AEGiS-BAYW: Syringes and spine

Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.

Syringes and spine

Bay Windows - February 13, 2008
Richard J. Rosendall

This week on Capitol Hill, supporters of syringe exchange programs (SEP) for HIV prevention celebrated a victory. Last year, Rep. Jos Serrano (D-N.Y.) led successful efforts in the House of Representatives to allow the District of Columbia to spend its own funds on syringe exchange after a nine-year ban. D.C. has the highest HIV infection rate in the country, and CongressÆ ban on local funding (interference not faced by the states) severely hampered prevention efforts. President BushÆs 2009 budget proposal calls for reinstating the local funding ban in D.C., but that will likely be ignored by congressional Democrats.

A campaign is now underway to overturn the older nationwide ban on federal funds, dating to 1988. We came close ten years ago.

In 1998, President ClintonÆs Secretary of Health and Human Services, Donna Shalala, was ready to call a press conference to confirm scientific findings that SEP helped decrease HIV infections without increasing drug abuse, and to announce that federal funds could be used for the purpose. At the last minute, Clinton bowed to pressure from his drug czar, General Barry McCaffrey, who claimed syringe exchange sent the wrong message to children. In the end, Shalala had to defend continuation of the federal funding ban despite confirming the effectiveness of syringe exchange.

POZ magazine founder Sean Strub urged Secretary Shalala to resign in protest. He wrote, "LetÆs hope that ClintonÆs modestly supportive (albeit failed) initiatives on gay issues are never confused with his record on AIDS, which is one of cowardice, opportunism, callous disregard and cynical dismissal." Scott Hitt, head of ClintonÆs AIDS advisory panel, said, "At best this is hypocrisy. At worst, itÆs a lie. And no matter what, itÆs immoral."

For two decades, the federal government, in the name of its ill-conceived "war on drugs," has blocked funding for a program proven to save lives. The irrationality of the "Just Say No" mindset, whether pertaining to drugs or sex, has been amply criticized. What is more disturbing is the silence and even complicity of people who know better. Clinton caved so many times on so many issues that one wonders what he thought the Oval Office was for. Oh, never mind.

What about the Clinton now running for president? Sen. Hillary Clinton answered a question last April from AIDS activist Charles King about SEP by saying, "I want to look at the evidence on it." Reminded that Secretary Shalala had affirmed the effectiveness of syringe exchange but that President Clinton had refused to end the federal funding ban, Sen. Clinton cited political realities. King pointed out that she had said we need a president with spine, and she replied, "WeÆll have as much spine as we possibly can, under the circumstances." By contrast, Sen. Barack Obama supports lifting the federal funding ban. John McCainÆs Senate office did not respond to an AP query, but he voted on the Senate floor against D.C. funding of SEP in 2001.

It is not only the feds who have allowed ideology to trump the evidence on this issue. For example, in 2006, after Massachusetts lawmakers finally passed a bill permitting the sale of hypodermic syringes without a prescription, it was vetoed by then-Gov. Mitt Romney. Fortunately, the veto was overridden. On the other hand, life-saving needle exchange programs have been limited to four Massachusetts cities (Boston, Cambridge, Northampton and Provincetown) due to local opposition. This underscores the need for federal leadership.

For now, with D.C. finally able to fund syringe exchange, there are many who deserve recognition for their leadership: Congresswoman Eleanor Holmes Norton (D-D.C.); D.C. Council member Jack Evans (D-Ward 2); PreventionWorks!, which in addition to operating an SEP without public funds, had to overcome police interference and community mistrust; AIDS Action; amfAR; DC Appleseed; Human Rights Campaign; The AIDS Institute and Director of Federal Affairs Carl Schmid; Washington AIDS Partnership and Executive Director Channing Wickham; and Whitman Walker Clinic and Associate Executive Director Dr. Patricia Hawkins.

On Feb. 7, National Black HIV/AIDS Awareness Day, the Harm Reduction Coalition launched a campaign with the NAACP, the National Urban League and other groups to lift the federal funding ban. African Americans are disproportionately affected by HIV, and intravenous drug use is a vector for new HIV infections. It is past time to put lives and science first; but experience shows that this requires more than a change of political party. It requires political will.

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