Decision on merits; Subjects: CIVIL AND POLITICAL RIGHTS, SWEDEN; [CCPR: UNO-Pakt II, Internationaler Pakt über bürgerliche und politische Rechte; Pacte international relatif aux droits civils et politiques; Patto II]
Volltext (verifizierbarer Originaltext)
GE.26-04569 (E) 060526 070526
Human Rights Committee
Views adopted by the Committee under the Optional
Protocol, concerning communication No. 3724/2020*, **
Communication submitted by:
E.B. (represented by counsel, Elin Edin)
Alleged victim:
The author
State Party:
Sweden
Date of communication:
20 February 2020 (initial submission)
Document references:
Decisions taken pursuant to rules 92 and 94 of
the Committee’s rules of procedure, transmitted
to the State Party on 19 March 2020 and
1 December 2022, respectively (not issued in
document form)
Date of adoption of Views:
11 March 2026
Subject matter:
Deportation to Albania
Procedural issue:
Level of substantiation of claims
Substantive issues:
Torture; cruel, inhuman or degrading treatment or
punishment
Articles of the Covenant:
6 and 7
Article of the Optional Protocol:
2
1.1
The author of the communication is E.B., a national of Albania born on 19 April 2005.
He claims that his removal to Albania would amount to a violation of his rights under articles
6 and 7 of the Covenant. The Optional Protocol entered into force for the State Party on
23 March 1976. The author is represented by counsel.1
1.2
On 19 March 2020, pursuant to rule 94 of its rules of procedure, the Committee, acting
through its Special Rapporteurs on new communications and interim measures, denied the
author’s request for interim measures to allow him and his mother to return to Sweden to
continue his medical treatment.2
* Adopted by the Committee at its 145th session (2–19 March 2026).
** The following members of the Committee participated in the examination of the communication:
Tania María Abdo Rocholl, Wafaa Ashraf Moharram Bassim, Rodrigo A. Carazo, Yvonne Donders,
Laurence R. Helfer, Konstantin Korkelia, Dalia Leinarte, Bacre Waly Ndiaye, Hernán Quezada
Cabrera, Akmal Saidov, Ivan Šimonović, Soh Changrok, Tijana Šurlan, Teraya Koji, Hélène
Tigroudja and Imeru Tamerat Yigezu.
1 The author was not initially represented by counsel and the communication was submitted on his
behalf by his sister; he retained legal representation on 8 September 2022.
2 At the time of the submission of the complaint, the author had been deported from Sweden.
United Nations
CCPR/C/145/D/3724/2020
International Covenant on
Civil and Political Rights
Distr.: General
7 May 2026
Original: English
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1.3
On 1 December 2022, pursuant to rule 94 of its rules of procedure, the Committee,
acting through its Special Rapporteurs on new communications and interim measures,
requested the State Party to refrain from removing the author to Albania while his case was
under consideration by the Committee.3
1.4
On 8 May 2023, the Committee, acting through its Special Rapporteurs on new
communications and interim measures, denied the State Party’s request to discontinue the
communication and decided to suspend the communication while the author’s renewed
asylum application was pending in the State Party. The suspension of the communication
was lifted on 11 June 2024.
Facts as submitted by the author
2.1
The author notes that he has been diagnosed with hydrocephalus (for which he has a
shunt), infantile autism, spastic dyspnoea of cerebral origin, tics, generalized epilepsy, sleep
hyperactivity, delayed psychomotor development and musculoskeletal contractions.
2.2
The author was diagnosed with hydrocephalus at 8 months of age. He was treated at
a hospital in Tirana, where he underwent surgery to place a shunt in his head to stop water
from draining into his brain. However, he states that the doctors in Albania refused to treat
him further. His family was told that it would be a waste of time to seek medical treatment
because of his bleak prognosis. He never learned to speak or walk. In addition, the muscles
in his legs and wrists did not develop normally.
2.3
The author’s mother decided to leave Albania to seek medical treatment for the author.
After they arrived in Sweden in 2012, the author needed emergency surgery to correct the
shunt in his head as it no longer functioned properly. If the surgery had not been conducted,
he could have died. The doctors in Sweden replaced the old shunt with a new one. Following
the surgery, the author began attending a school for students with disabilities in Sweden. He
was provided with support staff and aids to assist him.
