Cop-Out on Needle Exchanges

Clinton administration officials would have us believe they took a sensible middle road on Monday, producing incontrovertible evidence that needle exchange programs save lives but not going so far as to lift a prohibition on the use of federal funds for the controversial programs. Health and Human Services Secretary Donna Shalala, administration officials argued, would never have been able to gain approval for needle exchange programs from a skeptical Congress.

In fact, what the Clinton administration presented as moderation was really evasion, for Shalala’s department has not needed congressional approval since 1990, when Congress granted it authority to lift a ban on needle funding provided it could demonstrate just what Shalala announced Monday: that needle exchange programs lower the spread of HIV and do not increase substance abuse.

The administration’s decision to maintain the funding ban will surely cost lives, for injection drug users compose the group in which AIDS is spreading most rampantly. According to Surgeon General David Satcher, tainted needles account for 75% of all new AIDS infections among women and children and for 40% of all new AIDS infections overall.

Generous funding for needle exchange programs already exists. About $630 million is doled out yearly by the Centers for Disease Control for regional AIDS programs, and civic groups like the U.S. Conference of Mayors have asked Shalala to let them spend some of that money on needle exchange programs.

Some legislators understandably object to the notion of the federal government handing out needles to substance abusers. The programs, however, don’t stop at handing out needles; their primary aim is attracting and then treating the sort of substance abusers whom public health officials would otherwise have difficulty finding, and an abuser untreated is a threat to others.

Ideally, substance abusers would flock to treatment without any incentives. But this is the real world: Thirty-three Americans are infected each day with AIDS because of injection drug use. Needle exchange programs could change those sad numbers.