A report on how diseases such as HIV and TB spread across the globe warns that serious infections could be driven underground if the UK adopts a 'fortress approach' to immigrants.
As Ministers consider compulsory screening of asylum-seekers and refugees in order to combat the spread of communicable diseases, public health experts are warning that such measures could backfire.
The report, from the London School of Hygiene and Tropical Medicine, concludes that traditional ways of coping with international health risks, such as tighter border controls, no longer work. It warns that rapid movement of pathogens around the world thanks to air travel, tourism and illegal trafficking of people can take continents by surprise within days, as shown with the Sars outbreaks.
Tourists going abroad and young people living in Britain need to be given greater warning of health risks, and there should be easier access to clinics where diseases can be diagnosed and treated to quell the beginnings of any epidemic.
Many HIV specialists want the Government to set up a hard-hitting campaign to shatter the complacency of a younger generation who believe they are not at risk. It was the 'tombstone' adverts in the Eighties which alerted the nation to the risks of the disease.
Last year there were around 6,600 new cases of HIV, of which two-thirds were spread through heterosexual sex. Three out of four of these cases were acquired abroad, mostly from African countries where rates of HIV are high.
Aids physicians ignited a fierce debate on the role of immigrants and disease when some warned they could not cope with the influx of refugees into their clinics. Their opponents say this is due to the shortage of sexual health services nationwide, rather than a large increase in cases, and that the policy of dispersal for asylum-seekers means smaller clinics are now seeing more cases.
There are worries about politicians adopting a fortress mentality at a time when the focus in Westminster is increasingly on clamping down on asylum-seekers with HIV. A more effective move, doctors say, would be to prevent it spreading into the heterosexual population in the first place by fostering greater use of condoms.
Dr Angela Burnett, a GP in Hackney, east London, said: 'We offer screening to a lot of refugees, both for HIV and TB, and I'm surprised the rates are not higher, given where they come from. But to say they are banging on the doors, demanding free treatment is a fallacy. Most are not even aware they are entitled to treatment. Also, we have to remember that they come from areas of conflict. Many of the women have been raped, and I think their suffering needs to be kept in mind as part of the debate.'
Professor Michael Adler, a renowned HIV physician who was the Government's adviser on sexual health, said: 'The question is whether screening would affect your immigration status. Could it drive some diseases underground? I think it has the potential to do that. The real problem is that services are under such pressure that we're not picking up all the existing cases, and that is where improvements need to be made.'
There is growing unease about whether compulsory screening would encourage more people to try to enter Britain illegally. Canada, Australia and other countries have compulsory screening for the disease, but none has seen rates of infection falling.
Kelley Lee of the London School of Hygiene said: 'Border controls might reassure the public, but they are going to be ineffective. What no one wants is to have people walking around who might be infecting others but who are not going to get checks because they are worried about their immigration status. If they disappear off the radar screen, that could be really dangerous.
'Around four million people are thought to have been trafficked illegally around the world last year, a lot of them women who have to work as prostitutes. These are the kind of people who need to be encouraged to have voluntary screening, because without that we're all at risk.'
Her report may not go down well with the Cabinet Office, which is said to be considering plans to test all immigrants for HIV. Apart from the ethical consideration, the plan presents enormous logistical challenges.
Neil Gerrard, the Labour MP who chairs two all-party parliamentary groups, one on Aids and the other on asylum-seekers, said: 'There are 12.5 million people coming into Britain every year who are subject to immigration control. They are visitors, people on work permits, students, au pairs and asylum-seekers. How are we going to screen all of them? It would be an impossibility.'
