Published online by Cambridge University Press: 27 February 2017
AIDS is truly an international phenomenon, with cases now reported on every continent. To combat the AIDS epidemic, the nations of the world may be reverting to a pattern of quarantine and restrictions on international travel. For example, on April 23, 1986, the Federal Register gave notice of a rule proposed by the Centers for Disease Control of the United States Public Health Service that, if enacted, will add AIDS to the list of seven diseases that provide grounds for exclusion of aliens. This action would allow the U.S. Department of State to deny visas and the Immigration and Naturalization Service to deny admission to aliens subject to medical examination (generally immigrants and refugees) who are found to have AIDS. Although seemingly innocuous, the proposed regulation was initially seen by gay rights groups as an instrument that could potentially be used to harass homosexuals and other high-risk groups seeking entry to the United States. The proposed regulation also contrasts with the U.S. Public Health Service’s domestic strategy for coping with AIDS, which emphasizes education rather than quarantine as the principal means of controlling the disease.
1 As of Dec. 31, 1985, there were 17,815 reported cases of AIDS in the Americas. 61 Weekly Epidemiological Rec. 87 (1986) [hereinafter cited as Weekly Epidem. Rec.]. More recently, it was estimated that while approximately 21,000 U.S. residents meet the official criteria for AIDS of the Centers for Disease Control, an additional 100,000 to 200,000 are suffering from AIDS-related complex, and another 1 million to 2 million healthy U.S. residents may be infected with human immunodeficiency virus (HIV). Wall St. J., May 30, 1986, at 25, col. 3. As of Dec. 31, 1985, 2,006 cases of AIDS had been reported in Europe. 61 Weekly Epidem. Rec. at 125. As of Mar. 6, 1986, a status report on AIDS-related activities was available from 21 countries in Africa. Seven countries reported AIDS cases. Id. at 93. According to recent estimates by WHO, however, at least 50,000 Africans may have contracted AIDS since 1980, and as many as 2 million may be symptomless carriers of the disease. N.Y. Times, June 9, 1986, at A9, col. 6. As of Apr. 29, 1986, 203 cases of AIDS had been reported in Australia. 61 Weekly Epidem. Rec. at 168. As of Oct. 31, 1985, AIDS had been confirmed in 11 males in Japan, including 1 foreigner. Id. at 27. The first AIDS case was diagnosed in China (Taiwan) on Jan. 27, 1986. Id. at 154.
2 For a concise history of the use of quarantine, see Edelman, International Travel and our National Quarantine System, 37 Temp. L.Q. 28, 28–29 (1963). For a history of the AIDS epidemic, see Comment, AIDS: A Legal Epidemic, 17 Akron L. Rev. 717 (1984).
3 51 Fed. Reg. 15,354 (1986) (proposed Apr. 23, 1986).
4 Id. A spokesman for the Public Health Service indicated that tourists would not generally be required to have a medical examination unless they appeared to be ill. N.Y. Times, Apr. 24, 1986, at A13, col. 1.
5 The President of the National Lesbian and Gay Health Organization stated that she was concerned that immigration officers “because of their personal biases and prejudices, might routinely order medical examinations” for homosexuals. N.Y. Times, supra note 4, at A13, col. 1.
6 See generally Public Health Service Plan for the Prevention and Control of Acquired Immune Deficiency Syndrome (AIDS), 100 Pub. Health Rep. 453 (1985).
7 61 Weekly Epidem. Rec. at 27.
8 Interview with Dr. H. M. Ginzburg, Director, AIDS Project, National Institute of Allergies and Infectious Diseases, NIH (Aug. 19, 1986).
9 Special Report: Epidemiological Aspects of the Current Outbreak of Kaposi’s Sarcoma and Opportunistic Infections, 306 N. Eng. J. Med. 248 (1981).
10 Kornfeld, Stouwe, Lange, Reddy & Grieco, T-Lymphocyte Subpopulations in Homosexual Men, 307 N. Eng. J. Med. 729 (1982).
11 See, e.g., Prevalence of HTLV-III Infection among New Haven, Connecticut, Parenteral Drug Abusers in 1982–1983, 314 N. Eng. J. Med. 117 (1986).
12 See, e.g., Evatt, Gomperts, McDougal & Ramsey, Medical Intelligence: Coincidental Appearance of LAV I HTLV–III Antibodies in Hemophiliacs and the Onset of the AIDS Epidemic, 312 N. Eng. J. Med. 483 (1985).
13 See, e.g., Pape, Liautaud, Thomas, et al., Characteristics of the Acquired Immunodeficiency Syndrome (AIDS) in Haiti, 309 N. Eng. J. Med. 945 (1983).
14 See generally Curran, Morgan, Hardy, Jaffe, Darrow & Dowdle, The Epidemiology of AIDS: Current Status and Future Prospects, 229 Science 1352 (1985).
15 61 Weekly Epidem. Rec. at 69; see also Special Report: The AIDS Epidemic, 312 N. Eng. J. Med. 521, 522 (1985).
16 61 Weekly Epidem. Rec. at 72.
17 Laurence, Brun-Vizenet, et al., Lymphadenopathy-Associated Viral Antibody in AIDS, 311 N. Eng. J. Med. 1269 (1984).
18 Broder & Gallo, A Pathogenic Retrovirus (HTLV–III) Linked to AIDS, id. at 1292.
19 Wong-Staal, Shaw, Hahn, et al., Genomic Diversity of Human T-Lymphotropic Virus Type III (HTLV–III), 229 Science 759 (1985).
20 N.Y. Times, Apr. 13, 1986, §4, at 1, col. 1.
21 For a concise history of international cooperation in health matters, see Gutteridge, The World Health Organization: Its Scope and Achievements, 37 Temp. L.Q. 1 (1963).
22 Id. at 2.
23 Id.
24 WHO Const, art. 18(a).
25 Id., art. 21(a).
26 Id., art. 22.
27 See generally Delon, P., The International Health Regulations: A Practical Guide (1975)Google Scholar.
28 Id. at 13.
29 Id. at 10–11.
30 Id. at 7.
31 Director-General, Explanatory Memorandum, WHO Official Records, No. 37, 1951, at 330, quoted in 1 D. Leive, International Regulatory Regimes 3 (1976).
32 Id.
33 1 D. Leive, supra note 31, at 3.
34 N.Y. Times, Feb. 9, 1986, § 1, at 9, col. 1.
35 Free Needles for Intravenous Drug Users at Risk for AIDS: Current Developments in New York City, 313 N. Eng. J. Med. 1476 (1985).
36 Report of a WHO Meeting on AIDS, 32 Int’l Nursing Rev. 80 (1985).
37 Remarks of Professor Luc Montagnier, Pasteur Institute, at a conference at the Sydney Westmead Hospital, Sydney Morning Herald, Aug. 16, 1986, at 3, col. 1.
38 61 Weekly Epidem. Rec. at 93.
39 The U.S. Agency for International Development recently announced that it will give the WHO $2 million in the current fiscal year to help combat AIDS worldwide. N.Y. Times, June 16, 1986, at A10, col. 6.