April 1 was an important date in the debate over the ban on the use of federal anti-AIDS funds for syringe exchange. It was on that date that a congressional moratorium forbidding such funding expired, at which time the decision on whether or not to lift the ban was left entirely in the hands of Secretary of Health and Human Services Donna Shalala. With April 1 come and gone, and no such action taken by the Secretary, the Associated Press reported that the Presidential Advisory Council on AIDS has drafted a resolution calling on the President "to direct the Secretary... to immediately certify the efficacy of needle exchange programs in preventing HIV infection while not encouraging drug use... and, if she fails to expeditiously take such action, to ask for her immediate resignation."
Two weeks ago, the Presidential Advisory Council on AIDS issued a unanimously approved double-barreled resolution, expressing "no confidence" in the Clinton Administration for their handling of the syringe-exchange issue, and strongly urging Secretary Shalala to make the official determination that syringe exchange reduces HIV transmissions without fueling increased drug use. Such a determination is a prerequisite to the lifting of the ban.
The Week Online has learned that in a private discussion at the time of the resolution, members of the council made it known that they would not abide by more delay, and that even stronger action would be taken within 2-3 weeks if the secretary failed to act. Last week, however, the politics of the decision became even murkier as a letter from Drug Czar Barry McCaffrey to AIDS Policy Director Sandra Thurman indicating McCaffrey's opposition to syringe exchange was leaked to members of Congress and the press. While the decision is not McCaffrey's to make, the retired four-star general's opinion and support carry much weight as Republicans gear up for a Drug War legislative blitz later this month in an attempt to paint the Clinton Administration as "soft" on drugs.
The draft resolution, to be voted on by the Council on April 9, cites a "pattern of inaction, misrepresentation, disingenuous communication, inconsistent messages, and broken promises" which "has seriously eroded the secretary's and the administration's credibility on all AIDS prevention and related public health matters."
The Week Online spoke with Robert Fogel, a member of the Council and an outspoken critic of the administration's failure to lift the ban. "There was a conference call with members of the Process Committee earlier this week" said Fogel. "We had already been told that HHS was nearing the end of its review process, and so we felt that it was time, past time in fact, to make it clear that a determination has to be made on this issue."
Fogel continued, "The resolution is addressed to the President, not the Secretary. After months of being dealt with in a less than forthright manner by the Secretary, we felt it was important that the President be responsible to answer to us. We're giving the President time to return to the country and to take action on this, as the Council won't vote on it until the ninth. But I have little doubt that at that time the Council will pass the resolution, probably unanimously."
At a news conference last week (3/27), democratic lawmakers and health experts teamed up to urge that the administration lift the ban. Rep. Nancy Pelosi (D-CA) told reporters, "the science is in. The findings are clear. The administration has the evidence." Rep. Elijah Cummings (D-MD) and Rep. Lynn Woolsey (D-CA) joined Pelosi at the event.