Twelve leading medical and public health experts across the United States called on the Biden administration and Congress today to repeal the Title 42 border expulsions order as planned on May 23.
In response to a Tuesday Axios report that the Biden administration is considering a delay of the repeal of the order in response to political pressure, top medical and public health experts emphasized that there was never a sound scientific justification for Title 42 border expulsions, which instead result in profound health and human rights harms for asylum seekers.
The experts include staff at medical and public health schools at Harvard University, Johns Hopkins University, Columbia University, University of California Los Angeles, and other top universities, as well as health professionals who provide medical care in Tijuana, Mexico to asylum seekers impacted by Title 42 border expulsions. Adding their voices to the 1300+ medical professionals across 49 U.S. states and territories who called on the Centers for Disease Control and Prevention (CDC) to end “junk science” Title 42 border expulsions in October, 2021, today the 12 experts roundly condemned discriminatory border expulsions and urged the administration to lift the policy on May 23 as promised:
“This was never a policy based on protecting the American people from COVID-19, but rather to advance an anti-asylum agenda. It is past time to repeal the Title 42 border expulsions and meet our international obligations to refugees and asylum seekers.”
-Chris Beyrer, MD, Desmond M. Tutu Professor, Johns Hopkins Bloomberg School of Public Health
“The use of Title 42 is a cynical use of public health to justify a racist enforcement of immigration and asylum policy. As Ukrainian asylum seekers are welcomed to the U.S., Title 42 has been disproportionately used against migrants and asylum seekers from Latin America and the Caribbean. In addition to the racist bias of the use of Title 42, it has no scientific merit. Given that the U.S. remains the global epicenter of COVID-19, the presumption that immigrants and asylum seekers are likely to bring COVID-19 to the U.S. is preposterous. Haitian people have been particularly targeted because of the use of Title 42. During the Biden administration alone, the law has been used to send more than 215 full flights of Haitian people (both adults and children) to Haiti. Many of these people are fleeing political violence and others have not lived in Haiti for years if not decades, working largely in South America. Haiti is gripped by unprecedented violence, enough for even Doctors Without Borders, a group specifically focused on settings of conflicts, to be forced to suspend medical care due to gang violence. Sending asylum seekers back to a country under such threat violates international human rights laws. These deportations are based on a false premise of contagion, implemented along lines of racial bias and can be lethal to many fleeing political violence in Haiti and elsewhere. Sadly, more often than not, U.S. foreign policy has fomented much of the unrest. The use of Title 42 must be stopped.”
-Joia Mukherjee, MD, MPH, Chief Medical Officer, Partners In Health, Associate Professor of Medicine, Harvard Medical School
“Title 42 order is based on political rather than public health considerations and has costs for the lives and well-being of asylum seekers. Title 42 has no current epidemiologic or medical basis. There appears to be unequal treatment of asylum seekers in the United States based on nationality, ethnicity, and race. Ukrainian refugees seem to be receiving different treatment and possibly an exemption from Title 42, which is not afforded to asylum seekers at the southern border. The misapplication of Title 42 violates the principle of non-refoulment of refugees, the foundation of international humanitarian law, and enables discrimination based on the passport that one holds more importance than the purpose of their asylum.
–Rachel T. Moresky, MD, MPH, FACEP, Director, Columbia University sidHARTe – Strengthening Emergency Systems, Associate Professor of Emergency Medicine and Public Health, Columbia University Mailman School of Public Health & Vagelos College of Physicians and Surgeons
“Finally ending Title 42 – which expelled asylum seekers without allowing them to present their claims for asylum – is both the right and the smart thing to do. Since March 2020, we and other public health and medical experts have denounced the misuse of public health arguments to justify these expulsions. And any public health argument for Title 42 is now even more specious at a time when mask mandates and other precautions are being lifted. Human rights and health organizations like Physicians for Human Rights and Human Rights First have documented the severe mental health and health harms those expelled have suffered. The current arguments for extending Title 42 have laid bare that the order was implemented for political rather than public health reasons. Extending Title 42 is not the answer to the urgent need to create an equitable, humane, and trauma-informed asylum system.”
–Michele Heisler, MD, MPA, Medical Director, Physicians for Human Rights (PHR), Professor of Internal Medicine and Public Health, University of Michigan
“As an emergency medicine physician and frontline provider, I understand the real risks of Covid-19. It has therefore been with deep feelings of shame that I’ve watched the CDC, our highest public health organization, so clearly value politics over true science with Title 42. As one of the founders of Refugee Health Alliance, I’ve seen these false truths lead to loss of life, debilitating worsening of disease, continued trauma, and suffering for asylum seekers in Tijuana.”
-Hannah Janeway, MD, MS, Co-founder/Co-Director, Refugee Health Alliance, Assistant Clinical Professor of Emergency Medicine (voluntary), UCLA
“The United States is shamed by a historical legacy of using public health as a pretext to justify racist and xenophobic U.S. immigration policies. In the past, it was typhus, trachoma, and HIV, though the ever-shifting medical labels misused to exclude immigrants also went beyond so-called contagions to include mental disorders, chronic disability, or even a poor physique. Today the medical excuse misused to exclude is COVID-19. These exclusionary practices, including Title 42 border expulsions, are not now, and were not ever, based on public health principles.
