Build Families, Not Barriers

In 2007, the Centers for Disease Control and Prevention (CDC) issued Technical Instructions for Tuberculosis (TB) Screening and Treatment for Panel Physicians.

The primary goal of the new protocols is to minimize the number of immigrants entering the U.S. with multi-drug-resistant TB thereby curtailing the spread of this infectious disease among the U.S. citizenry. In May and June of 2009, CDC announced that immigrants over the age of 2 from Ethiopia and China would be subject to new TB protocols.

These new protocols require a series of tests for all immigrants, including children adopted abroad by U.S. citizens. For children adopted abroad by U.S. citizens, the tests will delay the adoption by a minimum of seven days depending on the test results could delay the issuance of visa to twelve (12) months or more.

Children adopted abroad by U.S. citizens are a unique immigrant population. Given the population’s unique situation, the implementation of these instructions is not in the best interest of these vulnerable children and should not be implemented for this population for the following reasons:

1. Adopted children of American citizens, much like children born to American citizens abroad, pose a negligible threat to the public health of the United States.

2. The CDC instructions deny U.S.-based medical treatment for children adopted by U.S. citizens.

3. The most vulnerable of all children are orphans who are older and have special needs. The new protocols will result in further developmental and physical delays for the children of American citizens.

4. The instructions do not apply to American citizens living abroad or their children and should not apply to children adopted by U.S. citizens.

5. The risk of TB transmission, even in active cases, is minimal for infected children under the age of 12 years.

6. After two weeks of treatment, and three negative AFB smears an infected person is no longer contagious. The CDC instructions therefore, are unnecessary when applied to adopted children of American citizens as the children will undoubtedly be treated immediately upon their entrance into the United States.

7. The new TB protocols will result in an increase in travel expenses for U.S.-citizen adoptive parents and unknown delays during adoption processes.

The CDC instructions, therefore, are unnecessary when applied to adopted children of American citizens. The new protocols are a significant and unnecessary roadblock, which may deny these children access to a permanent family. Implementing the protocols for this population is an excessive means of protecting against multi-drug resistant TB.