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Feature: Federal Needle Exchange Funding Ban Battle Continues

Years of effort by harm reductionists, public health authorities, HIV/AIDS researchers and activists, and drug law reformers to undo the more than 20-year-old ban on federal funding for needle exchange programs (NEPs) may come to fruition this year, but there are significant obstacles to overcome. Still, advocates of the reform are cautiously optimistic.

Since 1988, the US government has prevented local and state public health authorities from using federal funds for NEPs, which studies have shown to be effective in reducing HIV infection rates among injection drug users (IDUs) and their sexual partners, promoting public health and safety by taking syringes off the streets, and protecting law enforcement personnel from injuries. NEPS have been endorsed by the World Health Organization, the American Medical Association, Centers for Disease Control and Prevention Director Thomas Frieden, and former Surgeons General Everett Koop and David Satcher, among many others.


Chicago map demonstrating the impact of the
1000-foot rule -- click for larger copies and more
maps of Chicago and San Francisco (courtesy
Dr.Russell Barbour, Center for Interdisciplinary
Research on AIDS, Yale School of Medicine)

Injection drug use accounts for up to 16% of the 56,000 new HIV infections in the US every year -- or nearly 9,000 people. IDUs represent 20% of the more than 1 million people living with HIV/AIDS in the US and the majority of the 3.2 million Americans living with hepatitis C infection.

Still, those numbers could have been higher. In a 2008 study, the CDC concluded that the incidence of HIV among injection drug users had decreased by 80% in the past 20 years, in part due to needle exchange programs. There are today an estimated 185 NEPs operating in 36 states, the District of Columbia, and Puerto Rico. But they rely on local or private funds, and many of them are failing to meet demand because of lack of funding. While the CDC says that its public health policy goal is 100% needle exchange, current estimates are that only 3.2% of needles used by drug users in urban areas are exchanged for clean ones.

The federal funding ban was first removed in a July 10 vote of the House Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. A week later, the full Appropriations Committee approved the bill after voting down an amendment proposed by US Rep. Chet Edwards (D-TX) that would have reinstated the funding ban.

But the Appropriations Committee did approve an amendment dictating that federally funded NEPs could not operate "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity."

A floor amendment by Rep. Mark Souder (R-IN) to reinstate the funding ban also was defeated, clearing the way for repeal of the ban to pass the House. But the thousand-foot language remains in the appropriations bill approved by the House, and it's extremely objectionable to reform advocates. The Senate committee working on the issue did not include ending the funding ban, but reform advocates are pinning their hopes on both ending the ban and killing the thousand-foot restriction on the end-game House-Senate appropriations conference committee.

"The Senate has taken up their version of the bill in committee, but hasn't had a full vote," explained Daniel Raymond, policy director for the Harm Reduction Coalition. "At the committee level, the Senate chose not to take any action on the ban. At this point, there is a conflict between the House and the Senate." HRC is lobbying the Senate to repeal the ban, without the restrictions.

"We commend the full House for recognizing that NEPs are essential, effective tools that work in our fight against HIV and hepatitis transmission," said Kevin Robert Frost, chief executive of the Foundation for AIDS Research. "And while the compromise in the bill isn't perfect, we are hopeful that a final bill will reach President Obama's desk without limitations."

"We urge Congress to recognize both the benefit and cost-savings of syringe exchange programs, and the research that NEPs do not have detrimental impact on communities," said Marjorie Hill of Gay Men's Health Crisis, which has just released yet another study demonstrating NEPs' effectiveness in decreasing the transmission of blood-borne diseases. "For too long, we have allowed ideology to drive public health policy. It is time to remove the federal funds ban for syringe exchange and remove the harmful 1,000 feet restriction," added Hill.

"The House bill, as it stands, still puts ideology before science by limiting how federal funds can be used for NEPs," Frost said. "But we have time to fix the legislation, and I'm hopeful that the full US Congress will realize the importance of allowing local elected and public health officials to make their own decisions about how to address their HIV and hepatitis epidemics."

"I believe that the president, the Senate, and the House all want to do the right thing and they're trying to figure out how to do it," said Bill McColl of AIDS Action. "If they follow their own rhetoric about science- and evidence-based HIV/AIDS prevention policy, then they will remove the thousand-foot restriction," he said.

"The thousand-foot provision is a backdoor means of reinstating the funding ban," McColl continued. "There is almost no urban environment in which it would allow needle exchanges to operate. There are no currently existing needle exchanges that would be able to get federal funding, so it just doesn't make sense to change the policy that way. Drug policy groups have gone and literally shown Congress maps of what would be excluded. They've got letters from mayors and police saying this is not a workable provision. Again, Congress and the president know what the science is."

