WASHINGTON -- Republican politicians, joined by a few Democrats in tight election races, have stepped up their calls in recent days for a temporary ban on all travelers coming from West Africa -- despite the fact that medical experts say such a measure is not only unnecessary but potentially harmful to efforts to stop the spread of Ebola.
Why such a travel ban wouldn't work doesn't need to be speculative. In fact, for two decades, the United States did try to stop the spread of a deadly disease by banning everyone afflicted from entering the country. Those efforts failed, leading to discrimination, panic, a deterioration in the country's reputation, researchers barred from entering the U.S. to help find a cure, and individuals separated from friends and family for years.
More than 600,000 people with an AIDS diagnosis in the United States died despite the ban.
"In many ways, the Ebola ban is worse than the AIDS ban," said Lawrence Gostin, faculty director at the O'Neill Institute for National and Global Health Law at Georgetown University. "Of course, the AIDS ban was horrific. But the AIDS ban only applied to people who had HIV infection. This is going to apply to everybody just because they come from a particular region. They don't have to have had any exposure. They don't have to be infected at all."
The HIV/AIDS ban went into effect in 1987, thanks to President Ronald Reagan. It was strengthened through legislation in 1993 by Sen. Jesse Helms (R-N.C.), who wanted a "quarantine of those infected" with the virus. Foreigners already living in the United States who were infected with HIV also had to leave the country. Even at the time, public health experts were saying a ban was a bad idea.
Politicians fed upon -- and fueled -- the fear in the general public. A prominent gay rights advocate and war veteran was turned away from a Northwest Airlines ticket counter in San Francisco because he had AIDS, according to an Aug. 15, 1987, story in UPI. Three brothers infected with the virus were barred from a school in Arcadia, Florida. On Sept. 3, 1987, the Associated Press noted that a United Airlines employee was reportedly placed on leave after he told his employers that he had AIDS.
The public saw paranoia everywhere it turned; people were warned they could catch AIDS from toilet seats, and read headlines like one on the cover of Life magazine in 1985 proclaiming: "Now No One Is Safe From AIDS."
Similar panic is erupting over Ebola. A university has canceled a student trip to Kenya, which has not yet had any cases of Ebola. A bridal store in Ohio shut down after an Ebola-infected nurse shopped there. And in New Jersey, two students from Rwanda -- which has also not had any Ebola cases -- were forced to stay home after parents there believed the kids would spread the disease.
Another embarrassing legacy of the HIV ban was that the United States lost the privilege of hosting the 1992 International AIDS Conference -- the premiere event focused on fighting the AIDS epidemic -- which was set to be held in Boston. Instead, the conference was moved to Amsterdam. The conference didn't return to the United States until 2012, after the ban was repealed.
"The travel ban stayed in place for several decades, and over that time, it had a significant impact on the United States' scientific reputation around the world," explained Steve Ralls, the former spokesman for the group Immigration Equality, which worked on the repeal of the ban. "Leading AIDS and HIV researchers could not travel to the United States, could not collaborate with their colleagues in person here in the U.S., and the United States was unable to host an international AIDS conference during that entire period."
"It's often said by our diplomatic corps that it's the United States' humanitarian response to crises around the world that makes the world look to us as a leader," he added. "So we need to be careful about jeopardizing that diplomatic tool that I would say is very powerful as we work to help other countries deal with [Ebola]."
Rep. Barbara Lee (D-Calif.) was one of the lawmakers, along with then-Sens. John Kerry (D-Mass.) and Gordon Smith (R-Ore.), who successfully included language repealing the HIV ban in legislation reauthorizing the President's Emergency Plan for AIDS Relief in 2008. Bush signed the bill into law, and the ban was officially done in 2009.
"If we want to be a global leader in combating H.I.V./AIDS, we need to act like it," President Barack Obama said at the time. "Now, we talk about reducing the stigma of this disease, yet we've treated a visitor living with it as a threat."
Lee was pushed to action after attending the 2006 International AIDS Conference in Toronto and realizing that it couldn't be held in the United States until the ban was lifted.
"First, I think a travel ban keeps scientists, keeps patients, keeps activists, keeps policymakers from interacting with each other to find a cure and a vaccine, which is desperately needed. Secondly, it prevents ... equipment and ease of access to the most affected areas," said Lee.
Medical experts have made similar points, saying a travel ban would hurt efforts to stop the spread of Ebola. Mike Leavitt, who served as Health and Human Services Secretary under President George W. Bush, said he sees "lots of problems" with a travel ban. Thomas Frieden, head of the Centers for Disease Control and Prevention, said a ban wouldn't necessarily stop people infected with Ebola from coming into the United States, since they would likely find other ways to get in that are harder to track.
“If you try to shut down air travel and sea travel, you risk affecting to a huge extent the economy, people’s livelihoods and their ability to get around without stopping the virus from traveling," said World Health Organization spokesman Gregory Hartl. "You can’t ship goods in. Sometimes these goods are basic staples people need to survive -- food and fuel."
"There's no evidence that it's ever worked," said Gostin of the HIV travel ban, "and I can't imagine that it would work now."
Indeed, a 1989 review of HIV/AIDS travel restrictions said they were "ineffective, impractical, costly, harmful, and may be discriminatory."
Obama has also said he opposes an Ebola travel ban. Instead of barring all passengers coming from West Africa, the CDC is requiring that they come in through one of five U.S. airports in order to be checked for Ebola symptoms. They will also be closely monitored by public health officials for 21 days, which is the window for when Ebola symptoms may begin appearing.
Ebola, like HIV, is not an airborne disease and can be contracted only through direct contact of bodily fluids.
(Graphic by the Kaiser Family Foundation)
Unlike HIV, Ebola can be transmitted only when the individual is showing symptoms.
(Graphic by the Kaiser Family Foundation)
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