U.S. Senate passes landmark legislation to fight infectious disease, discrimination

August 2008

The U.S. Senate recently passed a bill that would repeal the ban on people with HIV/AIDS from entering the country.

The landmark legislation builds on the President’s Emergency Plan for AIDS Relief (PEPFAR) and lifts a ban that originated in 1987. As the bill moves toward the U.S. House of Representatives, where it is expected to pass, members of the HIV/AIDS community have taken notice.

“This is huge,” Paul Volberding, MD, professor and vice chair of the University of California San Francisco department of medicine and member of the Infectious Disease News editorial advisory board, said in an interview. “This means that we [as a country] can hold our head up a bit higher in the world. I think that the lifting of the ban is really encouraging because it suggests that we can use evidence and reason to correct some of the mistakes that were made in policy early in the epidemic.”

According to Volberding, some of the United States’ early responses were not necessarily mistakes; some of the restrictions that were in place at the time were appropriate then but are no longer appropriate in the present. However, the CDC has taken action and has created policies that are more effective for the present. “The travel ban never made sense to me and makes even less sense now,” he said. “Treatments are effective, and people know how to not become HIV-infected. Also, the likelihood of travelers to our country being any kind of a burden is almost nonexistent.”

However, the ban did have a negative effect at the time. “The last International AIDS Society conference held in the United States was in San Francisco in 1990,” Volberding said. “The reason it has never come back is because of the ban. We as an organization felt that it was so discriminatory and so unfair that we thought it would be inappropriate to have any more meetings in this country.”

Financial matters

Also included in the bill is the proposal to appropriate $50 billion during five years, approximately $41 billion of which will go toward the fight against HIV/AIDS. The remaining $9 billion will be roughly split between malaria and tuberculosis causes. This funding nearly triples that of PEPFAR. It is the most ambitious foreign public health program ever initiated by the U.S. government.

“We can be proud of the leadership the United States has taken through the research, PEPFAR and our contributions to the global fund. We can become the real source of hope for millions of people, and it is time that we can talk about that,” Volberding said.

The bill passed through the U.S. Senate with a vote of 80-16. It has been lauded by such groups as the Human Rights Campaign, the International AIDS Society and the HIV Medicine Association.

“Having the opportunity to take part in a very positive HIV program that reflects well on our country is a great morale boost for all of us in the medical community,” Volberding said.