In addition to eliminating federally-funded needle exchanges in vast swathes of the urban landscape, the thousand-foot rule would have other insidious effects, said McColl. "Having that rule would have undesirable side effects, in that it would separate needle exchange from other public health services. Our AIDS program does testing in areas with lots of drug use -- that's where we need to be testing, and that's where we want the population to have clean syringes. With federal funding available and with the thousand-foot rule, prevention services will be driven away from needle exchanges."

Alice Bell, prevention project coordinator for Prevention Point Pittsburgh, already lives with geographical restrictions. "We have a local regulation that specifies 1,500 feet from schools only, not all the other restrictions in the current language of the federal bill. We have to move our main needle exchange site because the building we're in is being sold, and we're having trouble finding a good place. Any federal restrictions would make it even tougher," she said.

Bell wants the federal funding ban ended, but worries that the thousand-foot rule would put a crimp in her efforts. "We still want it. We need the federal funding. Our program is expanding, but we can't really expand our exchange service because we don't have money for needles. The toughest thing is always getting money for needles. Ending the federal funding ban would make a huge difference to us."

Federal funding becomes even more significant when coupled with economic hard times and budget problems at the state and local level, Bell noted. "We're mostly funded through foundations and private donations, and we've begun getting some state and county money for overdose prevention and HIV prevention, but the needle exchange -- the core of what we do -- is the toughest to get funded."

"The Senate will most likely go along with the House in conference committee," said Drug Policy Alliance director of national affairs Bill Piper. "They will probably take a bunch of appropriations bills and put them in a massive omnibus spending bill. It is far from clear that there will be a ban in what comes out of the Congress."

But the thousand-foot rule has to go, he said. "A lot of groups have been lobbying really hard on the thousand-foot issue," Piper noted. "It would be an effective ban is many cities. Here in DC, for example, the only place you could do a needle exchange program would be down at the docks on the Potomac. The strategy is to convince the conference committee to either take that out or come up with something better."

Advocates are lobbying hard right now, said the Harm Reduction Coalition's Raymond. "Right now, we're doing a push to make sure the Senate is educated about the issue and ask the leadership to get on board with House's action to address the ban," he said. "The House version has the thousand-foot restriction, so we're also making the arguments about why that's not workable and needs to be redone. We've been circulating maps showing its impact to House members who are focused on the issue. This restriction goes far beyond any reasonable desire to balance public health with other interests. When that provision was thrown in at the last minute, its effects hadn't really been thought out," he argued.

"We keep up the work in reaching out to Congress on both House and Senate side," said Raymond, "and we're also asking the White House to show some leadership and urge the Senate to address the federal ban. We don't want this issue to get lost in the shuffle, we're calling on everyone in the community to make our voices heard and reaching out to our elected officials."

It may take awhile to get settled, said Piper. "The entire appropriations process is messed up, and a lot of will depend on if, when, and how the Senate deals with health care," he explained. "Supposedly, they will get the appropriations bills done by the end of October, but I think that's a fantasy. Last year, they didn't even do this year's appropriations bills until March."

Still, AIDS Action's McColl maintains a positive outlook. "I think the members who will be called on to vote on this understand the issues," he said. "I have a pretty good feeling about this. I'm hopeful this is the year."

1000 Feet from Everywhere

One of the articles we are finalizing for publication in Drug War Chronicle tonight deals with needle exchange, and the state of legislation in Congress to end the ban on use by states of federal AIDS funds to support needle exchange programs. A bill has passed the House of Representatives -- good news -- but it includes a provision that would render it nearly useless. This provision would require that needle exchange programs receiving federal funds not operate "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, or university, or any public swimming pool, park, playground, video arcade, or youth center, or an event sponsored by any such entity." I'm not sure how any program could track where all the different such entities decide to hold events. More importantly, the rule would basically prevent needle exchanges from operating at all, because the area encompassed is pretty much everywhere inside any city. Dr. Russell Barbour, at Yale School of Medicine's Center for Interdisciplinary Research on AIDS, has produced several charts that advocates are using now on the Hill, illustrating the impact the provision would have on AIDS prevention efforts in Chicago and San Francisco. He graciously provided them to us. Check them out here: (more below the fold)

A Heroin User in Stockholm

Another video from the Hungarian Civil Liberties Union, this time in partnership with the Swedish Drug Users Union. Sweden's government is one of the world's most prohibitionist, but nevertheless has moved toward harm reduction in recent years by expanding needle exchange into a national policy. Previously needle exchange was happening only in two cities in the nation's south. Well, there's still no needle exchange in Stockholm, according to HCLU, it's even hard to get into a methadone maintenance program, and those who do often face negative attitudes from the program's staff. Check out the video below, or here.
Location: 
Stockholm
Sweden

Tear It Down, friends!

