Keeping The Door Closed

By Dick Thompson/Washington

Should foreign citizens who are infected with the AIDS virus be permitted to enter the U.S.? No, says the Justice Department, which has imposed a ban on such immigrants and travelers. Yes, says the Department of Health and Human Services (HHS), which has been lobbying to change that policy. Change it or else, says Harvard University, which is about to withdraw as host of next year's International AIDS Conference unless the ban is lifted. The annual conference, which draws thousands of scientists, is the key forum for researchers investigating the worldwide epidemic. "It's impossible to have a meeting dedicated to AIDS to which people with the disease can't come," declares Alan Fein of the Harvard AIDS Institute.

The battle over immigration policy is yet another AIDS-related issue in which the politics of emotion have overtaken the reign of reason. The wrangling began in 1987, when Senator Jesse Helms pushed through an amendment that added AIDS to the Immigration and Naturalization Service's list of dangerous and communicable diseases that may not be carried into the country. Currently, travelers are requested to complete a questionnaire that asks if they are infected; would-be immigrants must submit to a blood test.

The International Red Cross, the National AIDS Commission and the World Health Organization all protested the policy, asserting that it was scientifically unjustified since AIDS is not highly contagious, unlike tuberculosis, syphilis and other diseases on the list. HHS Secretary Louis Sullivan has also pushed for removal of the ban.

But after a seven-month review, the Justice Department has refused to reverse its policy, though it has backed away from a medical justification and now says the ban is based on economic considerations. The concern, says a spokesman, is that the high cost of medical care would lead infected immigrants to become "public charges." Critics, including gay activists, complain that the government does not apply this sort of analysis to immigrants with heart disease or other expensive medical conditions. Nor has the department come up with a credible estimate of how many AIDS-infected immigrants are likely to seek entry: figures vary wildly from 500 a year to 6,000. The office of the Presidential Science Adviser has argued that "infections among immigrant aliens would represent a negligible increase in the infected pool."

Last week officials of the Justice and HHS departments were struggling to hammer out a compromise. The likely outcome would permit AIDS-infected foreign nationals into the U.S. for up to 30 days but require them to inform officials that they are carriers of the HIV virus. Another policy under consideration: permitting people with AIDS to immigrate if they can prove that they will not be an economic burden. In other words, the wealthy infirm would be waved through.

Harvard isn't buying such compromises. Any restriction on immigration or visas would be impermissible, officials there say. In addition, the disclosure requirement for a short-term visa, notes Fein, could put travelers at risk of losing their jobs or insurance and encountering other problems once they return home. Harvard is expected to announce next week its decision to withdraw as host of the June 1992 meeting.

Meanwhile, conference organizers are scrambling to find a city outside the U.S. with spare hotel rooms and meeting halls for 15,000 scientists. Laments June Osborn, who chairs the National Commission on AIDS: "Losing this kind of free exchange can cost investigators months of research time."