Centre for Health and International Relations (CHAIR), Department of International Politics, Aberystwyth University, Aberystwyth, UK.
Glob Public Health. 2012;7 Suppl 2:S159-75. doi: 10.1080/17441692.2012.735249. Epub 2012 Oct 31.
In 2010, the US repealed Section 212(a) of the Immigration and Nationality Act, which stated that a non-citizen determined to have a 'communicable disease of public health significance', is not admissible into the country without a waiver. This included HIV+ non-citizens. In the same year, several other countries, including China and South Korea, removed similar restrictions. This paper examines the global debate over HIV-related travel restrictions that has been ongoing since the mid-1980s and attempts to account for these recent policy changes. Entry restrictions have almost always been justified as necessary in two ways: to protect public health from the supposed threat posed by the entry of people living with HIV, and to limit the costs HIV+ migrants impose on domestic health systems. Opponents of these restrictions have consistently sought to challenge the evidence underpinning these claims and also to re-frame the issue in rights terms. However, in this paper I argue that this re-framing was not in itself sufficient to bring about policy change. Contributing to the literature on norm building and transnational advocacy both within and beyond global health, this article argues that some other crucial factors also have to be taken into account, including the changing political context (both domestic and international) and the network building strategies employed by opponents of the restrictions from 2008 onwards.
2010 年,美国废除了《移民和国籍法》第 212(a)条,该条规定,未经豁免,患有“具有公共卫生意义的传染病”的非公民不得进入美国。这包括 HIV+的非公民。同年,包括中国和韩国在内的其他几个国家也取消了类似的限制。本文考察了自 20 世纪 80 年代中期以来一直在进行的关于与 HIV 相关的旅行限制的全球辩论,并试图解释这些最近的政策变化。入境限制几乎总是以两种方式被证明是必要的:一是保护公众健康免受所谓的 HIV 感染者入境带来的威胁,二是限制 HIV+移民对国内卫生系统造成的费用。这些限制的反对者一直试图质疑这些说法所依据的证据,并从权利角度重新阐述这个问题。然而,在本文中,我认为这种重新阐述本身不足以带来政策的改变。本文为规范建设和跨国倡导的文献做出了贡献,既包括全球卫生领域内的,也包括全球卫生领域外的,本文认为,还必须考虑到一些其他关键因素,包括不断变化的政治环境(包括国内和国际),以及 2008 年以来限制措施反对者所采用的网络建设策略。