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Immigrants may face HIV test: Health Canada issues call for ’safety first’ policy

20 September 2000 (Toronto Star)

TORONTO, 20 September 2000 (Toronto Star)

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By Leslie Papp
Toronto Star Staff Reporter

Health Canada has recommended testing immigrants for HIV before granting them entry - a controversial move opposed by refugee advocates and AIDS activists.

It’s now up to Immigration Canada to weigh that advice from federal public health experts, and rule on testing newcomers.

"It’s under review right now," says Immigration Canada spokesperson Martin Theriault. "The Canadian public’s interests are our prime concern."

An internal Health Canada memorandum, obtained under the Access to Information Act, describes the existing policy (of no HIV screening) as "the highest health risk option, since persons who do not know their HIV status are currently admitted and thus present an increased risk of spreading HIV to others."

But Geraldine Sadoway, a staff lawyer at Parkdale Community Legal Services who handles immigration cases, said screening migrants for HIV would split families, forcing them to leave behind infected relatives.

"It’s horribly harsh," she said. "And it would deny the contributions of all the people in Canada who are HIV-positive by saying that people like them should not be allowed into the country."

Health Canada conducted extensive research before giving its advice, said Dr. Ron St. John, director of emergency response at the department’s population and public health branch.

"A lot of work went into it," he said. That included creation of a new computer model designed to scientifically evaluate the usefulness of screening for several infectious diseases.

According to that model, called the Montebello Process, screening immigrants for HIV - and excluding those who are infected - is Canada’s "best public health option." Immigrants are currently tested for syphilis and tuberculosis. Those with active disease are kept out until they’re cured. But there is no cure for an HIV infection.

Without screening, there’s no way of knowing how many newcomers carry the virus. But the Montebello Process calculates that, on average, a migrant with an infectious disease like HIV transmits the condition to at least one Canadian resident, St. John said. And that’s a "pretty conservative" estimate, he added.

Worldwide, 34.3 million people are infected with the human immuno-deficiency virus (HIV), which causes AIDS, according to data from the 13th International AIDS Conference in Durban this spring.

Several states restrict the entry of people with HIV. Singapore, for example, requires anyone who wants to live and work there for more than six months to undergo a test for the virus. Those found to be infected are expelled.

Australia screens newcomers but allows those with HIV to stay, provided they meet certain criteria, such as having a spouse who is a citizen.

The United States tests new immigrants for the virus and also bars people known to be infected from entering even for short visits. Health Canada’s proposal would apply to immigrants, refugees, and visitors coming to Canada for more than six months.

Health Canada documents indicate that the public appears firmly behind the HIV screening of migrants.

The polling firm Angus Reid found strong support for mandatory screening, and for the exclusion of migrants found to be infected. Some people felt that the health care system was already stretched to the limit, and immigrants with HIV would be an economic burden. Others worried about Canadians catching the virus.

"It’s depressing," said Toronto immigration lawyer Lorne Waldman.

People with HIV can live productive lives for many years, more than covering their eventual health care costs, he said. And, in any case, far more visitors come to Canada than immigrants and there’s no way to test everyone.

"You can’t build a wall around the country," he said.

Lee Zaslofsky, advocacy co-ordinator at the AIDS Committee of Toronto, warned that a dangerous precedent would be set if the Canadian government imposed HIV testing on a category of people. "It’s disruptive. It’s bad practice. There’s got to be a better way," he said.

Theriault, Immigration Canada’s spokesperson, said there’s no deadline for a decision on HIV screening.

"We have to strike a balance and make sure the Canadian public’s interests are taken into consideration, and also the right to freedom of movement," he said.