2.4
On 27 April 2012, the author’s family applied for asylum in Sweden; the application
was rejected on 16 November 2012 by the Migration Agency. The decision was appealed to
the Migration Court and to the Migration Court of Appeal, which rejected the appeal on
29 August 2013 and 25 October 2013, respectively. The author and his family subsequently
submitted four applications for residence permits citing impediments to the enforcement of
the expulsion order, pursuant to chapter 12 (18) and (19) of the Aliens Act, which were all
rejected. The enforcement of the expulsion order was handed over to the police authority, as
a voluntary return was deemed not possible. The family’s expulsion order was enforced on
13 January 2016, and they were deported to Albania.
2.5
In February 2016, the author and his family returned to Sweden, where they stayed
without legal residence status. On two occasions they applied for residence permits, but the
applications were rejected. After their initial expulsion order became statute-barred, they
reapplied for asylum, on 2 November 2017. The Migration Agency rejected the application
on 27 July 2018, and the decision was upheld on appeal by the Migration Court and the
Migration Court of Appeal on 31 October 2018 and 30 November 2018, respectively.
2.6
The author and his family subsequently submitted three applications to the Migration
Agency for residence permits, citing impediments to the enforcement of the expulsion order.
However, their applications were rejected by the migration authorities. The new expulsion
order was enforced on 22 November 2019, and the author and his family were again removed
to Albania. The author claims that throughout the domestic proceedings, the State Party’s
authorities were provided with ample evidence from Albanian medical professionals that the
medical treatment and medications the author needed were not available in Albania, and he
argues that although he qualified for protection under Swedish legislation, his applications
for protection had been rejected.
3 At the time, the author and his mother had returned to Sweden.
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Complaint
3.
The author claims that the State Party violated his rights under article 7 of the
Covenant by deporting him to Albania twice, a country where he claims he cannot obtain
adequate medical treatment, or medication for his epilepsy. He further states that he has
severe health problems and his life may therefore also be at risk owing to a lack of adequate
medical care if he is removed to his country of origin, amounting to a violation of his right
to life under article 6 of the Covenant.
State Party’s observations on admissibility and the merits
4.1
In a note verbale dated 19 November 2020, the State Party submitted its observations
on the admissibility and merits of the communication. It submits that the complaint should
be found inadmissible for failure to substantiate the claims for the purposes of admissibility.
4.2
The State Party provides information on the domestic proceedings. The author and his
family first applied for asylum in Sweden in 2012, based primarily on the author’s state of
health. Their applications were rejected by a final decision on 25 October 2013. The authors
subsequently submitted four applications for residence permits, with requests for new
examination pursuant to chapter 12 (18) and (19) of the Aliens Act, which were all rejected.
The expulsion order was enforced on 13 January 2016.
4.3
On 6 February 2016, the author and his family returned to Sweden. They again
submitted applications requesting residence permits or a new examination pursuant to chapter
12 (18) and (19) of the Aliens Act. The applications were rejected. After their expulsion order
became statute-barred, they reapplied for asylum, on 2 November 2017. Their applications
were again rejected by the Migration Agency, the Migration Court and the Migration Court
of Appeal on 27 July 2018, 31 October 2018 and 30 November 2018, respectively. The author
and his family submitted three applications requesting residence permits or a new
examination pursuant to chapter 12 (18) and (19) of the Aliens Act, which were all rejected,
and the new expulsion order was enforced, on 22 November 2019.
4.4
The State Party argues that in the present case there is no reason to conclude that the
domestic rulings were inadequate or that the outcome of the domestic proceedings was in any
way arbitrary or amounted to a denial of justice. It further submits that in the domestic
decisions the migration authorities paid due regard to the principle of the best interests of the
child and considered the consequences that an expulsion order might have for the author’s
health.