We in medicine and public health often pretend we are immune from the pernicious plagues of racism, xenophobia, and hate. Tragically, these pathologies continue to propagate within our ranks. Not anymore. Not in our name. Tools exist to calibrate mitigation procedures to safely process migrants in response to local COVID conditions. There is no public health justification for Title 42 expulsions.”
-Adam Richards, MD, PhD, MPH, Milken Institute School of Public Health, School of Medicine and Health Sciences, The George Washington University
“Blocking our borders for asylum seekers through Title 42 while allowing travel for everyone else is a blatantly discriminatory practice that doesn’t protect our public health in any way and also causes severe and irreparable harm. We have seen that the traumas inflicted by such policies reverberate across generations. This is cruel and unnecessary when we have a robust public health toolkit with evidence-based COVID-19 mitigation measures that would allow the United States to welcome and process asylum seekers safely and lawfully at U.S. ports of entry. We, experts in medicine and public health, are here to offer our guidance and support to help create humane policies within a human rights framework that effectively protect public health.”
-Vidya Kumar Ramanathan, MD, MPH, FAAP, Medical Director, University of Michigan Asylum Collaborative, Pediatrician
“Public health needs to be used for the public’s health. Simply put, redirecting public health for any other goal only undermines public health. Infectious diseases shouldn’t be used as a bugbear. We have the means to mitigate and protect against COVID-19. Those seeking safety are not the persons responsible for this epidemic. At this time more than any other, we need to strengthen communications and public trust in the impartiality and professionalism of public health. Any twisting of messaging undermines what matters most.”
-Megan Coffee MD, PhD, Assistant Professor, Mailman School of Public Health, Columbia University
“The continued use of Title 42 is nothing more than an inhumane immigration policy masquerading as public health. Title 42 is not, nor has it ever been, an effective approach to addressing the COVID-19 pandemic. Instead, Title 42 weaponizes public health for political purposes, directly contradicting the tenets of public health to promote and protect the health and wellbeing of all.”
–Katherine McCann, MPH, Senior Program Officer, Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University
“Delaying the repeal of Title 42 would potentially have devastating health effects on thousands of refugees in Tijuana, Mexico. While refugees are waiting to be processed they are exposed to violence, poor living conditions, and insufficient access to health care. We strongly oppose delaying the elimination of title 42. There is no scientific evidence backing Title 42 effectively reducing COVID exposure to U.S. populations. Instead, this policy highlights discriminatory policies meant to exclude migrants from their human right to seek asylum.“
-Dr. Lynnea W. Morm, DO, Refugee Health Alliance
“I am a child psychiatrist who regularly provides free evaluations to refugees and asylum seekers at the border. I can say without a doubt that those seeking refuge are there due to collateral damage from American international policies and campaigns. Title 42 has similarly been putting these displaced peoples in harm’s way – only compounding the traumatic experiences from their country of origin, their journey, and their wait in limbo – in a country which cannot safely repatriate them. I urge you to ameliorate some of the harm that has been done by lifting Title 42, as it has not prevented any spread of disease. Instead, it has only deepened the wounds of intergenerational trauma which may take decades if not centuries to heal, in the best of circumstances.”
-Valeria Karina Anaya, MD, Child, Adolescent, General Psychiatrist, Adjunct Voluntary Professor- Keck USC
“Title 42 is and always has been an immigration agenda under the guise of a public health policy. Discriminatory border expulsions of asylum seekers do nothing to safeguard public health. It is also beyond reckless that some members of congress are holding up global COVID-19 aid by trying to add a Title 42 provision to the package. Funding for global COVID-19 vaccine distribution protects Americans – Title 42 does not.”
-Amy Zeidan, MD, Assistant Professor of Emergency Medicine, Emory University School of Medicine, Adjunct Professor, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Co-Director Georgia Human Rights Clinic
PHR Resources on Title 42:
- Congressional testimony by Dr. Adam Richards, GWU/PHR: “Expelling asylum seekers under Title 42 has not done anything to protect us from COVID,” April 6, 2022
- New England Journal of Medicine perspective: “Misusing Public Health as a Pretext to End Asylum — Title 42,” March 23, 2022
- Report: “Neither Safety nor Health: How Title 42 Expulsions Harm Health and Violate Rights,” July 28, 2021
- Press release: “PHR Welcomes CDC’s Plans to Rescind “Scientifically Baseless and Politically Motivated” Title 42 Border Expulsions,” April 1, 2022
- Press release: “After Two Years of Health and Rights Abuses, it’s Past Time to End Title 42 Border Expulsions: PHR,” March 17, 2022
- Press release: “1,300+ Medical Professionals from 49 U.S. States and Territories Call on CDC to End ‘Junk Science’ Border Expulsion Policy,” October 28, 2021
- The Hill op-ed: “The CDC’s Title 42 order fuels racism and undermines public health,” October 16, 2021
- Press release: “PHR Condemns Biden Administration’s ‘Indefensible’ Extension of Title 42 Border Expulsion Order,” August 3, 2021
- Open Letter: “Coalition Letter to the Biden Administration on Title 42 Border Expulsions,” June 20, 2021
- Fact Sheet: Title 42 Border Expulsions: How Biden and the CDC’s Misuse of Public Health Authority Expels Asylum Seekers to Danger,” May 20, 2021
- Webinar: “Title 42: The Misuse of Public Health to Restrict Asylum,” May 6, 2021
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.