Pubdate: Tue, 05 Jun 2007
Source: Washington Post (DC)
Page: B01
Copyright: 2007 The Washington Post Company
Author: Susan Levine, Washington Post Staff Writer
Cited: North American Syringe Exchange Network
Cited: Prevention Works!
Bookmark: (Needle Exchange)


Shift in Congress Stirs Hope Among D.C. AIDS Officials

Nearly a decade after it was first imposed, a unique congressional 
ban limiting the District's effort to fight AIDS could be lifted and 
the city again allowed to use local tax dollars for needle-exchange programs.

The ban's changed prospects owe to the changed balance of power on 
Capitol Hill, particularly in the House of Representatives, which has 
attached the prohibition year after year to legislation governing the 
District's budget. With Democrats now in control and support growing 
to give the city a vote in Congress and greater autonomy generally, 
health advocates are optimistic that the restriction could be history by fall.

"The moment may have come. The stars may have aligned," said Walter 
Smith, executive director of the nonprofit DC Appleseed Center for 
Law and Justice.

The District has among the worst rates of HIV-AIDS infection in the 
country -- with intravenous drug users accounting for about one-third 
of new AIDS cases annually. But it is the only city prohibited from 
spending its own funds to provide clean syringes to addicts. "There 
is a connection between those two facts," Smith said, "and it is time 
to uncouple it."

The first hurdle will come today as a key House subcommittee takes up 
the appropriations bill that includes the city's spending plan. Its 
chairman, Rep. Jose E. Serrano (D-N.Y.), said he and his colleagues 
should not be telling the District what to do with its money.

"I don't appreciate the fact that so many people throughout the last 
few years have used the D.C. appropriations bill . . . as the 
punching bag or the battleground for so many social issues," Serrano 
said in an interview late last week.

Yet his opposition goes beyond political philosophy to public health 
and how best to attack the epidemic. The effectiveness of 
needle-exchange programs has been proven nationally, Serrano said: 
"This is where people who are really hurting go for help." Although a 
reversal of Congress's past action is not a certainty, he said he is 
ready to push the issue.

"This is one I'm really concerned about," he said.

Despite the controversy over such programs, more than 210 are in 
place in 36 states. About half receive local or state funding, 
according to the North American Syringe Exchange Network.

Proponents, armed with a significant body of research, say that 
giving clean needles to addicts saves lives by decreasing the shared 
use of potentially contaminated syringes and, therefore, the 
transmission of HIV and other blood-borne diseases such as hepatitis. 
They say the interaction with users also draws them into treatment 
and counseling -- without encouraging greater drug use, as critics maintain.

Congress first targeted the District in 1998, when opponents of 
needle-exchange programs not only strengthened a ban on federal 
financing but also barred using the city's resources on such efforts. 
The next year, it appeared the language might be dropped. But when 
the D.C. budget reached the House floor, conservative Republicans 
again added a rider.

Until now, there had been little hope of a different outcome.

"This is the worst example of political disempowerment and abuse of 
the city," said Del. Eleanor Holmes Norton (D-D.C.). "It's a 
life-and-death matter and a public health matter. There is no 
question that countless deaths have occurred because of this attachment."

Norton began lobbying her party's leadership early this year and 
expressed confidence last week that its majorities in the House and 
Senate will allow the District to resume public funding of its one 
local needle-exchange program. She can point to significant backing 
within the city. Serrano and Sen. Richard J. Durbin (D-Ill.), 
chairman of the subcommittee that initially handles the D.C. budget, 
received a letter last month endorsed by representatives of more than 
two dozen medical, public health, social service and philanthropic 

"Please help us battle the HIV/AIDS epidemic in the District," it urged.

J. Channing Wickham, who signed the letter as executive director of 
the Washington AIDS Partnership, sees the timing as propitious. 
Between increasing acceptance of home rule and the accumulated 
medical evidence, he said, "all signs are very, very positive."

The ban's prime author, Rep. Todd Tiahrt (R-Kan.), remains on the 
Appropriations Committee. His position has not changed, and despite 
the new political equation, he will probably try once more to 
constrain District funds, spokesman Chuck Knapp said.

"We hope it passes," Knapp said, "but realistically it's a different 
political environment."

Mayor Adrian M. Fenty (D) already has pledged to direct dollars 
toward needle-exchange programs if the ban is removed, a commitment 
he reiterated in a statement Friday. The lack of city financing has 
hamstrung the small nonprofit group that drives into sometimes-bleak 
neighborhoods five days a week in search of those in the grips of 
heroin and other drugs.

"It has restricted our growth," said Paola Barahona, who has been 
executive director of Prevention Works! since its start nine years 
ago in response to the federal stricture. Even so, the privately 
funded organization passed out more than 236,000 needles last year. 
That count meant regular contact with about 2,000 users, many of them 
women. Statistics indicate that 40 percent of women living with AIDS 
here were exposed to the virus through injecting drugs.

"We're talking about people who are missed by all other health 
outreach programs," Barahona said. And numbers, she added, "that are 
just the tip of the iceberg." 
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MAP posted-by: Richard Lake