4.5
The State Party notes the author’s claim that the expulsion order violated his rights
under article 7 of the Covenant due to his state of health. It refers to the Committee’s
jurisprudence in Z. v. Australia,4 in which the Committee indicated that an author’s medical
condition must be of an exceptional nature for it to trigger a State Party’s non-refoulement
obligations under article 7 of the Covenant. In addition, the State Party refers to the
jurisprudence of the European Court of Human Rights in Paposhvili v. Belgium,5 in which
the Court noted that “only very exceptional circumstances” may raise an issue under article
3 of the Convention for the Protection of Human Rights and Fundamental Freedoms
(European Convention on Human Rights) in a health context, and in which it stated that such
circumstances should be understood to refer to situations involving the removal of a seriously
ill person in which there are substantial grounds for believing that the person, although not
at imminent risk of dying, would face a real risk, on account of the absence of appropriate
treatment in the receiving country or the lack of access to such treatment, of being exposed
to a serious, rapid and irreversible decline in his or her state of health resulting in intense
suffering or to a significant reduction in life expectancy.6
4 CCPR/C/111/D/2049/2011, para. 9.5.
5 Application No. 41738/10, Judgment, 13 December 2016.
6 Ibid., paras. 136 and 183.
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4.6
The State Party notes that in the author’s case the migration authorities examined
whether the enforcement of the author’s expulsion order would violate article 3 of the
European Convention on Human Rights due to his cited medical condition and concluded
that it would not. According to the domestic decisions, the author suffers from congenital
hydrocephalus, and he underwent surgery for the insertion of a shunt in January 2006 in
Tirana. In 2013, he underwent a second shunt procedure in Sweden. He was assessed for
habilitation during his time in Sweden and underwent an operation in July 2018 that was
conducted to check and regulate his shunt. He attended a special school in Sweden and
received extensive assistance with his daily needs.
4.7
As regards the assessment in the domestic proceedings, the migration authorities
found that the situation in Albania could not be considered such that an individual health
condition such as that suffered by the author could give rise to treatment constituting grounds
for protection. In making that assessment, consideration was given to the fact that the author
had received care in his country of origin and had also been able to return there without being
subjected to treatment constituting grounds for protection. As evidence of the claim that care
for hydrocephalus is not available in Albania, the author submitted, during the domestic
procedures, copies of four certificates allegedly issued by the Albanian health ministry, three
of them ostensibly issued by the minister responsible for health. The certificates stated that
the surgical procedures and follow-up care that the author needed could not be offered in
Albania because the equipment required for inserting shunts was lacking. In its decision dated
27 July 2018, the Migration Agency questioned whether a health minister would issue
certificates such as those submitted. Furthermore, it was noted that copies generally have
lower probative value than original versions of certificates. It was also noted that the
certificates did not contain any reason why the necessary care could not be offered in Albania.
In this context, it was noted that the author had undergone a shunt procedure in his country
of origin in 2006, and that he had thus received care for hydrocephalus in Albania. It was
observed that there was no information indicating that access to such care had deteriorated
since. The author was thus not considered to have shown that care had ceased to be available
or had dramatically deteriorated in the country.
4.8
Furthermore, the Migration Agency made a medical country of origin information
(MedCOI) enquiry during the domestic asylum procedure, and the response indicated that
care was available in various institutions in Albania, including at the Mother Teresa hospital
in Tirana, where neurosurgeons at the hospital confirmed that care for hydrocephalus was
still carried out and that special schooling was available at an institute for “handicapped”
children in Tirana. The Migration Agency thus noted that there was no support in the relevant
medical country of origin information for the claim that adequate care or habilitation was
lacking in Albania for the type of medical care needed by the author.
4.9
In their decisions, the migration authorities also took into account the author’s
adaptation to life in Sweden. In this respect it was noted that his father was residing in Albania,
as were other relatives. It was found that it would not be contrary to his best interests to be
with both of his parents, and his family network, in his country of origin and that it would
not damage his psychosocial development to return to Albania. The State Party submits that
the author thus did not demonstrate that the migration authorities failed to take into account
relevant facts or risk factors in their assessments, and also submits that he has not shown that
the authorities’ assessments were arbitrary or amounted to a manifest error or denial of justice.
Author’s comments on the State Party’s observations on admissibility and the merits
5.1
On 14 October 2022, the author submitted his comments on the State Party’s
observations. He maintains that the communication is admissible, and he reiterates his claims
as presented in his initial complaint.
