Editorial:
The
Clinton
Administration's
refusal
to
act
on
needle
exchange
is
a
sad
triumph
of
politics
over
government
9/20/97
In Washington, it is apparently easy to forget that the responsibility of government is first and foremost to govern, and only secondarily to politic. To lose sight of this seemingly obvious hierarchy can lead to great harm as the public good, indeed even the lives of innocents, may be sacrificed to "political concerns" which is itself but a euphemism for the career prospects of one or another politician. Such is now the case with the issue of needle exchange. Federal law requires, and Secretary of Health and Human Services Donna Shalala has long maintained, that money which goes to the states for the purpose of AIDS prevention would only be freed for the funding of needle exchange if and when her office could determine that such programs reduced the spread of the AIDS virus without increasing the prevalence of drug use. A perspective that favors spread of AIDS -- always deadly -- over increased drug use -- a serious problem but not comparable to the AIDS epidemic -- seems a bit skewed to begin with. But Donna Shalala failed to note yet another criteria: the political concerns which in the Clinton administration apparently take precedence over the mere lives of intravenous drug users, their partners and their children. In February, Shalala released a report confirming what everyone who had seen any of the now-voluminous research had known for some time. Needle exchange does in fact reduce the spread of the AIDS virus, and that intravenous drug use did not increase simply because people could get access to clean needles. In fact, in communities where such programs existed, drug use had not gone up at all. This came as a great relief to many who assumed that since the administration's stated criteria had been met, it was only a matter of time before the ban on the use of federal dollars to save lives would be lifted. But Shalala's revelation did not stir such feelings within the Clinton administration, which appears to be more concerned with the viability of Al Gore's presidential bid than with creating any sort of controversy by saving lives. Thus, nearly eight months after Shalala's determination, the ban has not been lifted. This past week, an amendment to the House appropriations bill passed which would take the matter out of the administration's hands entirely by specifically prohibiting use of federal AIDS funds for such programs. In a letter to Congress, Shalala asked that they not strip her authority on this matter, but months of inaction and the unnecessary deaths of thousands of American citizens make this request sound an awful lot like Brer Rabbit asking not to be thrown into the Briar patch. The administration is about to be taken off the hook by a Congress which has proven itself to be even less in touch with its moral responsibilities than the President. So on we go. This week, over a thousand demonstrators from across the country are in Washington to protest a policy that Elizabeth Taylor has called "premeditated murder." But these people, health care professionals and outreach workers, AIDS activists and clergy, people with AIDS and people who have lost loved ones, don't come from Washington, DC and thus they can't understand how easy it is for politicians who are striving to stay within the Beltway to change their priorities accordingly. So, while thousands of people continue to become infected in service to Al Gore's presidential aspirations, the administration sits and quietly hopes that Congress will take this one out of their hands. But politics is not the same as governing. And while averting a moral choice can be rationalized by politicians consumed with power, that does not make their inaction any less damnable. Adam J. Smith
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