HIV and American Visas

Andrew Sullivan's op-ed in the Washington Post reminds me of an experience at the State Department in the early 1990s. I was the deputy director of an office called OES/EHC, which stood for Bureau of Oceans, Environment and Science/Office of Environment, Health, and Conservation. Under the health responsibility I had an M.D. who in theory worked for me, although as a doctor, he made far more than I did. He wanted to take on the Jesse Helms visa ban on HIV-positive foreigners, and I went along to give him bureaucratic support. He took me to meet with HIV medical specialists in HHS and other agencies, and they convinced me that the Helms proposal was improper. At that time, the only basis for denying a visa to someone coming to the US was that they had a highly infectious disease. Jesse claimed that HIV was highly infectious, but the medical people said it was not. The only disease that was categorized as truly highly infectious was tuberculosis. They said that you couldn't catch HIV by sitting next to someone on a bus, for example.

So, my M.D. and I wrote a memo to the Secretary of State, then Jim Baker, saying that the Jesse Helms proposal should be rejected. Both my boss, the Assistant Secretary for OES, and the Assistant Secretary for Consular Affairs, who was responsible for visas, signed off on it. We sent it on its way to Baker, but it had to go through the Under Secretary for Economic Affairs, who was then Bob Zoellick, who is now President of the World Bank. Zoellick never passed the memo on to Baker; he kept it buried in his in-basket. I somewhat respected that decision, because the memo asked for a decision from Baker that put him in a no-win situation. Clearly the right legal, scientific thing to do was to reject the Helms proposal, because it had no legal or scientific justification. However, Jesse Helms was a great, powerful enemy of the State Department in the Senate. If Baker made Helms mad, there would be hell to pay on many other issues, probably ranging from the State Department budget to major issues of war and peace. So, Zoellick protected Baker from ever having to put his fingerprints on our memo.

It was bad law; it was unfair to HIV-positive people, but politically it was probably the best thing for the State Department. My colleagues and I periodically tried to press Zoellick to release the memo, but he never did. Neither of the Assistant Secretaries, much less people at our level, had the clout to bypass Zoellick.

I didn't know until I read Sullivan's column that Congress had subsequently passed a specific law banning HIV-positive people. A law has a better legal justification than Helms' regulation, although neither has scientific or humane justification, as Sullivan points out.

If you ask me, the fear of HIV is a sign of the same cowardice as the fear of terrorists. This generation of political leaders who grew up during Vietnam is, with a few exceptions, a generation of draft dodgers. They were either too afraid or too selfish to go to fight in Vietnam, and now they are afraid of HIV and terrorists, so afraid that they resort to torture of terrorists, and other extra legal means of dealing with both terrorists and HIV-positive people. It's a sad commentary on America.