Needle Exchanges Endorsed by NIH Panel, Federal Officials

HARM REDUCTION March-April 1997

On February 13, a panel of nongovernmental experts convened by the National Institutes of Health endorsed needle exchanges, citing evidence that such programs help prevent the spread of HIV and do not increase drug use. The 12-member panel charged that moral and governmental objections have brought about a "dangerous chasm" between science and public policy, and are blocking "lifesaving public health strategies," such as needle exchanges, drug education and safe-sex education. Their comments were greeted by a standing ovation. The panel called for government leaders to change policies that prevent such anti-AIDS efforts, a position that was also endorsed by the Washington Post ("Experts blast dissent on anti-AIDS efforts," Houston Chronicle, February 14, 1997, p. 6A; Paul Recer, "AIDS report backs needle exchanges and safe-sex education," Philadelphia Inquirer, February 14, 1997, p. A7; Editorial, "Needles and Classroom Candor," Washington Post, February 15, 1997, p. A22).

On February 18, a top federal official, HHS Secretary Donna Shalala, for the first time publicly endorsed needle exchange programs at the community level to prevent the transmission of HIV in intravenous drug users. She did not seek to lift the ban on using federal funds for such programs (Reuter, "Needle Program To Fight AIDS Wins Support," Washington Post, February 19, 1997, p. A10; Kim Painter, "Shalala says needle swaps help," USA Today, February 19, 1997, p. A1; Joanne Kenen, "Shalala praises needle exchange against HIV," Philadelphia Inquirer, February 19, 1997, p. A4).

"Needle exchange programs can be an effective component of a comprehensive strategy to prevent HIV and other blood-borne infectious diseases," said Shalala in a report to U.S. Senator Arlen Specter (R-PA). Shalala declined to say that needle exchanges do not increase illegal drug use -- a finding required by statute to be made by the Public Health Service before the ban on federal funding for such programs can be lifted.

The Centers for Disease Control and Prevention says that intravenous drug users, their sex partners and their children account for more than half of new HIV infections. A statement released by the White House said, "It's up to local communities to decide what kinds of HIV prevention programs are appropriate. We hope this report will provide useful information to them."

Needle exchange critics argue that exchanges encourage drug use, but supporters argue that exchanges are an outreach point to educate drug users about the dangers of drugs use and encourage drug treatment. Shalala, who reviewed scientific research and pilot projects, said, "Overall these studies indicate that needle exchange programs can have an impact on bringing difficult-to-reach populations into systems of care that offer drug dependency services, mental health, medical and support services."

For many years the Clinton Administration has denied the scientific evidence about the HIV preventing capacity of needle exchanges (see "Drug Policy Foundation Releases Secret Internal Administration Reports on Needle Exchange," NewsBriefs, March 1995). The adoption of needle exchange programs has been a centerpiece of "harm reduction" strategies in Europe and Australia for a decade. For other recent needle-exchange stories, see: "Needle Exchange Bill Dies in Colorado House," NewsBriefs, March 1997; "Grand Rapids, Michigan Mayor Proposes Needle Exchange Program," NewsBriefs, February 1997; "NIH Dirctor Approves Disputed Needle-Exchange Research," NewsBriefs, January 1997.

Contact the NewsBriefs office, for a copy of the report: "Report to the [Senate] Committee on Appropriations for the Department of Labor, Health and Human Services, Education and Related Agencies -- Needle Exchange Programs in America: Review of Published Studies and Ongoing Research," Donna E. Shalala, Secretary of Health and Human Services, February 18, 1997.