5.2
The author informs the Committee that at the time of the submission of the complaint,
he had already been deported to Albania, but that he has since returned to Sweden and is now
facing a risk of being removed from the State Party again under the previously issued
deportation order.
5.3
The author notes, in addition to infantile autism, hydrocephalus, epilepsy and the other
conditions referred to above, he has been diagnosed with a serious mental developmental
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disorder, spastic diplegic cerebral palsy, contractures of the hip knee and elbow joints, tonic-
clonic seizures and sensorineural hearing loss. He states that his shunt is vital and that when
he was deported to Albania, he was denied care at the only clinic in Tirana that treats his
condition.
5.4
The author provides further information on his medical conditions. He notes that
during the surgery he underwent at 8 months of age in Albania to treat the hydrocephalus,
the shunt was inserted in the third brain ventricle. After the operation, only one check-up was
conducted, even though regular check-ups are required for growing children, because over
time the shunt becomes too short and stops functioning. The author was unable to walk or
talk, and his mother stayed at home to care for him. There was no access to school, training
or physiotherapy in Albania. When the author was 2 years old, it was discovered that his
testicles had not migrated down into the scrotum, but it was decided to wait before having
surgery.
5.5
The author also provides further information on the medical procedures he underwent
in the State Party. In the summer of 2012, the family travelled to Sweden and applied for
asylum for the first time. In October 2012, magnetic resonance imaging (an MRI) was
performed in Sweden which showed very pronounced hydrocephalus. Surgery to change the
shunt was done in February 2013, whereby it was found that the old shunt had no adjustable
valve. A new shunt with an adjustable valve was inserted, so that the pressure could be
reduced. In May 2013, the author also underwent surgery for his hip, knee and ankle
contractures. The author started to be able to move on his knees, supported by his hands, but
this did not last long, and he was again unable to move on his own. In 2015, the author
underwent surgery to bring his testicles down to the scrotum.
5.6
In 2016, the family was deported to Albania for the first time. After one week, the
author fell ill with fever and vomited and also hit his head. When the family brought him to
Mother Teresa hospital in Tirana, he was denied care, as the staff stated that he was too ill.
In February 2016, after three weeks in Albania, the family returned to Sweden as they had
received no help in Albania, despite having tried. In 2018, the author underwent surgery on
both his feet. He also underwent a shunt revision as the shunt catheter to his abdomen was
found to be dislodged just below the valve.
5.7
On 2 November 2017, the family reapplied for asylum in the State Party. The
application was rejected on 27 July 2018 by the Migration Agency, which stated that the
author could access medical care in Albania.
5.8
In November 2019, the author was removed to Albania for a second time, after his
applications citing impediments to the enforcement of his removal order were rejected. After
the removal he lived in poor conditions for two years and did not have access to healthcare.
He had no bed and lay on a mattress pad on the floor. He was fed, washed and diapered on
the mattress, and was not able to leave the house as he cannot walk. He also could not use
his wheelchair in the house because it was too cramped. During the first three months back
in Albania he had several epileptic seizures but could not access medication for the seizures.
During seizures he bites himself and his mother, punches his head and is in severe physical
pain. He has subsequently been taking the required epilepsy medication Absenor, but he
gained access to said medication only after it was sent to him by a non-governmental
organization (NGO) in Sweden, as he was not able to access the medication in Albania. It is
difficult for his mother to care for him due to his weight (130 kg) and because his mother is
getting older. The author further refers to a medical certificate issued on 22 September 2022
by an Albania health centre, in which it is stated that after his return to Albania in 2019, the
author did not receive any medical treatment or habilitation in Albania as the required
medication was not available in the country.
5.9
The author argues that being removed to Albania again would put his life and health
at serious risk due to his poor health and the lack of adequate care in Albania. He refers to a
medical certificate signed by a chief physician, issued at the medical centre he has been
treated at in Sweden, dated 27 July 2022, in which it is noted that in Albania he did not have
access to the right medicine, to neurosurgery assessments or to orthopaedic help, including
operations. It was also noted in the certificate that the author needs such resources, which
were provided to him in the State Party but not in Albania, for his health and thus his survival.
