House Vote on Syringe Exchange Programs a Victory for Public Health

Last week, Congress took an important step in the fight against HIV/AIDS with a historic vote on syringe exchange programs. On July 25, the House voted to remove the ban on providing federal funding for syringe exchange programs.

Since 1988, the federal government has prohibited states from using their share of HIV/AIDS prevention money in syringe exchange programs, one of the most effective programs available to combat the HIV/AIDS epidemic, as well as Hepatitis C and other blood-borne illnesses. This policy was based on ideology rather than on evidence, and the repeal of this ban signifies that Congress is finally realizing that needle exchange programs are a safe and effective approach in reducing the public health problems associated with drugs.

Syringe exchange programs allow intravenous drug users to obtain hypodermic needles and associated injection equipment at little or no cost, and most of these services allow drug users to exchange used, dirty needles for new ones. They also often provide other public health services, such as HIV and Hepatitis C testing and access to substance abuse counseling. Numerous federally funded studies have shown that needle exchanges slow the spread of HIV and Hepatitis C and that they do not increase substance abuse. This scientific evidence has been confirmed by the Centers for Disease Control (CDC), National Institute of Health (NIH), World Health Organization (WHO), and the American Medical Association, among others. See the CDC’s Report here (PDF) confirming that needle exchange programs are helpful not only in reducing the spread of HIV and AIDS, but also as a way to get intravenous drug users into healthcare programs and to treatment that helps to get them off drugs.

Syringe exchanges are cost-effective and life saving programs. Each year,nearly 8,000 people in the US contract HIV/AIDS,and about 12,000 contract Hepatitis C,directly or indirectly from sharing contaminated syringes.The cost of preventing one case of HIV infection through syringe exchange programs is approximately $4,000 to $12,000, and yields savings of as much as $648,000 in medical costs per HIV infection and approximately $25,000 to $30,000 in medical costs per Hepatitis C infection prevented. Allowing states to use federal funding for these programs will help decrease the spread of these diseases.

Despite the overwhelming evidence to the contrary, some members of Congress still cling to the disproved notion that these programs promote drug use. HIV/AIDS funding is not the place to try to score political points; saving lives and slowing the spread of preventable diseases like HIV and Hepatitis C should take precedence to moralizing about drug use, particularly in light of the overwhelming scientific and health research showing how effective these programs can be. Local communities should be able to utilize every tool possible to address the spread of HIV and Hepatitis C, and removing the restriction on federal funding would in no way require states to implement syringe exchange programs if they do not wish to do so.

The decision by the House Appropriations Committee, led by Committee Chairman David Obey (D-Wis.), to remove the ban on federal funding of syringe exchange programs is a major victory for the HIV/ADIS community and public health advocates. And the subsequent defeat of the Souder Amendment, which would have maintained the federal prohibition, on the floor of the House of Representatives last week represented a triumph for science and health over the typical fear-mongering on issues involving drugs. (See our letter opposing the amendment here.)

Congress now has the chance to base health policy regarding syringe exchange programs on scientific evidence which shows that banning federal funding for syringe exchange programs will harm public health.

See a Coalition Letter on Syringe Exchange Programs, which was signed by dozens of national and local organizations. (7/14/2009)