Select Committee on Health Written Evidence


Memorandum by Migration Watch (HA 5)


  1.  One of the Targets identified in the Strategy of the Committee's Third Report of Session 2002-03 was "to reduce by 25% the number of newly acquired HIV infections . . . by 2007" (see para 77). Progress towards this target will be virtually impossible as long as the government refuses to test immigrants for HIV when they apply for visas.

  2.  The Committee stated in its Conclusions and Recommendations, at para 18:

    "We are concerned by the trends in HIV and support the Government in its aim to reduce the prevalence of undiagnosed HIV and in turn to safeguard public health. Early diagnosis of HIV not only reduces the chances of it spreading within the community but it also greatly improves outcomes for those infected. On the basis of evidence we have heard, however, we do not believe mandatory testing of asylum seekers, refugees, immigrants, visitors newly arrived in this country, and returning residents, to be an effective way of achieving the Government's aim."

  It is the submission of MigrationwatchUK that testing on arrival is a "straw man" and that the Committee is evading the real issue, namely mandatory HIV testing overseas of persons applying to immigrate to the UK, by a doctor approved by the British government. Such testing should be confined, initially, to countries of high HIV incidence.

  3.  This would provide immigration authorities with information, relevant to public health and public finances, to consider in their evaluation of each case. Refusal would not be automatic but there would have to be strong reasons to grant the visa. Such a policy would substantially reduce newly acquired HIV infections in the UK. It would also assist in restoring public confidence in the immigration system.


  4.  Whilst the number of diagnoses of homosexually acquired HIV infections has been fairly stable for around 10 years, the number of heterosexually transmitted infections diagnosed in the UK continues to rise. The increase has been particularly sharp since 1999. In its Third Report of Session 2002-03 ("The Report"), the Committee said of HIV diagnoses made in the UK, at para 59:

    "Most of those people diagnosed in the UK who have acquired infection heterosexually were not infected in this country. In answering our questions on heterosexual infection abroad, Dr Vicki King, a microbiologist in the Communicable Diseases branch of the Department of Health, confirmed this. In the late 1980s and early 1990s the majority of the African infections were acquired in East Africa but more recently the impact of the HIV epidemic in South Eastern Africa has been greater."

  5.  According to statistics produced by the Health Protection Agency, 90% of diagnoses of heterosexually transmitted HIV in 2003 were of cases thought to have been acquired overseas, largely from Africa. There is currently no mandatory testing for HIV of persons applying to immigrate to the UK. There is, however, such testing for applicants to immigrate to any of 47 other countries, including the USA, Canada, Australia and New Zealand.

  6.  According to Professor Pat Troop, Chief Executive of the Health Protection Agency, "Each HIV infection prevented can save between £500,000 and £1 million in treatment and lost productivity . . .". Taking the lower figure gives the cost of infection, from Malawi, Zambia and Zimbabwe alone, as £750 million per year. The Government's response so far is to increase funding for all Sexually Transmitted Diseases by £100 million a year for three years. As the Report states, at 58:

    ". . . specialist HIV service providers . . . have been struggling to meet increasing demand for counselling, testing and treatment . . . Our recommendations draw attention to serious concerns that the spiralling cost of HIV drugs will continue to deplete the resources needed by clinical and support services for sexual health . . ."


  7.  The sexual health crisis in the UK is being exacerbated by the unnecessary and avoidable importation of cases of HIV. This is also having the effect of taking up a disproportionate share of badly needed resources for tackling the existing domestic crisis. Whilst the Government may not be willing to consider a policy of refusing admission to immigrants on the basis of their HIV-positive status, we submit that this information should be available for immigration authorities to take into account when making decisions in individual cases, as is the case in 47 other countries across the world.

  8.  Rather than making testing for HIV compulsory on arrival in the UK—an option that the Committee has already (and rightly) ruled out—testing should be made compulsory as part of an application to immigrate to the UK. Tests could be carried out overseas by a doctor accredited for the purpose by the General Medical Council.

  9.  As a recent poll in The Economist showed, public hostility to immigration in Britain has grown considerably since 1997, and has done so across the board. If immigration policy is to enjoy public support, it must be and be seen to be in the national interest. The current levels of immigration by HIV sufferers and the cost of their treatment to the public purse is undermining public confidence in the immigration system, and must be effectively addressed.

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