NEEDLES, PINHEADS AND POLITICIANS

SAN FRANCISCO'S needle exchange program has been an unqualified success:
The city has not reported a single case of pediatric AIDS in three years.
And there's not exactly a shortage of junkie moms in San Francisco either.

HIV infection among women is low. Nationally, 14.9 percent of adults with
HIV are women. In San Francisco the figure is about 3.2 percent. ``One of
the reasons is that we've had needle exchange from early on in San
Francisco,'' Derek Gordon of the San Francisco AIDS Foundation opined. The
needle initiative prevented HIV from spreading through the needle
community. For the bargain price of about $500,000 annually, the program
has spared the lives of children born to drug shooters.

Last year I spent an evening at a local exchange for women. A stream of
women -- some down and out, a few remarkably smart looking -- turned in
1,615 used needles. Workers and volunteers in turn provided the women with
1,615 clean needles, drug treatment referrals for the rare user who asked,
juice, food, vitamins, medical checks and a play area so that children
wouldn't have to watch their moms clutching needles.

A lesson learned: Even self-destructive drug addicts can care enough about
their health to save their needles up for Thursday nights, gather those of
their friends and schlep to Valencia Street to trade them in for clean
paraphernalia.

Amazing grace, after I wrote a column about the needle exchange, I didn't
receive a single complaint from a neighbor. That's how well it was run. (As
an aside, there is another exchange a block from The Chronicle. I'm a quiet
needle exchange neighbor myself.) Having written the above, this is where I
am supposed to trash President Clinton for not keeping his campaign pledge
to earmark federal funds for needle exchanges. This is where I'm supposed
to excoriate Health and Human Services Secretary Donna Shalala as well,
because Clintonia didn't change its policy despite hints that a shift was
coming. I can't. I see the success of San Francisco's needle exchange --
and I cringe when I think of what would happen to it if federal funds
entered the picture. Federal funds inevitably come with strings attached. I
shudder at how Uncle Sam could botch a good program: paperwork, reporting
requirements, a phone book-size code on which disability-friendly and
transit-accessible buildings could be used, staffing regulations, motor
voter, formulas for gender, age and ethnic representation. Ugh.

You know that if this Congress would approve funding only for an exchange
program if members could add something truly counterproductive or stupid --
like, require clean-needle recipients to watch a DARE film.

(And it's not just because Congress is craven. It's also because members
understand the need to take their constituents' legitimate concerns to the
table when they fund any program.)

Which presents a point that needle-exchange supporters generally seem to
have forgotten: Not every good deed gets federal money. Some things are
better handled by private charities and local institutions. Needle exchange
doubtless is one of them. What's more, with zillionaire George Soros'
second annual donation of $1 million to needle programs, there is reason to
believe that private largesse can continue to carry the load.

Clinton critics have faulted the president for putting politics ahead of
lives. But if they really want to save lives, they might lay off Clinton
and instead fight for funding of smart local programs.