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The author further refers to a medical certificate issued on 17 February 2022 by another
medical doctor in Sweden, in which it is noted that without adequate seizure medication and
regular monitoring of the shunt, the author would be at risk of dying. It is further noted in the
certificate that the author has diagnoses for several chronic conditions for which there is no
curative treatment and that if he does not receive continuous care, medications and regular
checks of the shunt, his chances of survival will decrease.
5.10
The author asserts that available country information indicates that vulnerable groups
in Albania, such as children with disabilities, have limited access to medical care.7 He argues
that as his mother would be unable to care for him on her own, he would be at risk of
institutionalization upon return to Albania. He further notes that during their asylum and
residence applications, the family submitted four certificates from the ministry responsible
for health in Albania to substantiate that treatment for hydrocephalus is not available in
Albania. The certificates state that the surgical procedures and the subsequent care the author
needs cannot be offered in Albania because the equipment needed for the shunt is not
available. The Migration Agency questioned whether the health minister would issue such
certificates and deemed them to be of low probative value. The author argues that it would
however have been easy for the migration authorities to contact the ministry to have the
documents verified. He argues that apart from an inadequate shunt operation in Albania in
2006, he did not have access to further care in Albania between 2006 and 2013 and was also
denied care in 2019 after his removal to Albania. He additionally notes that he has lived in
limbo almost his entire childhood. He has experienced deportations with difficult
consequences for his health. From the age of 8 to the present he has lived in an uncertain
legal status.
Author’s further comments
6.1
On 10 July 2024, the author submitted further comments. He notes that the expulsion
order pending against him became statute-barred on 30 November 2022, after which he
submitted a new application for asylum. The application was rejected by the Migration
Agency on 31 May 2023; the decision was upheld on appeal by the Migration Court and the
Migration Court of Appeal on 8 April 2024 and 4 June 2024, respectively, based largely on
the same reasoning as the rejection of his previous applications.
6.2
The author notes that in the decision, the migration authorities stated that his invoked
grounds for asylum had previously been assessed by the Migration Agency and the Migration
Court, which had found that the author would have access to the medical care needed in
Albania and that no new circumstances had come to light that would give the migration
authorities reason to depart from this assessment. The author argues that the migration
authorities in their assessments failed to address the events that took place in Albania after
his deportation, and that they also failed to address the mental distress he suffered and his
lack of capacity to fend for himself due to his physical and mental disabilities. He further
notes that in their decisions the migration authorities stated that adequate health care would
be available to him in Albania, despite the facts that: (a) the certificates that he had submitted
contradicted this conclusion; (b) medicine had to be sent to him from Sweden after he was
deported; and (c) he had on several occasions been denied medical care in Albania when
trying to access such. He notes that in support of their conclusion, the migration authorities
also made reference to the fact that there is a special education facility for children in Tirana,
citing the information previously obtained through the medical country of origin information
request. He argues that this reference demonstrates that the migration authorities simply
repeated the reasoning from the previous decision without further inquiry, considering the
fact that at the time of the most recent decisions the author was no longer a minor.
6.3
The author states that in the decisions, the migration authorities made their assessment
that he would have access to the medical care needed on the basis of a medical country of
origin information response, and also states that as long as he is unable to refute with certainty
that the care available according to the medical country of origin information response will
de facto not be available or sufficient for him, it is considered that he will receive care. He
notes that migration authorities acknowledged that his hydrocephalus condition is life-
7 The author refers to United Nations Children’s Fund (UNICEF), Child Notice Albania (2015).
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threatening but concluded that the medical certificates submitted by him did not support the
finding that the model of shunt that was inserted in Sweden is the only one that would work
for him. He argues that this finding is however incorrect and that, as stated in the medical
certificates submitted by him, the shunt that was inserted in Albania was inadequate, leading
to the shunt replacement surgery in Sweden.
6.4
The author further notes that Clonidine, a medication that he is taking daily, is not
available in Albania. It is evident from the Fass platform, which provides information on
medications in Sweden, that Clonidine is not a replaceable drug. Although the medication
may not be crucial for his physical survival, it is important in order to reduce his mental
suffering, in particular anxiety and self-harming behaviour. To stop taking the medication
would result in more anxiety and stress, which increases the risk of epileptic seizures. He
argues that during the domestic proceedings the State Party limited itself to noting that he
had not demonstrated that Clonidine was vital for him, but failed to do its own inquiry into
what consequences he would face if he had to live without the medication. It is unreasonable
to place, as the State Party authorities have done, the entire burden of proof on him, given his
lack of legal capacity.
