The Chicago Tribune, 435 North Michigan Avenue, Chicago, IL 60611 - 10 March 1997

All the research cited in the report corroborates what already has been known for years: Needle-exchange programs reduce HIV infections and save money. They even encourage a significant percentage of addicts to seek treatment.

Yet Shalala couldn't bring herself to ask Congress to lift its 1992 ban on HHS funding of needle-exchange programs. The ban stands until the Surgeon General -- who reports to Shalala -- vouches to Congress that such programs are safe and effective.

AIDS is spreading faster among intravenous drug users than in any other group. According to a study by the National Academy of Sciences, between 1981 and 1993 the percentage of new HIV infections due to unsafe homosexual sex has dropped from 74 to 47 percent, while those attributable to the use of dirty needles by intravenous drug users has doubled, to 24 percent.

Indeed, despite the recently reported annual decline in AIDS deaths overall, AIDS has become the leading cause of death in the African-American and Hispanic communities, primarily because of drug use and dirty needles. Most tragically, many of the victims are the babies or innocent sex partners of HIV-infected addicts.

Needle-exchange programs work. In a 1993 study by Yale University, they were shown to reduce HIV infections by a third. Another study, funded by the Centers for Disease Control and Prevention, indicated that needle exchanges even worked as a bridge for getting significant numbers of users into rehabilitation.

One of the most persuasive arguments is financial. Some 70 needle-exchange research projects, of varying sizes and uncertain funding, operate mostly in large cities, including Chicago. Their average annual budget comes to approximately $169,000 -- about what it costs to treat just one HIV-infected addict during the course of the disease.

None of the six studies cited in the HHS report found any basis for the fear that needle exchanges encourage drug use.

Yet the argument -- largely symbolic -- against these programs is that it looks incongruous for one branch of the government to "subsidize" drug use, however indirectly, while other agencies wage a multibillion-dollar war against it.

It is Shalala's responsibility to sort out facts from symbols -- and fears from reality -- and argue for sound, effective federal policies. By simply tossing the needle-exchange hot potato back to Congress without comment, she has failed in that role.

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