Globally mobile populations and infectious disease outbreaks

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Clinical Infectious Diseases
http://www.journals.uchicago.edu/toc/cid/current
Volume 53 Issue 5 September 1, 2011

Crossing Borders: One World, Global Health
Clive M. Brown, Martin S. Cetron, Section Editors
An editorial feature on globally mobile populations and infectious disease outbreaks, written by the Centers for Disease Control and Prevention’s Division of Global Migration and Quarantine

An End to the Era of the US HIV Entry Ban
(Kent Taylor and Stacy Howard)—

In 1991 human immunodeficiency virus (HIV) infection was added to the list of diseases that bar entry to the United States (US) for non-US citizens as a requirement stipulated by congressional statute. Under the Immigration and Nationality Act, the Secretary of Health and Human Services (HHS) has the authority to establish requirements for the medical examination of immigrants and refugees that determine admission into the United States. These requirements are promulgated in Title 42, Part 34 of the Code of Federal Regulations (CFR), which includes specific, serious contagious illnesses, known as a communicable disease of public health significance. Almost 20 years after the inclusion of HIV on this list of diseases, this action has been reversed. The reversal was made possible by ending the statutory ban imposed by Congress in 1987.

In 2004, the Joint United Nations Programme on HIV/AIDS (UN/AIDS) and the International Organization for Migration issued a statement on HIV/AIDS-related travel restrictions. This statement provided guidance to governments in addressing the public health, economic, and human rights concerns involved in HIV-related travel restrictions. As more information became available about HIV transmission, which cannot take place through casual contact, combined with the reality of globalization, this entry ban became increasingly contradictory to US policies supporting civil liberties. In addition, the ban was detrimental in the fight against HIV/AIDS. After a thorough medical and epidemiologic review of HIV transmission, the Centers for Disease Control and Prevention (CDC) made a policy decision that an entry ban for HIV infection was not a viable control strategy for HIV.

CDC initiated the first step in removing HIV infection as an inadmissible condition by …

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