Pubdate: Mon, 27 Apr 1998 Source: Oakland Tribune (CA) Contact: NEEDLE EXCHANGE DECISION ENCOURAGES LOCAL CONTROL It was a classic case of science vs. politics. The federal government, specifically Health and Human Service Secretary Donna Shalala, announced the findings of a taxpayer-funded report on needle exchange programs and their effectiveness in preventing the spread of HIV. The news was that the exchange programs are effective at stopping the spread of HW without encouraging drug use. "We have concluded that needle exchange programs, as part of a comprehensive HIV prevention program, will decrease the transmission of HIV and will not encourage the use of illegal drugs," Shalala said Monday. But that's where the Clinton administration stopped. Yes, needle exchange programs prevent HIV and do not encourage anyone to take up a heroin habit just because the needles are free. But don't expect the federal government to fund a single needle exchange. AIDS advocates were stunned by the action, and accused President Clinton of ignoring scientific fact in accepting the findings but refusing funding. "It's like saying the world is not flat but not funding Columbus's voyage anyway,' said Daniel Zingale of the activist group AIDS Action. A needle exchange program is, at best, a political conundrum. No matter which side a politician backs, the other side will vociferously object. Half of HIV cases AIDS experts say that half of all people who catch HIV are infected by dirty needles, having sex which needle-using addicts or are children of infected drug users. Clearly, the culprit in these cases is the dirty needle. One of the biggest hurdles for exchange programs came from Clinton's administration. His own drug policy chief, Barry McCaffery, has vigorously fought the attempt to federally fund needle exchange programs, saying that it, would effectively condone intravenous drug use. Republicans have long decried such exchange programs. The rationale is that drug abusers are engaging in an illegal activity, and in giving them clean needles, taxpayers are legitimizing the activities of addicts. For people who have no fear of dirty needles whose only fear, in fact, seems that they may run out of their drug of choice - there is not much public sympathy. Local programs The Clinton administration hopes its findings on needle exchange programs will encourage local governments to seriously address the issue. Right now, there are 88 needle exchange programs throughout the United States. They are funded by private donations and some local public funding. Clearly, the need for such a program varies widely from state to state. One role the federal government could assume is that of advocacy for needle exchange programs. If a local gov- ernment is considering such a plan, the feds should be ready to attest to the value of exchange programs. There have been many science vs. politics issues in the world of HIV and AIDS. Public funding of research for an AIDS cure is close to $4 billion a year, and every year that appropriation is debated as being too much or too little, depending on the viewpoint. If the Clinton administration had decided to fund needle exchanges, It most probably would have faced accusations of being soft on drugs, and even aiding abetting drug addiction. Acknowledging the effectiveness of needle exchange programs but not approving funding for them can be seen as a convenient political escape. It can also be seen as a compromise on one of the most controversial aspects to the battle against AIDS. In this case, the middle-of-the-road approach serves the greater good by heightening the awareness of needle exchange programs while legitimizing them and leaving control in local hands.