugs through the private system. One could take a prescription to any pharmacy. Some drugs were ordered from South Africa but he was not aware of the timescale involved.

79. Mr Jones confirmed that with respect to his second report which provided a response to Dr Kibble’s report, he obtained information from other Embassy colleagues.

80. He was asked about a report that the Minister for Agriculture had banned NGOs from distributing food aid. He replied that the embassy had received no reports that food aid had been banned and there was no information forthcoming from NGOs to confirm that this had happened. He also had no information that a Food for Work Programme had been introduced.

81. Mr Jones was then cross-examined by Ms Monaghan. He explained that the terms of reference for his reports had been set in agreement with the UK Border Agency, Country of Origin Information Service and the Asylum Team. He confirmed that he had selected individuals for questioning. He had been pointed in the right direction by his colleagues. Further, some individuals he had interviewed had recommended others. If more time had been available, there would have been more interviews. He agreed that the list of questions had been attached to the report. The same questions were put to all interviewees but fewer were put to the individual interviewed by e-mail. He confirmed that his report had been prepared as a result of reliance on the responses he had received. He agreed that he had prepared notes rather than a verbatim transcript. After summarising the replies, he read them to his informants so that any amendments or additions could be made. He did not seek to filter information deliberately. He confirmed that the individual he interviewed at the WHO did not want her identity to be disclosed. He did not ask why and guessed that this might be for a variety of reasons. He could not speculate on what they might be. He agreed that one of the replies had been that not every facility had a CD4 counting machine available. He had not sought to check that information against other informants. It was pointed out to him that this information and information about long waiting lists and the politicisation of access to ART had not been mentioned in his report. He replied that he was unable to confirm this immediately but accepted that this was possible. He confirmed it would probably just have been an oversight. He stated that he had not included the identity of the individual from the Ministry of Health because he had not been given permission to use that individual’s name. He had asked but had not yet received a response.

82. With respect to the interview conducted with the Ministry of Health official, he explained that questions were asked but he then realised that the full list of questions had not been put so he then contacted the individual by e-mail but had not yet received a response to the other questions. He had made two attempts to obtain the information, once was before Christmas and the second time was in January.

83. Mr Jones confirmed that where no answer was recorded in an interview, that meant that the respondee had declined to answer the question. He was asked why certain sentences had been redacted. He replied it was because they would have given an indication of the identity of the interviewee.

84. Mr Jones agreed that the only people he interviewed were in Zimbabwe. With regard to his conclusions he accepted that not all interviewees had been asked the question about withholding drugs and therefore it was not right to say that no issues about that had been raised. He agreed that the issue of stigma had not been explored. He confirmed that documents had been attached to his report and that he did not undertake extensive research. He agreed, with regard to his second report, that he was not in a position to comment on whether the observations and responses made by others to Dr Kibble and Professor Ranger’s reports were valid. He confirmed that he had chosen the extracts from the DfID report that pertained to HIV. That concluded his evidence.