A DEADLY DECISION AGAINST NEEDLE EXCHANGES

The Clinton administration and Donna Shalala let a splendid opportunity to
help stem the spread of HIV slip through their hands Monday, for reasons
that can only be political. It was a shameful blunder.

In announcing the decision against lifting the ban on federal money for
needle exchange programs -- despite overwhelming evidence that such
programs work -- Shalala left herself open to legitimate criticism that she
was failing her duty as the nation's chief public health official. The
health and human services secretary, in effect, undermined the
administration's bad call with her own words.

"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," Shalala said. Pretty
compelling stuff. Yet she then upheld the federal ban, leaving it up to
local communities to decide whether to fund their own needle exchange
programs.

Backers of the federal funding ban say needle exchanges encourage drug use
- -- a reasonable fear, at first glance. But the evidence shows just the
opposite. Programs that encourage injectable-drug users to exchange
contaminated needles for clean ones can reduce the incidence of HIV by
curbing its spread through needle sharing. Such programs have also
encouraged many drug users to seek treatment by establishing trust between
users and the AIDS counselors who exchange the needles.

Across the country, needle exchange programs now operate with state, local
and private money. The AIDS Resource Center of Wisconsin's successful
needle exchange is funded entirely by private money, but it could reach far
more people if federal funds were available. What makes this even more
urgent is that about 40% of the total AIDS cases in the United States have
been linked to injection drug use. Even more ominous, at least 75% of
babies with HIV/AIDS were infected directly or indirectly as a result of
injection drug use by a parent.

Whether to allow use of federal funds for such programs reportedly was
debated heavily by White House officials over the weekend because some
short-sighted Republicans in Congress apparently threatened to ban federal
funds for any organizations that provide free needles, even if the federal
money was used for other purposes.

Shalala reportedly urged the White House privately to rescind the ban, but
that's a moot point now. The administration should have stood up to the
political pressure and made its solid case directly to the public. After
all, it's the public that stands to benefit the most from controlling the
spread of this terrible disease.