Despite Show of Support, Federal Funding Ban on Needle Exchange Unlikely to Be Lifted Anytime Soon

During July’s International AIDS Conference in Washington D.C., singer Elton John joined California Democratic Reps. Nancy Pelosi, Henry Waxman, Barbara Lee and others in a show of support for one of the more stigmatized and divisive HIV/AIDS prevention strategies: needle-exchange programs.

Needle exchanges are community-based programs where drug users can safely dispose of old syringes and exchange them for new, sterile ones. 

“Clearly, no one is thrilled that people are taking drugs,” John told attendees at a July 24 reception sponsored by the Syringe Action Fund. “But if we are going to end this epidemic, we have to stop sitting in judgment and start genuinely solving problems. Your extraordinary work constitutes the vanguard of this vital effort – not only saving lives through this effective intervention, but also bringing people in crisis to a greater awareness of the importance of their own medical care, and helping them reach the point where they can accept treatment for their addictions.”

Study after study has shown that needle-exchange programs do not increase drug use, and the American Medical Association, the Federal Centers for Disease Control and Prevention, the National Institutes of Health, the General Accounting Office and the National Academy of Sciences have all said the programs work to help reduce the spread of HIV.

Despite the evidence, the stigma is hard to shake.

Jeff McDowell, who attended the reception, runs the Atlanta Harm Reduction Coalition, which he says operates the only needle-exchange program in Georgia, where the practice is still illegal. He argues that injection drug users with HIV face a “double stigma” for both HIV and drug use. Watch McDowell in action in the clip below from ENDGAME: AIDS in Black America:

Today, there are at least 221 needle exchange programs in 33 states, but the programs aren’t legal in every state. A ban on federal funding for syringe-exchange programs was first imposed in the 1980s; although it was briefly lifted in 2009, the ban was reinstated in a federal spending bill in December 2011, when it became a casualty of contentious budget negotiations with Republican leaders.

“There’s too much moral baggage,” explains the Coalition’s program coordinator Mona Bennett. “It affects things like funding. People are scared to collaborate with us because we deal with ‘those nasty old needles.’ I know that there’s money that we can’t even apply for because of this question of legality.”

Some AIDS advocacy groups charged that the Obama administration reneged on an earlier campaign promise to lift the ban on account of political pressure and a fear of looking soft on drugs.  “The omnibus spending bill was the product of a tough negotiation, and the bill provides increased funding to implement health reform and Wall Street reform,” an Obama administration official told Kaiser Health News at the time. “But to reach a compromise, we had to accept certain provisions that we oppose, and this is one of them.”

Though attendees say the reception illustrated the political will that exists for lifting the ban, it won’t happen in the near-term.

Last week, congressional leaders struck a tentative, six-month deal on budget negotiations, which means there won’t be movement on lifting the ban until next March at the earliest. Neither Representatives Pelosi, Waxman nor Lee — who all helped lift the ban in 2009 — have plans to introduce legislation on the issue right now, but told FRONTLINE they would under a Democratic-controlled House.

Activists say they will continue to push to have the ban lifted. “We have a lot of work to do in conveying how successful these programs have been,” says Whitney Englander, the government relations manager for the Harm Reduction Coalition. “This is going to be a long-term battle, and it’s one that lives depend on.”