Fighting HIV-AIDS One Syringe at a Time

By José E. Serrano, a Democrat from New York and chairman of the House Appropriations subcommittee on financial services and general government (THE WASHINGTON POST, 29/08/08):

HIV infections among Latinos and African Americans in the United States are increasing at a dangerous rate. Hispanics represented about 22 percent of new HIV and AIDS cases diagnosed in 2006 — though they were only about 14 percent of the overall population. In addition, there are fewer HIV-positive people in seven of the 15 target countries of the Global AIDS Initiative than there are HIV-positive African Americans here at home.

Locally, the situation is even more dire: A recent Kaiser Family Foundation survey found that Hispanics in the District have the highest rate of new AIDS cases in the country.

Despite these alarming statistics, our federal government — which is working to reduce infection rates around the globe — is ignoring a simple, effective step that could be helpful in the United States. Since 1988, Congress has banned federal funding of syringe exchange programs. We must lift this ban.

At the end of 2006, nearly one-third of all U.S. AIDS cases — more than 300,000 — were linked to intravenous drug use. These are not just numbers but thousands of Americans — friends, relatives and colleagues — struggling with what can be debilitating challenges. Drug addiction can ruin lives, but even its enormous power pales in comparison to the havoc wreaked by HIV. While we strive to help people overcome drug addiction, we must also help them avoid HIV-AIDS and other infectious diseases.

Last year, in an annual spending bill that I wrote, I was able to lift a congressionally mandated ban on the District of Columbia using its own funds for syringe exchange programs. I believe that this was both a home-rule issue and a positive public health initiative. During debate on this measure, critics trotted out the tired claim that syringe exchange programs encourage drug use.

The facts do not support this claim. Consider what Elias A. Zerhouni, the respected director of the National Institutes of Health, wrote to Congress in 2004: “A number of studies conducted in the United States have shown that syringe exchange programs do not increase drug use among participants or surrounding community members and are associated with reductions in the incidence of HIV, hepatitis B, and hepatitis C in the drug-using population.” Despite overwhelming scientific evidence, legislators and others opposed to syringe exchange continue to ignore the proof that contradicts their claims.

It is time to move past stale arguments and change this federal policy. To that end, I recently introduced the Community AIDS and Hepatitis Prevention Act. This legislation would reduce the spread of HIV by removing all restrictions on the use of federal funds for syringe exchange programs. I am not suggesting that funding syringe exchange programs will end the nation’s HIV-AIDS epidemic, but there is no doubt that it would be an integral part of a comprehensive response.

Syringe exchange programs help address issues beyond HIV-AIDS. For one thing, they provide opportunities to reduce drug use; studies show that syringe exchange programs work as a gateway to other forms of intervention, including counseling, treatment and general education on risky behavior.

Unlike the federal government, many local and state governments allow and often finance needle exchange programs. As our economy sags, however, they are struggling to maintain their support. Helping them would save taxpayers money in the long run. The average lifetime health-care costs for an HIV patient are estimated at $618,900. Clean syringes cost around eight cents each.

We must, of course, keep searching for a cure for AIDS. Researchers and scientists continue to develop the medicines and expertise necessary to improve quality of life for people with HIV and to keep AIDS-related fatalities at bay. But these small victories have not happened in a vacuum — they have been extensively underwritten by the federal government.

After nearly three decades, HIV-AIDS remains a formidable enemy, but we no longer stand in fear. Our nation has developed many tools to fight it. We have taken difficult steps — including confronting prejudice about AIDS and funding medical research. We have the power to reduce the number of drug users who become infected with HIV. We must not let ideology stand in our way. The federal government should fund a prevention program that works.