You Can Make a Difference

 

 

Dear friends,

The drug war’s foundation is beginning to crumble thanks to your hard work.

By just four votes, the House last week voted down an amendment that would have upheld the ban on federal funding for syringe exchange programs.  The ban has been in place since the 1980s and is one of the pillars of the drug war. 

With such a close vote, it’s clear that every single email, letter and phone call to Congress played a part in defeating the amendment.  In addition to your emails, we had staff calling congressional offices for days leading up to the vote, and our offices in California, New York, New Jersey and New Mexico organized grassroots efforts to persuade legislators from those states to end the ban. 

You and I are closer than ever to tearing down some of the worst drug war policies.  It’s time for Congress to own up to its mistakes and stop putting politics before public health and sound science.  Help us hold them accountable by making a donation today. 

While this recent victory is exciting, we’re not done yet.  Now we need your support to prepare for upcoming opportunities to dismantle failed drug war policies.

Discriminatory sentencing and mandatory minimums for nonviolent drug offenses could soon be reformed. Congress is also on the verge of repealing both the Barr Amendment, which prevents the District of Columbia from setting its own marijuana policy, and the Higher Education Act drug provision, which excludes students with drug convictions from financial aid.

We need your help to make sure we have the resources to keep the momentum going and win more victories against bad drug war policies.  Your donation will help us keep up the fight to end the drug war.

Sincerely,

Bill Piper
Director, Office of National Affairs
Drug Policy Alliance Network

 

Glorious Kyrgyzstan -- the Best Harm Reduction Program in Central Asia

The Central Asian Republic of Kyrgyzstan sits along a drug trafficking route, and has an estimated 80,000-100,000 drug users, more than half of whom inject drugs. Unlike some countries in the region, Kyrgyzstan has embraced harm reduction strategies such as needle exchange and methadone maintenance. Even prisoners in Kyrgyzstan have access to these programs. By going this route, they have been able to curb the country's HIV epidemic. A new video from the Hungarian Civil Liberties Union -- in Russian, with English subtitles -- tells the story. Check it out:

More Big News: Needle Exchange Legislation Passes US House of Representatives

As I noted here two weeks ago, legislation to repeal the ban on use of federal AIDS funds for needle exchange programs was included in a House subcommittee's health budget bill. The language survived an attempt on the House floor to repeal it, and so has made it through the full House of Representatives. Satisfyingly, the Congressman who tried to delete the language was Mark Souder, who also lost a committee vote on Tuesday to significantly gut his anti-student aid drug law. Souder's pro-AIDS amendment lost 211-218. The flip side is that 49% percent of Congress voted to continue spreading HIV and Hepatitis throughout our communities.
Location: 
Washington, DC
United States

Feature: Winds of Change Are Blowing in Washington -- Drug Reforms Finally Move in Congress

Update:Needle exchange legislation was passed by the full House of Representatives on Friday afternoon.

What a difference a change of administration makes. After eight years of almost no progress during the Bush administration, drug reform is on the agenda at the Capitol, and various reform bills are moving forward. With Democrats firmly in control of both the Senate and the House, as well as the White House, 2009 could be the year the federal drug policy logjam begins to break apart.

http://stopthedrugwar.org/files/capitolsenateside.jpg
US Capitol, Senate side
While most of the country's and the Congress's attention is focused on health care reform and the economic crisis, congressional committees are slowly working their way through a number of drug reform issues. Here's some of what's going on:

