NEEDLE EXCHANGE II: Angry Reactions On All Sides
Under the headline, "Needle Exchange Cowardice," an editorial in today's San Francisco Chronicle strongly criticizes the Clinton administration for what it calls a "display of political timidity" on the needle-exchange issue. Despite an "unequivocal endorsement" of needle-exchange programs, Health and Human Services Secretary Donna Shalala "said the federal government will not pay to let drug addicts exchange used needles for clean ones." According to the Chronicle, that "was a craven bit of political double-talk from Shalala whose mission is to protect the health of the nation, when she knows that nearly 40% of all AIDS cases reported in the United States have been linked to illegal intravenous drug use." The editorial notes that "[s]tunned AIDS activists asked how federal public health officials could say needle exchanges work, but refuse to fund them." Dr. R. Scott Hitt, chair of President Clinton's AIDS advisory panel, said, "This is obviously immoral. ... Americans should ask why." The Chronicle concludes: "By refusing to fund needle-exchange programs that have proven to work in nearly a hundred cities ... the Clinton administration has shamefully chosen political expedience over human welfare" (4/21).
From The Front Lines
"Shalala has established a policy that is killing people," said Doug Nelson, executive director of the AIDS Resource Center of Wisconsin. "It's a complete abrogation of leadership. If Donna Shalala can't lead as the chief of public health policy in this country, then she should resign" (Fauber, Milwaukee Journal Sentinel, 4/21). David Hoover, the AIDS program manager for the Pima County (AZ) Health Department, said, "When you figure that the average lifetime cost of treatment for an individual with HIV disease is $169,000, [needle exchange] is a huge savings, when a syringe costs a dime" (Erikson, Arizona Daily Star, 4/21). Pat Christen, executive director of the San Francisco AIDS Foundation HIV Prevention Project, called the administration's unwillingness to lift the federal funding ban "immoral and deadly." He said, "This administration has shown a callous disregard for the disproportionate impact this decision will have on communities of color and women." Rep. Nancy Pelosi (D-CA) said the administration decision "shows a lack of political will in the midst of a public health emergency" (S.F. AIDS Foundation release, 4/20). The AIDS Policy Center for Children, Youth and Families said it supports Shalala's "determination that needle exchange programs prevent HIV transmission and don't encourage drug use." However, David Harvey, the center's executive director, said "it makes no senses to prohibit local and state health officials to use their federal HIV prevention funds for" needle exchange. "This is like refusing to throw a life vest to a drowning person," he said (release, 4/20).
Public Health Criticism
Dr. Joe Sanders Jr., executive director of the American Academy of Pediatrics, said the AAP finds "it quite troubling that the use of federal funds" for needle exchanges continues to be restricted, despite the administration's acknowledgement of their effectiveness. He said his group "believes prevention programs, including needle exchanges, should be encouraged and expanded. That cannot occur without appropriate, consistent funding sources" (release, 4/20). Dr. Mohammad Akhter, MPH, executive director of the American Public Health Association, said, "The administration today has recognized that needle exchange programs work to protect the health of the American people. In the face of such overwhelming scientific evidence, not releasing federal funds gives the impression that politics takes precedence over saving lives" (release, 4/20).
From The Opposite Viewpoint
Randy Tate, the head of the Christian Coalition, criticized the administration for supporting the efficacy of needle exchange. "This is 'Cheech and Chong' public policy. ... This is big-time kow-towing to the drug-legalization crowd, all on the backs of our children. It is hypocrisy of the highest order to talk about protecting kids from the harmful effects of cigarettes while planning to give them needles for their drug addictions" (release, 4/20). Robert Maginnis, a senior policy adviser at the Family Research Council, also criticized Shalala for backing needle exchange programs in general. "Needle giveaways are medical malpractice and reckless experimentation. These programs are much like the infamous Tuskegee experiment in which patients with syphilis were allowed to go untreated even though penicillin was available. ... Communities concerned about the spread of HIV and skyrocketing drug use should aggressively push treatment, not free needle programs" (release, 4/20).