August 24, 1997
IT IS DIFFICULT to tell what Health and Human Services Secretary Donna Shalala is waiting for. She hasn't lifted a ban prohibiting federal funding of needle exchange projects. But she admits there is data showing such programs can reduce the transmission of HIV among intravenous drug abusers. And there is evidence that needle programs that include drug counseling, such as Baltimore's, also help reduce the number of addicts.
To force the issue, U. S. Rep. Elijah E. Cummings, D-Md., introduced a bill in July that instructs Ms. Shalala to lift a 1988 ban that prohibits the federal government from funding needle exchange programs. The legislative prod shouldn't be necessary, but Ms. Shalala appears to be reluctant to take a step that she knows will be politically controversial. Congress ought to help her make the right decision by passing the Cummings bill.
He was a member of the Maryland legislature when it, too, was reluctant to allow needle exchange in Baltimore. But the program has proved its worth. Since the fall of 1994, the city has provided more than a million clean needles to 6,000 drug users. City Health Officer Peter Beilenson credits the program with a 40 percent reduction in AIDS cases among intravenous drug addicts. And a Johns Hopkins University study indicates a 20 percent drop in drug abuse among needle-exchange clients.
Mr. Cummings says needle exchange has also proven successful in San Francisco, Seattle and New Haven, Conn. The concept has met the two congressional criteria for lifting the funding ban: that needle exchanges reduce the spread of AIDS and not increase illegal drug use. The American Medical Association, the federal Centers for Disease Control and Prevention, the National Institutes of Health and the National Academy of Sciences all endorse needle exchange. HHS should add its support.
Billionaire philanthropist George Soros recently announced that he will give $1 million to help cities begin needle exchange programs. But his welcome generosity will hardly meet the need. The CDC has estimated that more than a third of the nation's new HIV cases are intravenous drug users, their sex partners and their children. Needle exchange, when done right, does not promote drug use; it can be a useful weapon against both addiction and AIDS.
Pub Date: 8/24/97