  • A bill that would eliminate the notorious sentencing disparity between crack and powder cocaine by removing all references to crack from the federal law and sentencing all offenders under the current powder cocaine sentencing scheme passed its first subcommittee test on Wednesday. This one was bipartisan -- the vote was unanimous. (See related story here)
  • The ban on federal funding for needle exchanges has been repealed by the House Appropriations Committee, although current legislation includes language barring exchanges within 1,000 feet of schools. Advocates hope that will be removed in conference committee. (Update:Needle exchange legislation was passed by the full House of Representatives on Friday afternoon.)
  • The Barr amendment, which blocked the District of Columbia from implementing a voter-approved medical marijuana law, has been repealed by the House.
  • Massachusetts Rep. Barney Frank's marijuana decriminalization bill has already picked up more cosponsors in a few weeks this year than it did in all of last year.
  • Virginia Sen. Jim Webb's bill to create a national commission on criminal justice policy is winning broad support.
  • The Higher Education Act (HEA) drug provision (more recently known as the "Aid Elimination Penalty"), which creates obstacles in obtaining student loans for students with drug convictions, is being watered down. The House Education and Labor Committee Wednesday approved legislation that would limit the provision to students convicted of drug sales and eliminate it for students whose only offense was drug possession. (See related story here.)
  • The "Safe and Drug Free Schools Act" funding has been dramatically slashed in the Obama administration 2010 budget.
  • Funding for the Office of National Drug Control Policy's youth media anti-drug campaign has been dramatically slashed by the House, which also instructed ONDCP to use the remaining funds only for ads aimed at getting parents to talk to kids.

"All the stars are now aligned on all these issues," said Bill Piper, national affairs director for the Drug Policy Alliance. "I've never felt so optimistic about drug policy reform in DC."

Looking into his crystal ball, Piper is making predictions of significant progress this year. "I have a strong sense that the Barr amendment and the syringe funding ban will be eliminated this year. The Webb bill will probably be law by December. There's a good chance that HEA reform and the crack sentencing reform will be, too. If not, we'll get them done next year," he said.

"Things are heating up like I've never seen before," Piper exclaimed. "It's like a snowball rolling downhill. The more reforms get enacted, the more comfortable lawmakers will be about even more. Cumulatively, these bills represent a significant rollback in the drug war as we know it."

Former House Judiciary committee counsel Eric Sterling, now head of the Criminal Justice Policy Foundation, was a bit more restrained. Congress is just beginning to come around, and there are dangers ahead, he said.

"We're seeing windows being opened where we can feel the first breezes of spring, but it's not summer yet," Sterling said. "There are people asking questions about drug policy more broadly, there is more openness on Capitol Hill to thinking differently. Liberals are not as afraid they will be attacked by the administration. The climate is changing, but my sense is we're still at the stage where members of Congress are only beginning to take their shoes off to put their toes in the water."

What progress is being made could be derailed by declining popularity of Democrats, the drug reform movement's failure to create sufficient cultural change and a stronger social base to support political change, and the return of old-style "tough on drugs" politics, Sterling warned.

"People need to be aware that as unemployment continues to rise, Democrats will be feeling afraid of repercussions at the polls," he said. "If the economic stimulus does not seem to be generating jobs, if there is a widespread sense of trouble in the country, the drug issue can easily be recast as a bogeyman to distract people. Members of Congress could start talking again about 'fighting to help protect your families.' Those old ways of thinking and talking about these issues are by no means gone," Sterling argued.

That is why he is concerned about building a social base to support and maintain drug reform. "The drug reform movement needs to create cultural change to support political change, and I fear we haven't done enough of that," he worried.

Sterling also warned of a possible reprise of the late 1970s and early 1980s, when the emergence of a parents' anti-drug movement helped knock drug reform off the agenda for nearly a quarter-century. The administration's effort to defund the Safe and Drug Free Schools Act in particular could spark renewed concern and even a reinvigorated anti-drug mobilization, he said.

"The administration says the Safe and Drug Free Schools program hasn't demonstrated its effectiveness and grant funds are spread too thin to support quality interventions, which may well be true," he said. "But little dribs and drabs of that get spread around the states, and that means a lot of people could be mobilized to fight back. The parents' community and prevention professionals will mobilize around these issues with renewed vigor," he predicted.

The Wild West show that is California's marijuana reality could also energize the anti-reform faction, Sterling said. "For those of us outside California, it's hard to fathom what's going on there. I don't think anyone back East can imagine a dispensary operating every quarter-mile along Connecticut Avenue," he explained. "I ask myself if this is growing in a way that could create a potential powerful reaction like we saw in the 1970s. There has already been a smattering of stories about marijuana use in school by patients. Will there be exposés next fall about medical marijuana getting into the schools, kids getting stoned? People in the movement have to be aware that very real and powerful emotions can be unleashed by these changes," he warned.

Still, "momentum is on our side," Piper said. "Webb's bill has bipartisan support, the sentencing stuff is taking off in a bipartisan way, and the crack bill has the support of the president, the vice-president, the Justice Department, and some important Senate Republicans. That's probably the steepest hill to climb, but I think we're going to do it."

