Source: Milwaukee Journal Sentinel (WI) Contact: (414) 224-8280 Website: http://www.jsonline.com/ Pubdate: Wed, 22 Apr 1998 A DEADLY DECISION AGAINST NEEDLE EXCHANGES The Clinton administration and Donna Shalala let a splendid opportunity to help stem the spread of HIV slip through their hands Monday, for reasons that can only be political. It was a shameful blunder. In announcing the decision against lifting the ban on federal money for needle exchange programs -- despite overwhelming evidence that such programs work -- Shalala left herself open to legitimate criticism that she was failing her duty as the nation's chief public health official. The health and human services secretary, in effect, undermined the administration's bad call with her own words. "A meticulous scientific review has now proven that needle exchange programs can reduce the transmission of HIV and save lives without losing ground in the battle against illegal drugs," Shalala said. Pretty compelling stuff. Yet she then upheld the federal ban, leaving it up to local communities to decide whether to fund their own needle exchange programs. Backers of the federal funding ban say needle exchanges encourage drug use - -- a reasonable fear, at first glance. But the evidence shows just the opposite. Programs that encourage injectable-drug users to exchange contaminated needles for clean ones can reduce the incidence of HIV by curbing its spread through needle sharing. Such programs have also encouraged many drug users to seek treatment by establishing trust between users and the AIDS counselors who exchange the needles. Across the country, needle exchange programs now operate with state, local and private money. The AIDS Resource Center of Wisconsin's successful needle exchange is funded entirely by private money, but it could reach far more people if federal funds were available. What makes this even more urgent is that about 40% of the total AIDS cases in the United States have been linked to injection drug use. Even more ominous, at least 75% of babies with HIV/AIDS were infected directly or indirectly as a result of injection drug use by a parent. Whether to allow use of federal funds for such programs reportedly was debated heavily by White House officials over the weekend because some short-sighted Republicans in Congress apparently threatened to ban federal funds for any organizations that provide free needles, even if the federal money was used for other purposes. Shalala reportedly urged the White House privately to rescind the ban, but that's a moot point now. The administration should have stood up to the political pressure and made its solid case directly to the public. After all, it's the public that stands to benefit the most from controlling the spread of this terrible disease.