Congress’s Holiday Message to People Who Use Drugs: Drop Dead

Fifteen days ago, President Obama delivered a major speech, recommitting the United States to fight AIDS here and abroad. This week, Congress will once again prohibit the use of federal funds for syringe exchange. Almost 30 years into the epidemic, we are still having this fight. This ridiculous, unproductive fight. It adds up to this: We deny people at extremely high risk of HIV the means to prevent infection.

By any measure, syringe exchange works. It dramatically reduces HIV infection without increasing drug use. Do you want to get drug users into treatment for addiction? Syringe exchange helps. Do you want to ensure that police officers aren't stuck with dirty needles in pat downs? Syringe exchange helps. Do you want to reduce the number of people on costly lifetime treatment for AIDS? Syringe exchange helps. Do you want to remove dirty needles from parks and playgrounds? Syringe exchange helps.

There is absolutely no dispute about the scientific evidence on any of these fronts. Eight federally funded reviews found that syringe exchange reduces HIV without increasing drug use. It is endorsed by every major medical association, including the American Medical Association, the American Academy of Pediatrics, and the American Nurses Association. In 2008, the CDC concluded that the incidence of HIV among injection drug users had decreased by 80 percent in the United States over a 20-year period in part due to syringe exchange programs. Two years ago Congress lifted the ban, giving states the option to use federal funds for syringe exchange.

Unfortunately, the reinstatement of the funding ban deals a lethal blow to HIV programs that are proven to work. State health departments with firsthand experience responding to injection drug use understand that peer-driven needle and syringe programs make their communities safer and healthier. In the midst of the fiscal crisis, many of these programs are being cut or scaled back, making federal funds all the more important. But sadly, once again politics trump public health.

Twelve percent of all new HIV infections in the U.S. are among injection drug users. We could bring that number to zero—and help people access treatment for addiction at the same time. But the Congress chooses not to.