These are all domestic drug policy issues, but drug policy affects foreign policy as well, and there, too, there has been some significant change -- as well as significant continuity in prohibitionist policies. And that situation is exposing some significant contradictions. Here, it is the Obama administration taking the lead, not Congress. The Obama administration has rejected crop eradication as a failure in Afghanistan, yet remains wedded to it in Colombia, and it has embraced the Bush administration's anti-drug Plan Merida assistance package to Mexico.

"The really exciting thing is Afghanistan and special envoy Richard Holbrooke's ending of eradication there," said Sanho Tree, drug policy analyst for the Institute for Policy Studies. "That's huge, and it has repercussions for the Western Hemisphere as well. The US can't have two completely divergent policies on source country eradication. On Latin America, I suspect there is a power struggle going on between the drug warriors and the Holbrooke faction. We need a Holbrooke for Latin America," he said.

The media spotlight on Mexico's plague of prohibition-related violence may be playing a role, too, said Sterling. "The mayhem in Mexico certainly created a lot of thinking about how to do things differently earlier this year," he noted. "The media climate has changed, and perhaps that's more important at this stage than the climate inside the Beltway."

But the Mexico issue could cut against reform, too, he suggested. "Where is all that marijuana in California coming from?" he asked. "If someone can make the case that Mexican drug cartels are supplying the medical marijuana market there, that could get very ugly."

As the August recess draws nigh, no piece of drug reform legislation has made it to the president's desk. But this year, for the first time in a long time, it looks like some may. There are potential minefields ahead, and it's too early to declare victory just yet. But keep that champagne nicely chilled; we may be popping some corks before the year is over.

Press Release: Congress and Obama Administration Embrace Major Drug Policy Reform

FOR IMMEDIATE RELEASE: July 22, 2009 CONTACT: Bill Piper at 202-669-6430 or Tony Newman at 646-335-5384 Congress and Obama Administration Embrace Major Drug Policy Reform Crack/Powder Disparity, Syringe Exchange Funding, Medical Marijuana, HEA Reform All Advancing Decades of Harsh and Ineffective Federal Laws Likely to be Dismantled this Year At least four of the worst excesses of the federal war on drugs appear likely to be rolled back this year – the crack/powder cocaine sentencing disparity, the federal ban on the funding of syringe exchange programs, the all-out federal war on medical marijuana, and the HEA AID Elimination Penalty. All four reforms are advancing quickly in Congress. “Policymakers from the President of the United States on down are calling for a paradigm shift so drug use is treated as a health issue instead of a criminal justice issue” said Bill Piper, director of national affairs for the Drug Policy Alliance. “Eliminating the crack/powder cocaine sentencing disparity, repealing the ban on federal funding for syringe exchange programs to reduce HIV/AIDS, allowing the District of Columbia to move forward with medical marijuana, and reforming the HEA Aid Elimination Penalty are all examples of pairing action with rhetoric.” The House Crime Subcommittee is expected to pass legislation today eliminating the crack/powder cocaine sentencing disparity that punishes crack cocaine offenses one hundred times more severely than powder cocaine offenses. Both President Obama and Vice-President Biden have spoken in support of eliminating the disparity. In numerous statements this year, Justice Department officials have called on Congress to eliminate the disparity this year. Last week, the U.S. House Appropriations Committee repealed the 20-year ban prohibiting states from spending their share of HIV/AIDS prevention money on syringe exchanges program to reduce the spread of HIV/AIDS, hepatitis C, and other blood-borne diseases. The full U.S. House takes up the underlying bill later this week. The ban is responsible for the deaths of tens of thousands of Americans. If the ban is not repealed, as many as 300,000 Americans could contract HIV/AIDS or hepatitis C over the next decade. President Obama called for elimination of the ban on the campaign trail. In legislation last week, the U.S. House repealed a provision of federal law that overturned a medical marijuana law approved by Washington, DC voters, setting the stage for the nation’s capital to make marijuana available to cancer, AIDS, and other patients, possibly as soon as next year. Earlier this year Attorney General Eric Holder declared that the Justice Department would no longer arrest medical marijuana patients, caregivers and providers, even if they violated federal law, as long as they were following the laws of their states. 13 states have legalized marijuana for medical use, but the Bush Administration raided medical marijuana dispensaries and made numerous arrests and prosecutions. In a vote yesterday, the House Education and Labor Committee reformed the HEA AID Elimination Penalty that denies loans and other financial assistance to students convicted of drug law offenses, including simple marijuana possession. Since 1998, more than 180,000 students have lost aid and many, no doubt, have been forced to drop out of college. Although the Obama Administration has not stated where it stands on the underlying law, it has said it wants to remove a question from financial aid applications that ask students if they have ever been convicted of a drug crime. In other drug policy news, Rep. Barney Frank (D-Mass.), chairman of the House Financial Services Committee, and Rep. Ron Paul (R- Texas) have introduced bi-partisan legislation to decriminalize possession of marijuana for personal use. Sen. Jim Webb, D-VA, President Reagan’s Secretary of the Navy, has introduced bipartisan legislation to create a national commission to study the U.S. criminal justice system and make recommendations on how to reduce the number of Americans behind bars, with a particular emphasis on reforming drug laws. Almost a third of U.S. Senators are cosponsors of the bipartisan bill and it is expected to pass the Senate sometime this year. “The ice is starting to crack,” said Bill Piper, director of national affairs for the Drug Policy Alliance. “The decades of harsh and ineffective laws that have led to overstuffed prisons and a growing HIV epidemic are starting to be challenged and hopefully soon dismantled.” ###

