Travel Ban on the Way Out

The HIV travel and immigration ban is going where it belongs

Thanks in part to insistent pressure from AIDS advocates over the last six weeks, the Obama administration has finally taken meaningful steps toward lifting the hated two-decades-old ban on travel and immigration to the U.S. by HIV-positive individuals.

Comments are now requested, and are needed to address the regulation fully -- including the fact that Health and Human Services "welcomes public comment" on the costs and benefits of mandatory HIV testing for immigrants.

After delays, confusion and years of waiting, on Tuesday, the Office of Management and Budget (OMB) released a proposed regulation that would overturn the ban. The agency rescinded it briefly after realizing that the Department of Health and Human Services had sent them the wrong version (oops!). Politico reported the original version calculated the cost and estimated new infections for 20 years, as opposed to five in the corrected proposal officially published in the federal registry today.

Not so Fast

Although the regulation seeks to fully overturn the ban, it includes some troubling assumptions that will need to be countered in public comments.

The regulation makes a "tentative conclusion" that "this change may be economically significant" even though countries that don't have an HIV immigration ban (almost every country in the world) report very few non-citizens relying on government medical care.

The regulation also leaves the door open for mandatory HIV testing of immigrants by stating, "Although the approach of removing HIV from the definition of communicable disease of public health significance but maintaining the mandatory testing component of the medical examination was not selected for this proposal, HHS/CDC welcomes public comment on the advantages and disadvantages of this or alternative approaches, such as (non-mandatory) testing ( i.e.,opt out/opt in approach)."

There will be 45 days to comment on the regulation and ensure that this ban is finally overturned, so advocates will definitely take HHS/CDC up on its offer, and debunk their inaccurate assumptions.

Although the AIDS community has been advocating against the travel ban for years, it didn't appear to be on the Obama administration's pressing priority list. The ban became an embarrassment, however, after a group of Canadian citizens were denied entry to the United States to attend the North American Housing and HIV/AIDS Research Summit, resulting in Andrew Sullivan airing the issue on Anderson Cooper 360. This was followed by the International AIDS Society condemning the ban and stating its desire to hold the 2012 International AIDS Conference in Washington, D.C.

The week of the Canadian kerfuffle, a group of activists were suddenly invited to a meeting with the OMB, Centers for Disease Control and AIDS czar Jeffrey Crowley regarding the lifting of the ban. Now the OMB has released its proposal and even cut the comment period from 60 days to 45 days. That's change -- and expediency -- we can believe in.

Keeping the OMB on Track

Once the regulation is officially published, advocates will have 45 days for comment. The CDC will develop responses to the comments; a final regulation will be drafted and submitted to OMB for up to 90 days for a second review, before publishing the final review.

The new reg is certainly the beginning of the end of a long national nightmare of the travel and immigration ban. A 1993 law preventing HIV-positive people from entering the U.S. was repealed in July 2008 by Congress and President Bush as part of the President's Emergency Plan for AIDS Relief (PEPFAR). But for the entry ban to be fully repealed the regulatory change that HHS will propose must also be made.

The OMB suggests that like-minded individuals submit short, identical comments to reduce the amount of time HHS needs to review and comment on letters.

We'll keep you posted when it's drafted so you can start commenting away, and make sure the ban is lifted once and for all!

Photo credit: http://www.flickr.com/photos/mmewuji/297723538/