The Trump administration has issued a directive not to issue U.S. visas to individuals suffering from severe health conditions such as heart disease, diabetes, cancer, respiratory, neurological, and metabolic disorders, as well as mental health conditions. Since Donald Trump was elected for a second term, the administration has tightened immigration rules across the United States. The new directive is expected to further narrow the scope for obtaining U.S. visas based on family or employment ties. The rate of these serious illnesses is increasing, especially among Bangladeshis. In this situation, experts believe that the new directive could reduce the opportunities for Bangladeshis to obtain visas and immigrate to the United States. However, there has been no clear instruction regarding non-immigrant visas such as B-1/B-2, F-1, or J-1, with final decisions left to the discretion of consular or immigration officers.
The Trump administration has also instructed that visa applicants who might rely on government assistance in the future due to age or health conditions be deemed ineligible. The directive was issued last Thursday, U.S. time. It stated that such individuals may be considered a “public charge,” or a potential burden on U.S. resources. In the meantime, the U.S. State Department has already sent instructions to U.S. embassies and consular offices worldwide. The issue has been widely covered by international media, including in the United States.
According to the new directive, an applicant’s health must be treated as a key consideration in the immigration application process. Certain complex illnesses, such as heart disease, respiratory diseases, cancer, diabetes, metabolic disorders, neurological conditions, and mental health problems, are listed as areas of concern.
The directive also calls on visa officials to take obesity into account, as it can lead to complications such as asthma, sleep apnea, and high blood pressure. Noting that treating such conditions could cost millions of dollars, the guidelines urged officers to consider the financial means of the visa applicant to see they are able to afford the medical expenses without assistance from the U.S. government. Officers have also been asked to verify whether any of the applicant’s family members suffer from chronic conditions or require special care that might prevent the applicant from maintaining regular employment.
Under the current U.S. visa policy, applicants are screened for infectious diseases, and they must disclose any history of drug or alcohol use, mental health issues, or violent behavior. They also have to provide proof of vaccination against diseases such as measles, polio, and hepatitis B. In this situation, by including the issue of complex diseases in the visa conditions, officials believe applicants will now face even stricter scrutiny, leading to an increased rate of visa denials. The directive is especially applicable to those seeking immigrant visas. However, since many Bangladeshis later apply for permanent residency after arriving in the U.S. on other visa categories, the new rule could potentially affect all types of visas.
Former Bangladesh Ambassador to the United States M Humayun Kabir told Bonik Barta, “Those who went to the United States for studies and were allowed to stay there on H-1B visas are now finding those opportunities increasingly restricted. The new health-related visa directive has been introduced as part of an effort to curb cyclical migration. Under this process, individuals who obtain permanent residency or citizenship in the United States later bring in their family members there.”
Stating that the new directive would further narrow the opportunities for permanent migration to the United States, he added, “I think the Trump administration is trying to restrict cyclical migration. Due to the new directive, those who aspire to settle permanently in the country will now face greater obstacles. If any family member has these health conditions, they will likely be denied visas. Many might also lose interest in going through such a complicated process. In such a situation, there are also concerns that other countries might follow the U.S. example and tighten their own immigration systems. Immigration contributes significantly to our economy. So we must now take initiatives on how to respond to these immigration challenges emerging globally.”
In Bangladesh, the number of people suffering from heart disease, cancer, and diabetes is increasing every year. Respiratory diseases are also on the rise due to environmental pollution. Medical researchers say there is no precise national statistics on how many new cancer patients are diagnosed each year in the country. However, according to a population-based cancer registry conducted by researchers at the Department of Public Health and Informatics of Bangladesh Medical University (BMU), 114 out of every 100,000 people in the country are suffering from cancer. Based on this study and Bangladesh’s total population of 173 million, the estimated number of cancer patients stands at 197,200.
According to the Global Cancer Observatory, a total of 167,257 new cancer cases were identified in Bangladesh in 2022. And between 2018 and 2022, a total of 346,337 cancer patients were diagnosed.
Data from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington shows that an estimated 2,720 people in Bangladesh are diagnosed with heart disease every day. The total number of heart disease patients in the country stands at 10.26 million. While in many other countries, 8 to 10 children per thousand are born with heart disease, the figure in Bangladesh is significantly higher. According to the Kids Heart Foundation (KHF), 25 out of every 1,000 children in the country are born with congenital heart disease.
Professor Dr. Abdullah Shahriar, general secretary of the Pediatric Cardiac Society of Bangladesh (PCSB) and head of Pediatric Cardiology at the National Institute of Cardiovascular Diseases (NICVD), told Bonik Barta, “Currently, diabetes, hypertension, and heart diseases are more common in our country. And these conditions are increasing among young people. The prevalence of these diseases is higher in Bangladesh compared to other countries. Due to the genetic characteristics of our population, the rate will likely rise further in the future. Students or professionals who go abroad often come to us for NOC (No Objection Certificates). They need to go through some medical tests. If these illnesses cause complications in obtaining visas, then many Bangladeshis will face difficulties. Many travel to the United States for study or work. Their chances of going to the U.S. may now become much slimmer.”
Bangladesh ranks eighth in the world in terms of the number of people living with diabetes. According to the National Guidelines for Diabetes Mellitus published in 2023, around 13.1 million people in the country have diabetes, with 14.2 percent of the population aged 20 to 80 suffering from the disease. A 2023 survey by the Bangladesh Lung Foundation found that around 7 million people in the country suffer from chronic obstructive pulmonary disease (COPD).
Dr. Kazi Nazmul Hossain, Assistant Professor in the Department of Endocrinology and Diabetology (Unit-2) at BIRDEM General Hospital, told Bonik Barta, “It was once believed that diabetes affected only older adults. But now we are seeing the disease increasing among the young population. Due to changes in diet, reduced physical activity, and genetic factors, we fear that the number of diabetes patients will continue to rise.”
According to the Pew Research Center, an estimated 300,000 people identified as Bangladeshi in the United States in 2023. Among them, 270,000 are of Bangladeshi origin. Around 71 percent of the Bangladeshi population in the U.S. are immigrants. The number of Bangladeshi immigrants in the country rose from 35,000 in 2000 to 190,000 in 2023. Of them, 55 percent have lived in the United States for more than a decade, and 60 percent have already obtained U.S. citizenship.
The new directive instructs visa officers to consider applicants’ financial capacity during visa approval. However, according to Pew Research Center data, Bangladeshi immigrants generally have lower income levels compared to other Asian immigrant groups in the United States. The median annual income for Bangladeshi households is $78,400, significantly lower than the $105,600 average for other Asian households.
The number of Bangladeshi students going to the U.S. has been rising each year. Most of these students aim for permanent residency in the country. Under the new visa directive, Bangladeshi students with relevant health issues will now have limited opportunities for immigration. According to the 2024 Open Doors Report on International Educational Exchange, there were 17,099 Bangladeshi students in the United States during the 2023–24 academic year. This represents a 26 percent increase from the previous year, moving Bangladesh from 13th to 8th place among countries sending international students within a single year. Over the past decade, the number of Bangladeshi students in the United States has risen by 250 percent. In the 2013–14 academic year, there were 4,802 students. The number grew to 17,099 in the 2023–24 academic year.
Tasneem Siddiqui, founder-chair of the Refugee and Migratory Movements Research Unit (RMMRU), told Bonik Barta, “The country decides to grant or deny visas. But denying visas based on illness violates human rights. No international law allows this. The United Nations has declared various rights. This is a violation of those rights. We have many immigrants living in the United States. Their parents travel back and forth regularly. This will have a big impact. The hardship for Bangladeshis living in the U.S. will increase.”