NEEDLE EXCHANGE: Federal Funding Ban May Be Lifted Soon

      Saturday's San Francisco Chronicle reported that the "Clinton administration is moving to lift a 10-year-old ban on using federal funds for needle exchange programs." While the administration's "official stand is that it is still studying the matter, a range of AIDS organizations and key individuals say they have been assured a decision is imminent -- and they are anticipating that the ban will be lifted." Dr. Scott Hitt, who chairs the White House advisory council on AIDS, "said he believes an announcement could be made within a week." Rep. Nancy Pelosi (D-CA) said, "We have reason to be optimistic that the administration will lift the ban, because it will fit comfortably within their perspective of research, prevention and care of people with AIDS. I know they are committed to stop the spread of AIDS, and I am confident they won't let politics stand in the way of that."

Freeing Up Vital Funds
      Approximately 100 communities nationwide "run needle exchange programs without federal funds." The Chronicle reports that 30 of them are in California, with the San Francisco AIDS Foundation operating "the largest in the nation, using a combination of city and private funds to hand out 2.2 million needles a year." Lifting the federal needle exchange ban would allow San Francisco to "spend federal AIDS prevention funds on needle exchanges and free up funds for other programs," and allow communities "that do not have a needle exchange program to initiate one." The Chronicle reports that "more than half of new cases of HIV infections are related to drug use," and "at least 14,000 new cases of HIV could be prevented each year if needle exchange programs were widely in place across the nation." Regina Aragon, policy director of the San Francisco AIDS Foundation, said, "There could certainly be a financial benefit to San Francisco, and it would certainly benefit hundreds of other programs around the country that do not have the kind of support that San Francisco has."

Applying Pressure
      The federal ban can only be lifted if Donna Shalala, Secretary of the U.S. Department of Health and Human Services finds "sufficient scientific evidence" that "needle exchange programs reduce the spread of HIV," and "do not encourage drug use." The Chronicle reports that "those close to the controversy" believe that Shalala "will lift the ban in light of the mountain of scientific evidence demonstrating the efficacy of needle exchange programs." In addition, a "major obstacle" to lifting the ban "appeared to be removed" last week when two Canadian researchers said their research on needle exchange programs "had been misinterpreted by" AIDS czar Barry McCaffrey, who believed the results showed needle exchange programs lead to increased drug use. Last week, the president's AIDS advisory panel "held a conference call to decide whether to approve" a resolution "calling on Shalala to resign" for not moving to lift the ban. "But they decided to hold off after administration officials said a decision on the ban was imminent," the Chronicle reports. Last month, the panel approved a resolution voicing "no confidence" in the White House's AIDS policy.

Debating The Issue
      The administration still has not made a final decision on whether or not to lift the ban. Some AIDS advocates are "skeptical" that the administration "is moving on the issue," but others believe that it is "ready to act." Daniel Zingale, executive director of AIDS Action in Washington, DC, said, "They understand where the science comes down on this issue" (Freedberg, 4/11).