STICKING IT TO NEEDLES

Here it is only Wednesday, and already we have a winner of the Craven
Cop-Out of the Week Award. It goes to the Clinton administration for its
decision to continue denying federal funds to needle-exchange programs even
though it believes those programs slow the spread of HIV without
encouraging drug abuse.

Since 1981, 40% of the nation's 625,000 reported AIDS cases have been
linked to intravenous drug use with dirty needles. Among women of
childbearing age, the rate is 70%; among HIV-positive babies, 75%.

In response, more than 100 exchange programs have sprung up in 28 states.
How are they doing? Great. A New Haven, Conn., program cut the HIV
infection rate among drug users 33%. The National Research Council and the
Institute of Medicine have concluded that exchange programs can cut
transmission 30% or more. The National Institutes of Health concurs.

Drug use? Studies report that properly designed programs are an effective
bridge between users and treatment programs. In one case, participation
tripled in 180 days. In another, 58% of those in the exchange program
joined within six months.

Final statistic: An article in the medical journal Lancet last month
calculated that a national exchange program in the United States could have
prevented up to 9,670 infections since 1987, saving up to $540 million
(calculated against the average $56,000 federal cost per patient). By
comparison, allowing localities to use federal money wouldn't cost
taxpayers one extra penny; AIDS prevention programs would just reallocate
existing funds.

The administration knows all this. Yet fearing a backlash in an election
year, it will only endorse the programs, not fund them. It says the
endorsement alone will inspire local governments to establish exchanges.
But if Clinton won't stand up, why should any governor or mayor? Maybe
because they embrace the principle that health policy should be based on
science, not self-interest. Or maybe simply because they have more
character.