No More Waiting

Dear friends,

We can't miss our chance to dismantle a backwards drug war policy.

Tell your representative to end the syringe exchange funding ban today!

Take Action
Email your representative

Congress let politics trump public health when it banned funding for syringe exchange programs, despite volumes of scientific evidence that these programs save lives and money.

Now, for the first time since the 1980s, you and I finally have the chance to end this backwards ban.

Repealing the ban could come up for a vote in the House THIS WEEK. We can't afford to wait another twenty years, so let's tell Congress to save lives by ending the syringe exchange funding ban now.

Syringe exchange programs reduce the spread of HIV/AIDS by making sterile syringes widely available, but states are banned from using their share of federal HIV/AIDS prevention money on these programs.

Repealing the ban costs no taxpayer money but will save lives.

Tens of thousands of people have contracted HIV unnecessarily since this ban was put in place in the 1980s, and many of them are dead now — all because politicians wanted to "send a message" about drug use.

You can help save lives AND dismantle a hysterical drug war policy. Join me in telling Congress to repeal the syringe exchange funding ban today!

Sincerely,

Bill Piper
Director, Office of National Affairs
Drug Policy Alliance Network
Location: 
Washington, DC
United States

Harm Reduction: House Subcommittee Approves Legislation Eliminating the Needle Exchange Funding Ban

The longstanding ban on use of federal AIDS grant funds to support needle exchange programs will soon be history, if the Subcommittee on Labor, Health and Human Services of the House Committee on Appropriations has its way. Led by Rep. David Obey (D-WI), the subcommittee left the language which has imposed the ban these many years out of the new bill. According to Obey's office:

This bill deletes the prohibition on the use of funds for needle exchange programs. Scientific studies have documented that needle exchange programs, when implemented as part of a comprehensive prevention strategy, are an effective public health intervention for reducing AIDS/AIV infections and do not promote drug use. The judgment we make is that it is time to lift this ban and let State and local jurisdictions determine if they want to pursue this approach.

http://stopthedrugwar.com/files/nline.gif
popular needle exchange logo
The vote followed a protest at the US Capitol in which 26 AIDS activists chained themselves together in the Capitol Rotunda earlier in the day.

President Obama pledged during his primary campaign to eliminate the ban. Legislation allows the president to do so if certain scientific findings are made, specifically that needle exchange programs do not increase community drug use levels, and do reduce the spread of HIV. These findings were made long ago, and the Clinton administration acknowledged them, but declined to eliminate the ban. Earlier this year the Obama administration punted the issue to Congress by including the ban in its budget proposal while verbally expressing support for needle exchange. Whether Obey's subcommittee took action because of administration support, or despite a lack of administration support, I don't know. Perhaps a greater savant than I will enlighten us.

Now the bill heads to the full committee, after which it will go to the floor of the House of Representatives. Drug warriors may try to add the ban back at either stage. Victory also depends on what happens on the Senate side. Assuming the House and Senate do not approve exactly identical Labor and HHS budgets, it will go to a conference committee that includes both Reps and Senators.

Elimination of the ban will neither increase nor decrease the amount of money the federal government spends on AIDS prevention, at least not directly. What it will do is allow state governments who receive federal AIDS grants to choose whether or not to spend some of that money on needle exchange. Those states which are in the habit of using scientific evidence to guide their policies will undoubtedly support needle exchange.

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