President Obama on Friday announced the end of a 22-year travel ban against people living with HIV, the New York Times reports. The president previously pledged to eliminate the ban before the end of the year, saying it is “rooted in fear rather than fact.” He said that a rule to lift the ban would be published on Monday and take effect after a standard 60-day waiting period (Preston, New York Times, 10/31). Obama made the announcement while signing a bill (S 1793) to reauthorize the Ryan White Program, which provides federal assistance to low-income people living with HIV/AIDS (Holland, Reuters, 10/30).

The ban was enacted in 1987 and requires U.S. health officials to list HIV as a “communicable disease of public health significance.” The ban in practice particularly has affected tourists and men who have sex with men, according to the Times. Although waivers are available, the procedure for HIV-positive, short-term visitors was complicated, leading many not to apply (New York Times, 10/31).

The ban effectively prevented thousands of students, tourists and refugees from entering the country and complicated the adoption process for children with HIV. In addition, no major international HIV/AIDS conference has been held in the U.S. since 1993 because many HIV-positive researchers and advocates cannot enter the country (Superville, AP/Boston Globe, 10/31). Some advocates said that the ban also discourages travelers and some foreigners already living in the U.S. from taking an HIV/AIDS test or seeking medical care (New York Times, 10/31).

The ban places the U.S. among about 11 other countries that block HIV-positive visitors (AP/Boston Globe, 10/31). When the ban is lifted, visitors and immigrants will not be required to take an HIV test. Obama said, “If we want to be a global leader in combating HIV/AIDS, we need to act like it,” adding, “Now, we talk about reducing the stigma of this disease, yet we’ve treated a visitor living with it as a threat” (New York Times, 10/31). Sen. John Kerry (D-Mass.), who co-authored legislation that the Senate passed last year to lift the ban, said the ban is “discriminatory” and has “gone the way of the dinosaur, and we’re glad it’s finally extinct” (AP/Boston Globe, 10/31).

International health officials said that repealing the ban would give HIV/AIDS researchers from various countries the freedom to visit the U.S., which would allow for conferences in the coming years. Socorro Gorss, assistant director of the Pan American Health Organization, said, “We think this is going to give a very positive image of where the U.S. is going in terms of eliminating stigma and discrimination in relation to HIV” (New York Times, 10/31).

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UNAIDS welcomes President Obama’s
announcement of the final rule removing entry restrictions based on HIV status from US
policy. The removal of HIV-related travel restrictions in the US overturns a policy that had
been in place since 1987. Such restrictions, strongly opposed by UNAIDS, are discriminatory
and do not protect public health.

“I congratulate President Obama on announcing the removal of the travel restrictions for
people living with HIV from entering the United States,” said United Nations Secretary-
General Ban Ki-moon. “I urge all other countries with such restrictions to take steps to
remove them at the earliest.”

The United Nations Secretary-General has made the removal of stigma and discrimination
faced by people living with HIV a personal issue. He called for the removal of travel
restrictions for the first time in his address to the General Assembly during the High Level
Meeting on AIDS in 2008. “That they should be discriminated against, including through
restrictions on their ability to travel between countries, should fill us all with shame,” said
Secretary-General Ban in a speech to the Global AIDS Conference in August last year.

At his request, several countries including his home country, the Republic of Korea, are in
the last stages of removing travel restrictions. Other countries that are considering removal
of travel restrictions include China and Ukraine. In 2008, the UNAIDS board strongly
encouraged all countries to eliminate HIV-specific restrictions on entry, stay and residence
and ensure that people living with HIV are no longer excluded, detained or deported on the
basis of HIV status.

“Placing travel restrictions on people living with HIV has no public health justification. It is
also a violation of human rights,” said Michel Sidibe, Executive Director of UNAIDS. “We
hope that other countries that still have travel restrictions will remove them at the earliest.”
Nearly 59 countries impose some form of travel restrictions on people living with HIV. The
International Guidelines on HIV/AIDS and Human Rights state that any restriction on liberty
of movement or choice of residence based on suspected or real HIV status alone, including
HIV screening of international travellers, is discriminatory. Travel restrictions do not have an
economic justification either. People living with HIV can now lead long and productive
working lives, a fact that modifies the economic argument underlying blanket restrictions;
concern about migrants’ drain on health resources must be weighed with their potential
contribution.

Source
UNAIDS

Researchers at Yale University have developed synthetic molecules capable of enhancing the body’s immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.

The molecules - called “antibody-recruiting molecule targeting HIV” (ARM-H) and “antibody-recruiting molecule targeting prostate cancer” (ARM-P) - work by binding simultaneously to an antibody already present in the bloodstream and to proteins on HIV, HIV-infected cells or cancer cells. By coating these pathogens in antibodies, the molecules flag them as a threat and trigger the body’s own immune response. In the case of ARM-H, by binding to proteins on the outside of the virus, they also prevent healthy human cells from being infected.

“Instead of trying to kill the pathogens directly, these molecules manipulate our immune system to do something it wouldn’t ordinarily do,” said David Spiegel, Ph.D., M.D., assistant professor of chemistry and the corresponding author of both papers.

Because both HIV and cancer have methods for evading the body’s immune system, treatments and vaccinations for the two diseases have proven difficult. Current treatment options for HIV and prostate cancer - including antiviral drugs, radiation and chemotherapy - involve severe side effects and are often ineffective against advanced cases. While there are some antibody drugs available, they are difficult to produce in large quantities and are costly. They also must be injected and are accompanied by severe side effects of their own.

By contrast, the ARM-H and ARM-P molecules, which the team has begun testing in mice, are structurally simple, inexpensive to produce, and could in theory be taken in pill form, Spiegel said. And because they are unlikely to target essential biological processes in the body, the side effects could be smaller, he noted.

“This is an entirely new approach to treating these two diseases, which are extraordinarily important in terms of their impact on human health,” Spiegel said.

HIV is a global pandemic that affects 33 million people worldwide, while prostate cancer is the second leading cause of cancer-related death among American men, with one out of every six American men expected to develop the disease.

Funding for this research was provided by the National Institutes of Health.

Source: Suzanne Taylor Muzzin

Yale University