Source: San Mateo Times
Pubdate: Tue, 21 Apr 1998


WASHINGTON - Programs that let drug addicts exchange used needles for clean
ones fight AIDS and do not encourage illegal drug use the Clinton
administration declared today - but it will not allow federal tax dollars
to fund the prograins.

The administration hopes that Health and Human Services Secretary Donna
Shalala's strong endorsement will encourage communities to start their own
needle exchanges. But AIDS activists have said that federal money - so far
banned - is key, and they are sure to see Shalala's decision as a defeat.

"The scientific evidence does show needle exchange programs reduce the risk
of infection with HIV and do not encourage the use of illegal drugs," said
an administration official today, speaking on condition of anonymity. But
"the administration has decided that the best course at this time is to
have local communities use their own dollars to fund needle exchange

Shalala will tell state and local officials that to start a needle
exchange, the programs must be part of a comprehensive HIV prevention
strategy that includes referring participants to drug treatment and
counseling. Also, needles must be made available only on a replacement
basis, the administration official said.

Needle exchange programs are one of the hottest topics in the AIDS crisis.
Half of all people who catch HIV are infected by dirty needles, sex with
injecting drug users or are children of infected addicts - totaling 33
people every day, AIDS experts say.

Needle exchange is not a new concept in San Mateo County, which was among
the first communities in the nation - after San Francisco and Tacoma, Wash.
- - to establish such a program, said Joey Tranchina, an outreach worker and
executive director of the AIDS Prevention Action Network in Redwood City.

Tranchina has been overseeing needle distribution in The County since 1989,
and said last year 329,000 needles were exchanged here with funding from
the United Way, Peninula Community Foundation and other local charitable

While Tranchina said "a lot of people are going to be crestfallen" by the
government's refusal to allocate federal funds to needle exchange programs,
he said he doesn't see it as a disaster.

Rather, "The last thing we need is the federal government to turn (needle
exchange) into an overregulated beauracracy," Tranchina said.

He added that government involvement could actually make it harder to raise
important private funds for such programs by creating the impression that
the government is taking care of the matter, he said.

The important thing about Shalala's announcement today, he said, is that it
acknowledges that needle exchange programs save lives by curbing the spread
of diseases like AIDS and Hepatitis C, and raises public awareness about
the need for such programs.

He called the announcement a "baby-step" in the right direction, but warned
"We have to stop looking to the politician for leadership on health issues.

Numerous scientific studies and public health groups have declared that
needle exchanges reduce the risk of getting the HIV virus, and 88 needle
exchanges operate around the country with private, state or local funding.

But Congress had banned letting communities use federal tax dollars to pay
for needle exchanges until Shalala certified that scientific studies proved
they both reduced spread of the HIV virus and did not encourage drug use.

After a months-long review by her top scientific advisers, ShaIala this
morning decided that needle exchanges are scientifically backed.

The scientific review found that the needle exchanges that work best are
part of a larger and-HIV program that pushes addicts toward drug treatment.

Indeed, one study of a needle exchange in the Bronx, New York, found that
providing clean needles to heroin addicts in addition to offering them
methadone treatment both lowered the risk of HIV infection and lowered
their overall drug use.

But whether to allow federal funding was a politically charged question
that administration officials debated heavily over the weekend. Ultimately,
Shalaia decided that whether to fund a needle exchange was up to each

The decision came after Republicans in Congress had threatened to ban
federal funding of needle exchanges altogether if Shalala did decide to
attempt it. And President Clinton's own drug policy chief. Barry McCaffery,
has vigorously fought that attempt, saying it would send the wrong message
to children.

"Such a program would in reality use tax dollars and the authority c of the
federal government to push drug paraphernalia into already drugravaged
inner cities. This is reckless and irresponsible," Sen. Chuck Grassley,
R-Iowa, said in a weekend statement.