Last week, UK opposition-party leader Michael Howard announced that his party would deny visas to prospective immigrants who test positive for tuberculosis (TB). HIV tests would also be mandatory under the Conservative policy, but visas would not necessarily be withheld. This plan, says Howard, is a strategy to minimise the public-health threats posed by immigrants. But the intense debate these proposals have generated-mainly because of their similarity to current government policies-has unfortunately obscured a more important point: that disease must not be a basis for discrimination, writes The Lancet.

In the UK, migration has been blamed for a steady increase in newly diagnosed HIV infections, but absolute numbers remain small. Percentage calculations, such as those cited in Howard's publicity material, exaggerate the relative burden of immigration-related illness. According to the Health Protection Agency's most recent report, the number of newly diagnosed HIV infections thought to have been contracted outside the UK in 2003 number only around 3000.

Reacting to public fears over perceived threats, countries including Canada, USA, Australia, and New Zealand, have adopted stringent policies for compulsory screening of new entrants for TB and HIV. But the only UK public inquiry into the issue came out firmly against the idea, concluding that "there is no evidence to suggest that such a policy would be effective at protecting public health". The All Party Parliamentary Group on AIDS, which set up the inquiry, expressed grave concerns that the government was seeking ways to "exclude vulnerable individuals on the basis of poor health".

The Lancet comments: "Policies that discriminate against visa applican
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Contact: Udani Samarasekera
pressoffice@lancet.com
44-207-424-4949
Lancet
24-Feb-2005