HE WAFFLES, AGAIN: CLINTON PLAYS POLITICS WITH NEEDLE EXCHANGE

Congress in 1989 banned the spending of federal money on needle-exchange
programs to combat AIDS until there was ample evidence to demonstrate that
the programs reduced the spread of HIV without encouraging or increasing
drug use. There now is such evidence, plenty of it, from various university
studies. Needle-exchange programs accomplish considerable good without any
of those theoretical negative consequences. There is no reasonable public
health argument, based on science or objective research, to conclude
otherwise.

That is the message top federal scientists had prepared for President
Clinton in hopes he would take the first steps to lift the ban.
Unfortunately, Clinton has opted to use the winds of politics as the gauge
to set his course on this public health policy.

The Clinton administration has decided to acknowledge the value of needle
exchange programs while declining to lift the ban on federal support.
Clinton is likely right to conclude that this Congress would fight such a
change in policy. But he is wrong not to try. By not doing so he derails a
needed debate about needle exchange programs that might help a leery public
distinguish baseless scare tactics from evidence-based medicine.

Every day, an estimated 33 drug users are infected with HIV by contaminated
needles. Many also contract an incurable strain of hepatitis. As many as
four in 10 of all new HIV infections are a direct or indirect result of
tainted needles. The figure is even higher for women -- perhaps even 75
percent -- and for their babies contract the same deadly disease. The
health-care costs, largely footed by taxpayers, are enormous. Programs that
exchange used needles for new, clean ones not only save lives, but save
millions in government dollars as well.

The supposed downside to needle exchange programs is that they condone the
illegal use of drugs or glamorize narcotics to children. A review of all
available studies by the National Institutes of Health, however, found no
such basis for the concerns. Rather, there is "increasingly strong
evidence" that needle exchange programs both reduce AIDS and increase the
likelihood that addicts seek treatment. Every time an addict exchanges
dirty needles for clean ones is an opportunity for public health officials
to educate that addict about available treatment options.

Needle exchange is merely one of many strategies necessary to reduce and
ultimately conquer AIDS. Lifting the ban on federal funding would merely
allow communities that receive federal funds to fight AIDS to decide for
themselves whether a local exchange program makes sense.

Although new drug combinations have provided hope to thousands who have the
virus, we are in no position to ignore a crucial weapon because of
political sensitivities. This is yet another circumstance in which Clinton
says all the right words rather than doing the right deeds.

Copyright ) 1998 The Sacramento Bee