Challenging Washington's ban on needle-exchange funds
Challenging Washington's ban on needle-exchange funds
By Ian Urbina
Copyright by The International Herald Tribune
Published: May 28, 2007
WASHINGTON: The American capital is the only city in the country barred by federal law from using local tax money to finance needle exchange programs. It is also the city with the fastest-growing number of new AIDS cases.
These two facts keep Ron Daniels on the move, tirelessly driving his rickety Winnebago from drug corner to drug corner across the rougher parts of this city, counseling the addicted and swapping clean needles for dirty ones.
Faced with an AIDS problem growing here at a rate 10 times the national average, Daniels, director of Prevention Works, the city's only needle exchange program, is armed with a shoestring budget of $385,000 in private donations, a fraction of what programs in other major cities receive in state and local funds.
Since Washington is not part of a state, Congress controls the city's local system of government, and for nearly a decade members of the House, citing concerns about worsening drug abuse, have inserted language into the bill approving the city's budget to prohibit financing such programs.
That may soon change.
"This city's situation is totally improper," said Representative José Serrano, the New York Democrat who heads the subcommittee responsible for the D.C. appropriations bill. "It's politically obscene to have Congress tell the District of Columbia that it can't use local funds for something like needle exchange programs, which have been proven to have a major effect on fighting a deadly disease."
Calling the matter both a public health concern and a basic political right of home rule, Serrano said he planned to make it a priority to remove the language that prevents the city from financing such programs. The city's mayor, Adrian Fenty, has said he will provide city funds as soon as Congress takes such action.
Washington was among the first cities nationally to create an AIDS monitoring office after the virus appeared in the United States. But it has slid backward in its fight against the disease, which is commonly spread by intravenous drug users sharing needles.
"For every person I help, there're seven more I can't reach," said Daniels, 49, who describes his program as providing a thin wall between the city's drug and AIDS epidemics. "But I'd be reaching a lot more if my hands weren't tied." Critics of needle exchange programs argue that rather than reducing the suffering of drug users and preventing them from spreading diseases, the programs foster further drug use.
"We need to fight drugs, not show people that they can be used in a safe manner," Representative Sam Graves, Republican of Missouri, said last year during House floor debate about drug policy.
Daniels says fighting drugs is exactly what his program does.
"The needle is just an enticement, really," he said, looking through the screen door of his van at the line of about 10 people who gather within minutes of his arrival at a corner on the city's grittier Northeast side.
He says his program, which reaches about one-third of Washington's estimated 9,700 intravenous drug users, relies on clean syringes to attract users so he and his staff of four can counsel them about HIV testing and drug rehabilitation.
In Washington, with just over half a million residents, 1 in 20 are HIV positive. Its rate of new AIDS cases is 128.4 per 100,000 people, compared with a national average of 13.7 per 100,000, according to 2005 data, the most recent available from the federal Centers for Disease Control and Prevention, which ranks the district alongside the 50 states.
Intravenous drug use is the second-most-common way HIV is spread among men in Washington, with unprotected sex being first, according to city health officials. For women in the city, sharing needles is the most common mode of HIV transmission, city officials say.
In 1988, Congress banned the use of federal money for needle exchange programs, though it included an exception allowing the president to waive the federal ban if review by the surgeon general or secretary of health and human services determined that syringe exchange programs had been proved effective and did not increase drug use.
A number of federal studies found that such programs did not increase drug use, and in 1998 Donna Shalala, then secretary of health and human services, concluded, "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."
But President Bill Clinton did not remove the ban on syringe exchange financing, and in 1998 Congress reinforced the ban by removing the executive waiver.
More than 200 needle exchange programs exist in over 36 states, according to the North American Syringe Exchange Network. The New York Times
By Ian Urbina
Copyright by The International Herald Tribune
Published: May 28, 2007
WASHINGTON: The American capital is the only city in the country barred by federal law from using local tax money to finance needle exchange programs. It is also the city with the fastest-growing number of new AIDS cases.
These two facts keep Ron Daniels on the move, tirelessly driving his rickety Winnebago from drug corner to drug corner across the rougher parts of this city, counseling the addicted and swapping clean needles for dirty ones.
Faced with an AIDS problem growing here at a rate 10 times the national average, Daniels, director of Prevention Works, the city's only needle exchange program, is armed with a shoestring budget of $385,000 in private donations, a fraction of what programs in other major cities receive in state and local funds.
Since Washington is not part of a state, Congress controls the city's local system of government, and for nearly a decade members of the House, citing concerns about worsening drug abuse, have inserted language into the bill approving the city's budget to prohibit financing such programs.
That may soon change.
"This city's situation is totally improper," said Representative José Serrano, the New York Democrat who heads the subcommittee responsible for the D.C. appropriations bill. "It's politically obscene to have Congress tell the District of Columbia that it can't use local funds for something like needle exchange programs, which have been proven to have a major effect on fighting a deadly disease."
Calling the matter both a public health concern and a basic political right of home rule, Serrano said he planned to make it a priority to remove the language that prevents the city from financing such programs. The city's mayor, Adrian Fenty, has said he will provide city funds as soon as Congress takes such action.
Washington was among the first cities nationally to create an AIDS monitoring office after the virus appeared in the United States. But it has slid backward in its fight against the disease, which is commonly spread by intravenous drug users sharing needles.
"For every person I help, there're seven more I can't reach," said Daniels, 49, who describes his program as providing a thin wall between the city's drug and AIDS epidemics. "But I'd be reaching a lot more if my hands weren't tied." Critics of needle exchange programs argue that rather than reducing the suffering of drug users and preventing them from spreading diseases, the programs foster further drug use.
"We need to fight drugs, not show people that they can be used in a safe manner," Representative Sam Graves, Republican of Missouri, said last year during House floor debate about drug policy.
Daniels says fighting drugs is exactly what his program does.
"The needle is just an enticement, really," he said, looking through the screen door of his van at the line of about 10 people who gather within minutes of his arrival at a corner on the city's grittier Northeast side.
He says his program, which reaches about one-third of Washington's estimated 9,700 intravenous drug users, relies on clean syringes to attract users so he and his staff of four can counsel them about HIV testing and drug rehabilitation.
In Washington, with just over half a million residents, 1 in 20 are HIV positive. Its rate of new AIDS cases is 128.4 per 100,000 people, compared with a national average of 13.7 per 100,000, according to 2005 data, the most recent available from the federal Centers for Disease Control and Prevention, which ranks the district alongside the 50 states.
Intravenous drug use is the second-most-common way HIV is spread among men in Washington, with unprotected sex being first, according to city health officials. For women in the city, sharing needles is the most common mode of HIV transmission, city officials say.
In 1988, Congress banned the use of federal money for needle exchange programs, though it included an exception allowing the president to waive the federal ban if review by the surgeon general or secretary of health and human services determined that syringe exchange programs had been proved effective and did not increase drug use.
A number of federal studies found that such programs did not increase drug use, and in 1998 Donna Shalala, then secretary of health and human services, concluded, "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."
But President Bill Clinton did not remove the ban on syringe exchange financing, and in 1998 Congress reinforced the ban by removing the executive waiver.
More than 200 needle exchange programs exist in over 36 states, according to the North American Syringe Exchange Network. The New York Times
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