![](media/image1.png){width="1.4236111111111112in"
height="1.1159722222222221in"}

A year ago, on Worlds AIDS Day 2006, the President took a modest step to
try to right at least part of this wrong. Although the public health
community wishes that he had gone further in his recommendations, at
least he was willing to tackle a piece of the problem. We do not quarrel
with his intent; we embrace it, modest as it is. Our quarrel is with the
result. The proposed new rule fails to achieve what was widely
understood to be his intent---to eliminate an undue burden on
HIV-positive persons seeking short-term access to the United States.
Since the Administration feels constrained by the language of the
statute, it has a duty to say so much more forcefully and to seek a
legislative fix.

There are several well-known, egregious problems with current law: (a)
it is not based on public health evidence; (b) it is not uniformly
enforced, with travelers from the mostly Western European visa-waiver
countries receiving almost no scrutiny; (c) it makes unreasonable
demands on HIV-positive persons seeking temporary entry to the U.S.; and
(d) it often puts those seeking a "visa waiver" at risk in their home
countries by effectively disclosing HIV-status to all. The policy is
also an embarrassment to the United States. No other Western countries
have such a restrictive policy, and the policy itself prevents important
international meetings from being held in the United States.

The latter point may appear to be a small one, but it has a direct
impact on HIV infections in the United States. The biennial
international AIDS conference has a huge impact on domestic news
coverage of HIV and AIDS, and how to prevent it. In light of the fact
that infections in the U.S. are higher than previously thought, it is
absolutely essential that the country avail itself of every opportunity
to shine a light on the problem to educate---over and over
again---American citizens. The international AIDS conference would
provide such an opportunity, but the conference will not be held in the
United States while current U.S. policy is in effect. It poses too many
requirements and personal risks to attendees.

The proposed rule claims to share the President's "firm commitment to
enable, on a categorical basis, the admission into the United States for
short visits of HIV-positive aliens," but then it proceeds to include
requirements that mirror the unwarranted and unnecessary information and
certification requests made in the current case-by-case individualized
process. Its main improvement over current law---to permit consular
officials at U.S. embassies around the world to make the determination
rather than involve the Department of Homeland Security---does not begin
to make up for its failures to achieve the stated objective.

Curiously, the Federal Register posting makes a strong legal case for
the government's authority to simplify the short-term visa process in a
manner that some might find inconsistent with the statute.
Unfortunately, after defending its authority to act, it fails to do so
in a meaningful way.

The proposed rule fails to achieve the President's stated objective in
several ways:

1.  It perpetuates the myth that HIV-positive persons "have a
    communicable disease of public health significance" as ordered by
    Congress in conflict with the conclusions of U.S. and international
    public health experts.

2.  It perpetuates the case-by-case determination of eligibility for a
    short-term visa.

3.  It perpetuates the onerous requirements on applicants, e.g. they
    must: be aware of their HIV-positive condition; have received and be
    following adequate medical counseling; be under medical care; be in
    possession of or have access to any medically necessary drugs they
    might need for their anticipated stay; and, have sufficient
    financial means to cover anticipated medical expenses.

It perpetuates the need to record an applicant's HIV-positive condition
on the person's passport, thus creating the real possibility that the
applicant will face health or even life-threatening discrimination upon
return home. In light of these serious shortcomings, we urge the
Secretary to withdraw the proposed rule and go back to the drawing board
to create a new rule that responds to the President's commitment and
instruction. We also urge the Administration to be explicit in its
request to change the unfair statutory language that created this
discriminatory policy in the first instance.

These comments are respectfully submitted on behalf of our 460
organizational and 4,000 individual members dedicated to improving the
health of those in the developing world.

Sincerely,

![](media/image2.png){width="3.178472222222222in" height="1.0in"}

Nils Daulaire

President and CEO