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The Feb. 18 memo by Health and Human Services Secretary
Donna E. Shalala, forwarding to Congress a report on the
latest research on the effectiveness of needleexchange
programs in reducing HIV infections among drug users, is a
triumph of pusillanimous politics and double talk over
facts and sound public policy.

All the research cited in the report corroborates what
already has been known for years: Needleexchange
programs reduce HIV infections and save money. They even
encourage a significant percentage of addicts to seek
treatment. Yet Shalala couldn't bring herself to ask
Congress to lift its 1992 ban on HHS funding of
needleexchange programs. The ban stands until the surgeon
generalwho reports to Shalalavouches to Congress that
such programs are safe and effective.

AIDS is spreading faster among intravenous drug users
than in any other group. According to a study by the
National Academy of Sciences, between 1981 and 1993 the
percentage of new HIV infections due to unsafe homosexual
sex dropped to 47 percent from 74 percent, while those
attributable to the use of dirty needles by intravenous
drug users doubled, to 24 percent.

Indeed, despite the recently reported annual decline in
AIDS deaths overall, AIDS has become the leading cause of
death in the AfricanAmerican and Hispanic communities,
primarily because of drug use and dirty needles. Most
tragically, many of the victims are the babies or innocent
sex partners of HIVinfected addicts.

Needleexchange programs work. In a 1993 study by Yale
University, they were shown to reduce HIV infections by a
third. Another study, funded by the Centers for Disease
Control and Prevention, indicated that needle exchanges
even worked as a bridge for getting significant numbers of
users into rehabilitation. One of the most persuasive
arguments is financial. Some 70 needleexchange research
projects, of varying sizes and uncertain funding, operate
mostly in large cities, including Chicago. Their average
annual budget comes to approximately $169,000about what
it costs to treat just one HIVinfected addict during the
course of the disease.

None of the six studies cited in the HHS report found
any basis for the fear that needle exchanges encourage
drug use.

Yet the argumentlargely symbolicagainst these
programs is that it looks incongruous for one branch of the
government to "subsidize" drug use, however indirectly,
while other agencies wage a multibilliondollar war against
it.

It is Shalala's responsibility to sort out facts from
symbolsand fears from realityand argue for sound,
effective federal policies. By simply tossing the
needleexchange hot potato back to Congress without
comment, she has failed in that role.