FUNDING BAN ON NEEDLE EXCHANGES COSTS MONEY AND LIVES

HIV Alliance is in the forefront of the battle to prevent new
infections and to care for those living with HIV/AIDS in Lane County.
Our battle is not the most attention-grabbing "war" of the moment,
and agencies in the trenches of this war are severely hampered by
ignorance - not least the ignorance of our elected representatives.
With congressional elections approaching in November, we want to
highlight one aspect of our battle: the fight for needle exchange programs.

The World Health Organization estimates more than 25 million people
have been killed by AIDS since the disease was recognized in 1981.
Some estimates place the 2005 death toll at 3.1 million - an average
of 8,500 people every day. This makes it one of the most destructive
pandemics in history.

Although other problems and challenges seem to have priority in our
minds, the scope of the AIDS pandemic worldwide is increasing. The
human tragedy of this disease plays out every day as 8,500 families
lose loved ones.

HIV Alliance has been operating an injection drug use outreach
program for the past seven years. This program provides injection
drug users with clean needles as part of a comprehensive health care
strategy to prevent the reuse and sharing of contaminated needles.
Sharing contaminated needles is a major cause of the spread of HIV.

Injection drug use is the No. 1 way HIV presents itself to the
heterosexual community and is the No. 1 cause of pediatric HIV. A
recent report estimates that one in 50 kids in school today will have
experimented with injection drug use by the time they graduate. There
are an estimated 10,000 injection drug users in Lane County.

It is a misconception that injection drug users are only homeless
people under bridges. A significant percentage of injection drug
users in Lane County are parents, professionals, business owners and students.

HIV Alliance's needle exchange program is part of a comprehensive
harm-reduction strategy. The aim is not only to exchange dirty
needles, but to provide education about risk-reduction strategies and
encourage-ment for at-risk people to test for HIV on a regular basis.
Referrals to other medical, detox, drug treatment and social service
agencies are provided. Free HIV testing and counseling are available.

The New England Journal of Medicine reported this year that injection
drug users who access needle exchange services weekly are twice as
likely to enter detox.

Controversy has surrounded needle exchange programs in the U.S. since
their inception. Critics argue that providing drug users with the
opportunity to exchange dirty needles encourages and condones drug
use and the associated criminality. In the 1990s, Congress sided with
the critics and placed a moratorium on the use of federal funds for
needle exchange programs.

HIV Alliance is heavily dependent upon limited private funding for
our program. Without increased support by Oct. 31, our program will
have to be suspended, presenting a serious threat to the health of
our community.

According to the Centers for Disease Control and Prevention, up to 40
percent of new infections in the country can be related to injection
drug use. Furthermore, an international study demonstrated that 52
cities without needle exchange programs experienced, on average, a
5.9 percent increase in HIV infection rates each year compared with a
5.8 percent decrease in 29 cities with needle exchange programs
(study published in 1997 in the medical journal Lancet).

Hundreds of studies have been conducted on the effectiveness of
needle exchange programs, all of which have been summarized in a
series of eight federally funded reports dating back to 1991. Each of
these eight reports concluded that needle exchange programs can
reduce the number of new HIV infections and do not appear to lead to
increased drug use among users or the general community.

No increased drug use among drug users and the general community were
the original two criteria that had to be met by law before the
federal ban on funding for needle exchange programs could be lifted.
Congress has since changed the law to continue to ban funding even if
the criteria are met.

HIV Alliance asked the two candidates seeking to represent Oregon's
4th District in the U.S. House of Representatives their positions on
the continued federal ban. Rep. Peter DeFazio provided us with the
following statement: "We must do all we can to reduce the
transmission of deadly but preventable diseases like HIV/AIDS. Needle
exchange programs, as part of a comprehensive HIV prevention
strategy, have been proven to lower the rate of new cases of HIV
infection and do not increase drug use. They are also extremely
cost-effective when compared to the cost of caring for an HIV/AIDS
patient. That's why I have consistently fought efforts to eliminate
federal funding for needle exchange programs."

According to a campaign representative, Jim Feldkamp supports the
current ban because he does not believe federal funds should be used
to support drug habits.

It defies logic that the ban should continue. We are not arguing here
for the increase of federal funds to HIV/AIDS prevention - that is an
entirely different debate. We are only seeking the end of the
restrictive ban on the use of current federal funds for needle
exchange programs. Our premise is simple: Needle exchange programs
reduce infection rates, and the lower infection rates reduce the
number of people needing treatment for HIV/AIDS, ultimately saving lives.

This is a pragmatic, pro-life position. Some in our community oppose
needle exchange programs, ostensibly on moral grounds. How moral is
it to allow babies of injection drug users to be infected with HIV
because of opposition to providing their drug-addicted parents with
uncontaminated needles? How moral is it to not protect innocent
sexual partners of injection drug users - and their partners, and
their partners? We must recognize that this is how the disease spills
over into the general population and how countries in Eastern Europe
have lost control over the AIDS pandemic.

Does the ban lead to an efficient allocation of taxpayer dollars?
According to the Journal of Acquired Immune Deficiency Syndromes and
Human Retrovirology (Vol. 16, 1997), the lifetime cost of treating an
HIV positive person is $195,188. The cost of a clean needle is 9 cents.

Dr. David Satcher, the former U.S. surgeon general, observed in 2000
that, "After reviewing all of the research to date, the senior
scientists of the department and I have unanimously agreed that there
is conclusive scientific evidence that syringe exchange programs, as
part of a comprehensive HIV prevention strategy, are an effective
public health intervention that reduces the transmission of HIV and
does not encourage the use of illegal drugs."

When will Congress heed this advice and help prevent thousands of new
infections?