The New Jersey legislature last Friday passed a bill permitting the creation of needle exchange programs (NEPs) to block the spread of HIV/AIDS and other blood-borne illnesses in up to six Garden State municipalities. Now, health officials in cities including Atlantic City, Camden, Jersey City, Newark and Paterson are preparing to lay the bureaucratic groundwork for getting programs up and running. Atlantic City and and Camden have already passed ordinances allowing for such programs, while officials in the latter three cities are considering similar action.

In a statement released after the vote, Democratic Gov. Jon Corzine said he would sign the bill into law. "The science is clear: Needle exchange programs reduce sharing of contaminated needles, reduce transmission of HIV and hepatitis C and serve as gateways to treatment," Corzine said. "The bottom line is that this program will save lives. I applaud the legislature for getting it to my desk, and I look forward to signing the bill and seeing the program implemented rapidly."

[inline:niagill.jpg align=left caption="Sen. Nia Gill, sponsor of Senate needle exchange bill"]New Jersey has the nation's fifth-largest number of HIV and AIDS cases. The state ranks first in women with the virus and third in infected children. It is also the only state in the nation with neither needle exchange nor non-prescription access to syringes. (A syringe access bill passed the Assembly, but was not acted on in the Senate this year. Advocates hope for a vote early next year.) In numerous studies, NEPs have been shown to decrease the rate of infection among injection drug users, a leading vector for the disease.

The public health victory came 13 years after the notion was first proposed in New Jersey and nearly five years after the Drug Policy Alliance made it a key legislative priority in the state. "This is one of the happiest days of my life, the culmination of 4 ½ years of incredibly hard work," said Roseanne Scotti, who, as head of DPA's New Jersey office, has become the most prominent public advocate of needle exchange in the Garden State. "Now we are at the beginning of really being able to prevent injection-related HIV and Hep C infections."

Victory last week didn't come without a fight, complete with accusations of racism and genocide by some of its most vocal opponents. Sen. Ronald Rice (D-Essex) led the opposition, and during final debate on the bill he called it "an experiment" on minorities and compared it to the federal government's Tuskegee experiment in the 1930s, where hundreds of black men were intentionally infected with syphilis without being told or treated. "The end result is the same -- death for a class of minorities and women," Rice said.

But Sen. Nia Gill (D-Essex), a sponsor of the bill, accused Rice of using stale arguments and standing in the way of cities that want to enact NEPs. "If Newark doesn't want it, Newark doesn't have to have it," Gill said. "We've crafted the bill so it's permissive -- it would let Camden try to save the lives of its people. Why not let them have a chance to save lives?"

Also opposing the bill was Sen. Diane Allen (R-Burlington), who said she couldn't vote for it after speaking to the parents of a child who died of a drug overdose. "We're using taxpayer dollars to send people deeper into the abyss," she said.

In the end, public health arguments prevailed, with the Senate approving the bill 23-16, and, moments later, the Assembly approving it 49-27. Supporters had been unsure of the bill's prospects in the Senate before the vote.

"The action we are taking today will save lives," said Assembly Speaker Joseph Roberts (D-Camden) after the votes were counted.

"I'm very pleased," said Atlantic City health officer Ron Cash. "This is an opportunity for the city to use the tools we need to fight HIV/AIDS here."

Atlantic City is ready to go and waiting for the state, Cash told Drug War Chronicle. "The state health department has to produce an application form, and then we will submit a proposal. We could have a program running as early as March, but more likely it will be the middle of next year."

The victory was the result of hard work and a favorable political conjuncture, said Scotti. "This was partly the cumulative result of all the years of work, but we're also in a very good place politically," she said. "We have a governor, a Senate president, and an Assembly speaker who are all behind it, and that's critical. But part of arriving at this point was doing all the work to bring them along."

Scotti's work is not done, she said. "We'll be working on implementation and helping the cities get their programs going. Atlantic City and Camden already have ordinances in place, Newark Mayor Booker has spoken publicly about the need for NEPs, the Paterson health department is very interested, and so is Jersey City."

If the latter three cities join Atlantic City and Camden, that will make five, leaving room for only one more municipality under the new law. If there is interest from more cities, advocates could go back to the legislature, said Scotti. "The more the merrier," she said. "If we get more interest, we will push the legislature to amend the law."