NEEDLE PIONEER REMAINS FAITHFUL TO HIS MISSION

Outside of Tacoma, he's known as the godfather of needle exchange.

But in his hometown, few seem to know much about Dave Purchase or the
empire he built.

What began as one man handing out clean syringes to drug users along
Pacific Avenue in the 1980s has become the Point Defiance AIDS
Project, a nonprofit corporation that with the backing of the
Tacoma-Pierce County Health Department gives away more than 800,000
clean needles each year.

The North American Syringe Exchange Network, one of its programs,
includes a buyers' club that purchases syringes for virtually every
needle exchange program in the country.

It bought roughly 17 million syringes last year for some 180 needle
exchange programs.

Purchase travels the world, preaching the gospel of needle exchange
and helping fledgling programs get under way.

"He has actually transformed AIDS prevention work worldwide," said
Jeannie Darneille, a state House member and executive director of the
Pierce County AIDS Foundation. "And it started here in Tacoma."

All of this suggests that opponents of the needle van are up against
a formidable foe.

'I'm Right'

Purchase, 66, has weathered controversy before and come out on top.

In the early days of the movement, he was even told that a group of
people prayed regularly for his untimely death.

"I'm still here," he said recently.

Purchase says he's motivated because he has truth on his side.

"I'm right," he said.

Purchase figured he would get arrested, but it wasn't going to stop him.

It was the late 1980s, AIDS was beginning to spread through the
community of intravenous drug users, and he had the time and money to
do something about it.

In 1983, a drunk driver plowed into his motorcycle at the
intersection of North 11th and Stevens streets.

Purchase, a drug counselor for the Metropolitan Development Council,
nearly lost his right leg.

He was about to return to work after years of rehabilitation when he
started thinking about the AIDS crisis. He couldn't very well help
people kick drugs if they died of AIDS first. The idea of slowing the
spread of AIDS by giving drug users clean needles was getting a lot
of talk in the U.S., but it hadn't been tried except for a few
underground programs.

A settlement from the wreck provided some of the money he needed to
get started. Others pitched in, and in August 1988 Purchase took a
borrowed TV tray and a folding chair near the corner of 15th Street
and Pacific Avenue and started handing out needles.

Tacoma police kept watch over the operation but didn't arrest him.
Though it was illegal at the time, city leaders - after much debate -
decided to lend their tacit approval.

"The politically correct police pretty much had me surrounded," said
state Rep. Steve Kirby, a former City Councilman who opposed needle
exchange at the time. "There's still a question in my mind about how
good this is."

The national news media soon descended on Tacoma, which had the
distinction of becoming the first public needle exchange program in
the country.

Purchase was a star.

Money and syringes dropped into his lap. He would shake hands with a
stranger and end up with a wad of cash.

He didn't expect it to last.

"I thought, 'This is either going to work or it isn't, but either way
come the first of October, I'll be looking for a job.'"

By January 1989, not only was he still operating, but also he had
landed a contract with the Tacoma-Pierce County Health Department.

The operation was no longer just the first public needle exchange in
the country - it was now the first publicly funded needle exchange
program as well.

Backed By Studies

The Health Department has renewed the contract every year, though the
amount has dropped steadily over the past three years from more than
$336,000 in 2001 to $256,000 this year as part of an overall decline
in health and human services funding.

As needle exchange programs opened in new cities, critics continued
to blast them, saying they encouraged drug use and sent the wrong
message to young people.

But numerous studies support the claim that needle exchange programs
slow the spread of AIDS.

One of them, ordered by Congress and released in 1995 by the National
Research Council, concluded that "well-implemented needle exchange
programs can be effective in preventing the spread of HIV and do not
increase the use of illegal drugs."

A few years later, Donna Shalala, Health and Human Services secretary
in the Clinton administration, said she had confidence in the
scientific research. But a ban on federal spending for the programs
remained intact.

In Pierce County, the rate of infection today is about the same now
as it was in 1988, Purchase said.

In communities without needle exchange programs, or where they were
started later, the rate of HIV and AIDS among drug users went up
dramatically, Purchase said.

"There has been no epidemic here," he said. "If we quit tomorrow, the
epidemic starts tomorrow."

The courts have generally sided with needle exchanges, too.

Tacoma's needle exchange led to a court challenge and a judge's
ruling that it is legal for health officials to distribute needles to
illegal drug users as part of an HIV/AIDs prevention program.

Through it all, Purchase kept giving out needles. And he received so
many calls from others looking to start similar programs that he
started the North American Syringe Exchange Network in 1992 as part
of the Point Defiance AIDS Project.

Within two years, the buyers' club purchased $155,000 worth of
needles. Last year, it bought a couple of million dollars worth of
syringes and other supplies.

The organization buys syringes in bulk from a distributor and sells
them to needle exchange operations at cost, Purchase said. The
arrangement means that small operations can buy syringes at the same
discount prices as larger operations. The network doesn't charge a
fee, he said.

Nearly 20 years after Purchase gave away his first syringe, needle
exchange has become part of a larger movement known as "harm reduction."

The idea is to reduce the negative consequences of drug use. The
movement is controversial because it also accepts that some people
will not stop using illegal drugs. Even so, scarce funding, not
political pressure, tends to be the biggest threat to needle exchange programs.

The federal government still won't fund them, a decision that rankles
advocates.

Relatively Well-Funded

"You shouldn't be doing public health with private funds," said Don
Des Jarlais, an ally of Purchase and director of research for the
Baron Edmond de Rothschild Chemical Dependency Institute at Beth
Israel Medical Center in New York.

Most programs receive funding from state or local governments and
private foundations.

Compared to some, Purchase's Point Defiance AIDS Project is
relatively well-funded.

It has an annual budget of more than $500,000. A little more than
half of its funding comes from the Tacoma-Pierce County Health
Department contract. As executive director, Purchase earns $79,000.
Sixty percent of his pay comes through his work with the North
American Syringe Exchange Network and the remaining 40 percent is
from the Health Department contract.

For nearly two decades, Purchase has kept Tacoma's needle exchange
running by convincing people that it's the right thing to do - and by
keeping quiet when no one is complaining.

Des Jarlais, who came to Tacoma in the early days to study the
program, said Purchase is a charismatic and effective spokesman for
needle exchange.

"He can actually inspire others to go out and do the right thing,"
Des Jarlais said.

Purchase said he has never considered quitting.

"I'd have to live with that," he said. "This is life and death. There
were unnecessary deaths, unnecessary and preventable deaths. That offended me."

So he learned to tune out his critics.

"As long as there isn't a big obstacle in the way," he said, "we'll ignore it."