6.5
The author argues that in the domestic proceedings, the State Party authorities thus
failed to assess his case with due diligence and to attach due weight to the risk of irreparable
harm, in the form of physical and mental suffering and even death, if he were to be forcibly
returned to Albania again. He notes that even in Sweden he is at risk, as he needs advanced
care as well as habilitation services. Even under the current circumstances, he faces the risk
of, among other things, blood clots, pulmonary embolism, skin infections, oedema formation
and increased muscle atrophy.
State Party’s further observations
7.1
On 10 October 2024, the State Party submitted further observations on the
communication. It notes that after the expulsion order became statute-barred on 30 November
2022, the author reapplied for asylum, on 16 February 2023, primarily on the same grounds
as his previous application, that is, his state of health. In their assessment of the author’s
claimed grounds for international protection, the migration authorities noted that Albania was
considered a safe country of origin. Moreover, and with respect to his cited grounds for
asylum, both the Migration Agency and the Migration Court concluded that no new
circumstances had emerged concerning his access to medicine and care in Albania. On the
basis of available and updated country of origin information, relevant and adequate care was
deemed accessible in the country. Consideration was also given to the prevailing situation in
Albania and any potential or intersecting risks the author might face upon return. The
Migration Court further noted that the author had relatives to support him in his country of
origin. The Migration Agency also noted that, according to a medical country of origin
information inquiry, special needs education was available in Tirana.
7.2
The State Party thus submits that the author’s removal to Albania would not entail a
violation of article 7 of the Covenant, given that care and other needs can be met in the
country of origin.
Issues and proceedings before the Committee
Consideration of admissibility
8.1
Before considering any claims contained in a communication, the Committee must
decide, in accordance with rule 97 of its rules of procedure, whether the communication is
admissible under the Optional Protocol.
8.2
The Committee has ascertained, as required under article 5 (2) (a) of the Optional
Protocol, that the same matter is not being examined under another procedure of international
investigation or settlement.
8.3
The Committee notes the State Party’s submission that communication should be
found to be inadmissible for failure to substantiate the claims for purposes of admissibility.
It notes the author’s claim that if removed to Albania he would be at risk of irreparable harm,
including a risk to his life due to his status of health. The Committee considers that the author
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has sufficiently substantiated these claims for the purposes of admissibility. Accordingly, the
Committee declares the communication admissible under articles 6 and 7 of the Covenant
and proceeds with its consideration of the merits.
Consideration of the merits
9.1
The Committee has considered the communication in the light of all the information
submitted to it by the parties, in accordance with article 5 (1) of the Optional Protocol.
9.2
The Committee notes the author’s claims that the State Party violated his rights under
articles 6 and 7 of the Covenant by deporting him to Albania twice, where he lacked access
to adequate medical care, and that his rights under article 6 and 7 would again be violated for
the same reason if he were to once again be removed to his country of origin. The Committee
further notes the author’s argument that in the domestic proceedings, the State Party
authorities failed to assess his case with due diligence and to attach due weight to the risk of
irreparable harm in the form of physical and mental suffering, or even death, he would face
if he were to again be forcibly returned to Albania. It notes the State Party’s submission that
there is no reason to conclude that the domestic rulings were inadequate or that the outcome
of the domestic proceedings were in any way arbitrary or amounted to a denial of justice. It
also notes the State Party’s argument that the migration authorities conducted a medical
country of origin information enquiry during the domestic asylum procedure, which
confirmed that care for hydrocephalus was available at the Mother Teresa hospital in Tirana
and that special schooling was also available in Tirana, and that there was thus no support in
the relevant country of origin information for the claim that adequate care or habilitation was
lacking in Albania for the type of medical care needed by the author.
