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Congress Set to End Needle Exchange Funding Ban: A New Front Opens in War on HIV/AIDS

Call to Action

We can no longer afford to waste time. With PEPFAR, we have made significant progress in global HIV prevention and treatment in heavily AIDS-burdened nations. Yet, we still live in a world where, for every 2 individuals treated for HIV, 5 more become infected. Federally-funded needle exchange programs will help curb HIV transmission in the injecting drug user community and reduce the risk of new infections among everyone.Thankfully, Chairman Obey took a major stride in support of this rights- and science-based prevention method last week.Yet, Representative Tiahrt and his cohorts will try to reintroduce the ban language into the spending bill, perhaps as soon as Friday, July 17.Who will get through to the opposition? Who will tell them that we need to break from politics as usual?We each must do our part to ensure Chairman Obey’s efforts are not in vain. We have an unprecedented opportunity to persuade our legislators to vote for long overdue change.Call members of the Appropriations Committee at 202-224-3121 TODAY. Call:

  1. Committee Members: Ask them to support Chairman Obey’s efforts and request that they vote against any amendment to the Labor, Health and Human Services Appropriations bill that would reinstate the federal ban or put further restrictions on syringe exchange. Conclude with Clean Needles Save Lives!
  2. Chairman Obey: Thank him for his commitment to ending the 20-year prohibition on this vital, science-based harm-reduction method.

Issue Overview

Last Friday, House Appropriations Committee Chair David Obey (D-WI), took the first — and courageous — step toward ending the 20-year ban on federal funding of needle exchange.For two decades now, a culture war has taken place, one pitting science against ideology and public health against politics. This prohibition has done nothing but impede efforts to address the global HIV/AIDS crisis.In its markup of the Labor-HHS-Education spending bill, the Subcommittee removed the ban on federal funding of needle exchange programs (NEPs). Lifting the ban provides greater options for States and local jurisdictions that require new and effective tools to prevent the spread of HIV. The ban equips those on the front lines to decide if, how, and where they want to implement syringe access and disposal services.Since the domestic policy is applied to U.S. foreign assistance, removing the ban also has a tremendous positive impact on harm-reduction efforts beyond our borders. This is particularly important in curbing the HIV/AIDS pandemic, since one-third of all HIV infections outside of sub-Saharan Africa are attributed to injection drug use (IDU).Longstanding Support from Health and Drug Policy LeadersThe ban language was first introduced in 1988, but evidence in support of funding NEPs has been piling up since before 1998, when then-Health and Human Services Secretary Donna Shalala and then-Surgeon General David Satcher detailed the effectiveness of these programs. Research has proven that needle exchange programs:

  • Reduce HIV transmission;
  • Do NOT increase drug use;
  • Provide entry points for drug treatment and other support services; and
  • Do NOT increase local crime rates.

The World Health Organization (WHO), the United Nations coordinating authority on international public health, has also indicated similar findings in this PDF document.Domestic and International SupportThere are a host of domestic and international organizations and agencies that support NEPs including:

  • the WHO,
  • Centers for Disease Control and Prevention (CDC),
  • the National Institutes of Health (NIH),
  • American Medical Association (AMA),
  • American Public Health Association (APHA),
  • American Bar Association (ABA), and
  • National Institutes on Drug Abuse (NIDA), among others.

For a longer list of supporting organizations, download this PDF document.Drug Czar SupportIn April 2009, Gil Kerlikowske, former Seattle Police Chief, in confirmation hearings (PDF) for his appointment as the new Director of the White House Office of Drug Control Policy, responded to Congressional questions regarding national needle exchange policy. He stated:

Needle exchange programs have been proven to reduce the transmission of blood borne diseases. A number of studies conducted in the U.S. have shown needle exchange programs do not increase drug use. I understand that research has shown these programs when implemented in the context of a comprehensive program that offers other services such as referral to counseling, healthcare, drug treatment, HIV/AIDS Prevention, counseling and testing are effective at connecting addicted users to drug treatment.

Opposition Aims to Sustain Culture WarHealth experts almost universally agree that NEPs reduce transmission of HIV and protect not only drug users but also the general population.Unfortunately, some members of Congress still refuse to accept the overwhelming scientific evidence. They are mounting opposition to removing the federal ban. The Washington Post recently reported Ranking Sub-committee Member Todd Tiahrt (R-KS) as saying,

I am very concerned that we would use federal tax dollars to support the drug habits of people who desperately need help.

In 1998, Former Surgeon General David Satcher warned,

One of the worst things that can happen in this country is for us to say, if the science doesn’t agree with our perspective, then we want to suppress the science.

Representative Tiahrt and others on the opposition are doing just that. They are blatantly ignoring the evidence and preparing to wage yet another battle in the culture war. As the legislation moves through Congress – maybe as early as this Friday (July 17th) – they will try to restore the ban to the bill and sustain the status quo which has until now hampered a more comprehensive response to the HIV/AIDS crisis, domestically and abroad.Undoubtedly, the opposition’s anachronistic anti-harm-reduction ideology has contributed to the rapid spread of the HIV epidemic. Needle sharing is a highly efficient form of HIV transmission, and the practice has led to explosive epidemics throughout our country and around the globe.The HIV pandemic continues to grow exponentially among populations in Eastern Europe and Central and South-East Asia, where it is largely driven by unsafe injection practices. Studies in cities around the world have shown that without adequate harm-reduction polices and programs, HIV prevalence rates can rise among drug users to as high as 90% in a very short period of time. Importantly, HIV also spreads sexually beyond drug user networks, infecting non-injecting partners.For more information on syringe exchange programs and materials for advocacy, please visit Harm Reduction Coalition: Syringe Access.