ADMINISTRATION BACKS OFF SUPPORT FOR NEEDLE EXCHANGE

WASHINGTON -- The Clinton administration refused yesterday to use federal
tax dollars to buy clean needles for drug addicts, even though it said
needle exchanges fight AIDS without encouraging illegal drug use.

Health and Human Services Secretary Donna Shalala said her scientific
endorsement should encourage more communities to start their own needle
exchanges.

But Shalala, under orders from the White House, sidestepped a political
fight with conservatives and stopped short of providing communities with
federal money to let addicts swap dirty needles for clean ones.

Half of all people who catch HIV are infected by needles or by sex with
intravenous-drug users, or are children of infected addicts. The decision
bitterly disappointed AIDS activists, who said they couldn't recall another
medical program the government had declared lifesaving but refused to try
to pay for.

"They've now said we know how to save lives and we don't want to do what's
necessary to save the lives," said an angry Dr. Scott Hitt, chairman of
President Clinton's AIDS advisory council. "This administration is now
publicly stating how to slow it (the AIDS epidemic) down and is saying they
lack the courage to do it."

"It's like saying the world is not flat but not funding Columbus' voyage,"
added Daniel Zingale of AIDS Action.

Republicans continued to argue that needle exchanges were bad policy, and
Rep. Gerald Solomon, R-N.Y., said he would push for Congress to ban federal
funding altogether in case Shalala changed her mind.

"Why not simply provide heroin itself, free of charge, courtesy of the
American taxpayer?" asked Sen. John Ashcroft, R-Mo. President Clinton's own
drug policy chief, Barry McCaffrey, spent the weekend arguing that needle
exchanges jeopardize the administration's war on drugs and send the wrong
message to children. Officials familiar with the heated debate said
McCaffrey's objections were central to killing a proposed compromise, a
pilot project paying for needle exchanges in 10 cities.

Asked about the criticisms, National Institutes of Health Director Harold
Varmus said that they were being made only by politicians, not scientists.
Every major public health organization has supported needle exchanges.

The Clinton administration is counting on Shalala's endorsement to persuade
communities to expand the 110 needle exchanges now operating in 22 states.
And Surgeon General David Satcher suggested communities could avoid the
political impasse: Seek federal dollars for all other HIV prevention
activities, from youth education to drug treatment, so that local money
could be directed to buy needles.

When asked if more funding would help, Satcher responded: "Yes, we think we
would save more lives."

The nation's top science organizations have long said needle exchanges
would cut the AIDS toll. Activists say federal funding is key to expanding
the programs.

But Congress banned federally funded needle exchanges unless Shalala
certified that such programs fight the spread of HIV without encouraging
drug use.

Monday, Shalala did that, saying a review of studies concluded that
programs that provide drug counseling and push addicts into treatment work
best.