HIV at the gates Tom Smith

Well, here's a shocker.  I don't really agree with Orin Kerr and Andrew Sullivan that the ban on travelers with HIV coming to the US should be lifted, or that it is "absurd."  It certainly is not absurd.  Absurd means something that is against reason, that flies in the face of reason.  Public health restrictions on travel have apparent reasons.  They are there to inhibit the spread of disease.  I would be surprised if you could come into the US if you were infected with some contagious, deadly disease such as measles or, I don't know, Marburg virus.  (Though Sullivan appears to be claiming this is the case -- see below.) HIV is far less contagious than many pathogens, but it is still contagious.  And it is certainly deadly enough.  The fact that one of the ways to spread it is through sex seems irrelevant to me.

I'm too lazy to investigate this and so will just ask, do other STDs make you ineligible to travel to the US?  Such as say syphilis?  If so, I don't see why HIV should be treated any more leniently.  But if not, then Sullivan has a point.

The tone of Orin's post is -- what am I missing here?  What could the reason for such a ban possibly be?  Well, the reason is, uh, that we don't want people with deadly, contagious diseases coming to the US and spreading them around.  I'm not an expert on the law of travel and public health, but that would be my inference.  We don't consider a promise not to do so reassuring enough, given the costs.  It's a costs and benefits thing, beloved of policy makers.  Foreigners have no fundamental right to travel to the US last I checked. (Though it would not surprise me to learn that they have acquired one in my mental absence.) If there's a sound public health reason to stop a traveler at the borders, then you should, unless there is some strong countervailing reason, and for that you could have an exceptions process.  I do know that travel has profound implications for the spread of disease and that public health officials pay a lot of attention to it.

I do see that Andrew Sullivan claims in his column that HIV is the only medical condition that would make you unable to enter the US.  Is that really true?  If I were in the throes of an Ebola meltdown could I really just stroll through customs and no one would ask me why I was bleeding all over the place?  I seem to recall something about a lawyer with antibiotic resistant TB, who was an American citizen and a lawyer, and had left the US for his wedding, having to sneak back into the US, because of his condition.   Are all restrictions on entry into the US special cases?  Is the rule really, Bird Flu?  Come on over!  If so, that strikes me as bad policy. That would be absurd.  Not shocking, given the ubiquity of stupid policies, but still absurd.  There are lots of nasty diseases out there that I think should, other things being equal, disqualify you from visiting our fair shores.  Quite possibly HIV is not one of them.  That's a question for some policy maker who knows what he is talking about.  But somehow I think we are not getting the whole story here.