9.3
The Committee recalls its general comment No. 31 (2004) on the nature of the general
legal obligation imposed on States Parties to the Covenant, in which it referred to the
obligation of States Parties not to extradite, deport, expel or otherwise remove a person from
their territory when there were substantial grounds for believing that there was a real risk of
irreparable harm, such as that contemplated by articles 6 and 7 of the Covenant, in the country
to which removal is to be effected (para. 12). The Committee has also indicated that the risk
must be personal8 and that there is a high threshold for providing substantial grounds to
establish that a real risk of irreparable harm exists.9 All relevant facts and circumstances must
be considered, including the general human rights situation in the author’s country of origin.10
The Committee recalls that it is generally for the organs of States Parties to examine the facts
and evidence of the case in question in order to determine whether such a risk exists,11 unless
it can be established that the assessment was clearly arbitrary or amounted to a manifest error
or denial of justice.12
9.4
The Committee further recalls its jurisprudence that States Parties should give
sufficient weight to the real and personal risk that a person might face if deported, and that it
is incumbent upon the State Party to undertake an individualized assessment of the risk that
the person would face if removed, including access to adequate medical care. 13 In this
connection, the Committee recalls that persons with disabilities, including psychosocial or
intellectual disabilities, are entitled to specific measures of protection so as to ensure their
8 For example, K v. Denmark (CCPR/C/114/D/2393/2014), para. 7.3; P.T. v. Denmark
(CCPR/C/113/D/2272/2013), para. 7.2; X v. Denmark (CCPR/C/110/D/2007/2010), para. 9.2; Q.A. v.
Sweden (CCPR/C/127/D/3070/2017), para. 9.3; and A.E. v. Sweden (CCPR/C/128/D/3300/2019),
para. 9.3.
9 See, for example, X v. Denmark, para. 9.2; Q.A. v. Sweden, para. 9.3; and A.E. v. Sweden, para. 9.3.
10 See, for example, X v. Denmark, para. 9.2; Q.A. v. Sweden, para. 9.3; and A.E. v. Sweden, para. 9.3.
11 See, for example, Pillai et al. v. Canada (CCPR/C/101/D/1763/2008), para. 11.4; and Z.H. v.
Australia (CCPR/C/107/D/1957/2010), para. 9.3.
12 See, for example, K v. Denmark, para. 7.4; Y.A.A. and F.H.M. v. Denmark
(CCPR/C/119/D/2681/2015), para. 7.3; Rezaifar v. Denmark (CCPR/C/119/D/2512/2014), para. 9.3;
Q.A. v. Sweden, para. 9.3; and A.E. v. Sweden, para. 9.3.
13 Ali and Ali Mohamad v. Denmark (CCPR/C/116/D/2409/2014), para. 7.8. See also Committee on the
Rights of Persons with Disabilities, N.L. v. Sweden (CRPD/C/23/D/60/2019), para 7.4; Committee
against Torture, Harun v. Switzerland (CAT/C/65/D/758/2016), paras. 9.6 and 9.9; and European
Court of Human Rights, Paposhvili v. Belgium, para. 183.
CCPR/C/145/D/3724/2020
GE.26-04569
9
effective enjoyment of the right to life on an equal basis with others.14 The Committee further
notes that during the majority of the domestic proceedings the author was a child. It recalls
that the principle that the child’s best interests shall be a primary consideration in all decisions
affecting the child forms an integral part of every child’s right to measures of protection.15
9.5
In the present case, the Committee notes that it is undisputed that the author has been
diagnosed with complex health conditions, including autism, a serious mental developmental
disorder, spastic diplegic cerebral palsy, hydrocephalus and epilepsy. It further notes that it
is undisputed, and supported by medical certificates, that the shunt is vital and that without
regular neurosurgical follow-up care, the author would be at risk of dying should there be a
need for further adjustments or replacements of the shunt. The Committee also notes that is
also undisputed, and supported by medical certificates, that the author is in need of regular
medication to treat other health conditions, including epilepsy, which without medication
will lead to seizures.
9.6
The Committee notes the State Party’s argument that during the domestic proceedings
the migration authorities conducted a medical country of origin information enquiry, which
confirmed that care for hydrocephalus was available at the Mother Teresa hospital in Tirana.
