Santa Obama delivers – two bans lifted this season

I want to like Obama as much as the next progressive-minded person, but it seems to me he’s dropped the ball big time on some pretty key campaign promises—troops out of Afghanistan and healthcare reform including reduced cost, improved quality and full access.  So, it was a pleasant surprise this holiday season when Mr. President delivered two nice big packages to the AIDS service movement.  While these two major changes directly affect US law, they both have a significant effect for people living with HIV worldwide, as well as for international prevention efforts.

On December 18th, congress voted to lift the ban on Federal funding for needle exchange programs, while the new laws allowing people with HIV to enter the US came into effect on January 4th.  The lifting of the travel ban has had lots of attention in the media and blogosphere; the lifting of the federal ban on needle exchange funding, not so much.  Of course, we enthusiastically applaud both moves, but I have been anxious to learn what these changes will look like in practice—what effect do they have in the US and around the world?  Where’s the “fine print”?  Is there a catch?  I found some answers, both good and not-so-good.

The lifting of the travel ban means that an HIV test will no longer be part of the medical examination that is required of people applying for residency in the United States.  It also means that somebody applying for a visa or attempting to cross the border cannot be turned away simply because they have HIV.  You could say it’s a good ol’ fashioned case of American DADT—they won’t ask and you don’t have to tell.  But what about those visitors who are already flagged in the system as HIV positive, who have already applied for visas and been denied, or who have been banned while trying to cross the border?  It is possible these people will have to take additional steps to apply to have their entry ban waived or overridden.  It is also possible that border guards will take issue with HIV positive foreigners trying to enter without meds for fear they are somehow trying to take advantage of the stellar American healthcare system (!?!) and get meds there.  This could be a problem for all the healthy HIV positive people out there who aren’t taking meds.  It remains to be seen how exactly things will pan out.

On to US needle exchanges … Basically, it has been left to state governments to fund (or not fund) these harm reduction programs which have been proven time and again (even here in Vancouver) to curb the spread of both HIV and HepC.  They also play a vital role in connecting injection drug users with the healthcare and support services that open the door to recovery from addiction.  While many states have chosen to (mostly under)fund syringe programs, more conservative states (including states like Florida and Nevada, who badly need them!) have opted out.  There has been no possibility of federal funding, since it was banned in 1988.  Now the possibility is there, but here’s the potential catch … no funding has been promised.  Let’s see if any becomes available.  Meanwhile, the ban had a significant influence on international AIDS prevention programming, because guess who holds the purse strings for many of the AIDS prevention efforts around the world?  You got it, USAID.  Hopefully this new “acceptance” of needle exchanges by the US government will mean other governments have more freedom to direct US funding to harm reduction programs.  As always, time will tell.

-Miriam

This was posted on Friday, January 15th, 2010 at 10:00 am and is filed under HIV Prevention, News . Feel free to respond, or trackback. Read our comments policy.

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