It however notes the author’s information that the shunt operation he underwent in Albania
in 2006 was inadequate, as the shunt had no adjustable valve and as no follow-up care was
provided, even though regular check-ups are essential. The Committee notes his claim that
when the family was deported for the first time to Albania in 2016, he was denied care at the
Mother Teresa hospital when he fell ill, as his needs were deemed to be too complex. It
additionally notes his information that when deported to Albania for a second time in 2019,
he was again denied access to medical care in the period he spent there and had to have
medication sent to him through an NGO in Sweden, as he was unable to access the required
epilepsy medication in Albania. The Committee further notes that during the domestic
proceedings the author submitted two medical certificates from physicians in Sweden (see
para. 5.9 above), a medical certificate issued by a health centre in Albania (see para. 5.8) and
four certificates from the ministry responsible for health in Albania to substantiate that
adequate treatment for hydrocephalus was not available in Albania (see para. 5.10). The
Committee especially notes that the medical certificates submitted by the author state that he
has several chronic diagnoses for which there is no curative treatment and that if he does not
receive continuous care, medications and regular checks of the shunt, his chances of survival
will decrease. The Committee further notes the author’s argument that the migration
authorities failed to assess all the claims raised by him, and that they based their finding that
medical care would be available to him in Albania solely on the medical country of origin
information response, while dismissing the certificates submitted by him and not taking note
of his described experiences of being unable to access medical care after his removal to
Albania first in 2016 and then in 2019. In this connection, the Committee specifically notes
the author’s argument that the four certificates he submitted from the ministry responsible
for health in Albania to substantiate that treatment for hydrocephalus was not available in
Albania were dismissed by the migration authorities as being of low probative value, without
the migration authorities making any attempt to have said documents verified.
9.7
Taking the above considerations into account, the Committee concludes that the State
Party migration authorities failed to adequately assess the claims raised by the author by not
verifying the certificates submitted by him in the course of the domestic proceedings, and by
failing to adequately take into account the author’s claims that upon his removals to Albania
in 2016 and 2019 he had been denied essential medical care and had also had to rely on
epilepsy medication being sent to him by an NGO in Sweden, as he was unable to access the
medication required in Albania. The Committee thus concludes that the failure to verify that
the author would in fact have access to essential medication and medical care in Albania prior
to his removals to Albania in 2016 and 2019 amounted to a violation of his rights under
14 General comment No. 36 (2019) on the right to life, para. 24.
15 Bakhtiyari et al. v. Australia (CCPR/C/79/D/1069/2002), para. 9.7; and M.E. v. Greece
(CCPR/C/143/D/3597/2019), para. 10.3. See also Committee on the Rights of the Child, general
comment No. 14 (2013) on the right of the child to have his or her best interests taken as a primary
consideration, paras. 1 and 13.
CCPR/C/145/D/3724/2020
10
GE.26-04569
articles 6 and 7 of the Covenant, and that for the same reason the new removal decision of
4 June 2024, if implemented, would violate his rights under articles 6 and 7 of the Covenant.
10.
The Committee, acting under article 5 (4) of the Optional Protocol, is of the view that
the facts before it disclose a violation of the author’s rights under articles 6 and 7 of the
Covenant.
11.
Pursuant to article 2 (3) (a) of the Covenant, the State Party is under an obligation to
provide the author with an effective remedy. This requires it to make full reparation to
individuals whose Covenant rights have been violated. Accordingly, the State Party is
obligated to review the author’s applications for asylum or residence permits, taking into
account the State Party’s obligations under the Covenant and the Committee’s findings in the
present Views, and to provide the author with adequate compensation. The State Party is also
under an obligation to take all steps necessary to prevent similar violations from occurring in
the future.
12.
Bearing in mind that, by becoming a Party to the Optional Protocol, the State Party
has recognized the competence of the Committee to determine whether there has been a
violation of the Covenant and that, pursuant to article 2 of the Covenant, the State Party has
undertaken to ensure to all individuals within its territory and subject to its jurisdiction the
rights recognized in the Covenant and to provide an effective and enforceable remedy when
it has been determined that a violation has occurred, the Committee wishes to receive from
the State Party, within 180 days, information about the measures taken to give effect to the
Committee’s Views. The State Party is also requested to publish the present Views and to
have them widely disseminated in the official language of the State Party.