THE NEEDLES AND THE DAMAGE DONE

Syringe Exchanges Are About the Most Logical Thing We Could Do to
Stop HIV, but Politics Isn't Logical.

The House of Representatives showed the courage of President Obama's
convictions on the needle exchange issue.

Candidate Obama vowed repeatedly to end the ban on federal funding
for needle exchange programs -- a 21-year-old policy that blocks
federal dollars from supporting the most effective, cost-efficient
HIV prevention tool ever dreamed up.

President Obama, however, retained the ban in his 2010 budget
proposal -- punting the issue to Congress.

But thankfully, late last month the House voted 263 to 153 to lift
the ban. Rep. David Obey, D-Wis., was instrumental and courageous in
getting the bill through the House. It now goes to the Senate.

The funding ban is among the most glaring examples of politics
trumping science in modern governance. Congress imposed it in 1988,
arguing that by letting addicts swap dirty needles for clean ones,
syringe exchanges encourage drug use. But research from all over the
world has proved that notion apocryphal. It's now clear beyond a
doubt that these programs not only dramatically reduce HIV
transmission, they also offer excellent conduits to addiction recovery.

Moreover, since we're all concerned about our government's solvency,
syringe exchange programs are stunningly good for the balance sheet.
Research pegs the lifetime cost of treating an HIV infection at
$620,000 -- and given the real overlap between HIV infection and
poverty, particularly among drug users, much of that tab is born by
publicly financed programs like Medicaid. Needle exchanges,
meanwhile, cost between $4,000 and $12,000 per infection avoided,
according to a 2006 study.

All of which is why candidate Obama emphatically endorsed lifting the
ban on federal funding. He already has the power to do so as the
president: Congress gave the Department of Health and Human Services
the right to repeal the ban whenever it could prove that syringe
exchange programs don't foster drug abuse. President Bill Clinton's
health secretary, Donna Shalala, did just that way back in 1998 --
but Clinton's political team overruled her effort to let science guide policy.

Even now, politics is undermining Obey's effort. An amendment to his
House bill bars money for any program that's within 1,000 feet of a
long list of venues, ranging from schools to swimming pools and video
arcades. It's a poison pill: There's no meaningful place to put an
exchange in a dense urban area without violating this rule.

Obey has said he'll try to strip the amendment once the bill reaches
conference committee, where it must be reconciled with whatever the
Senate passes. Of course, that's assuming the Senate passes a bill
without the same counterproductive language.

That brings us back to Obama's stated convictions. It's time for the
president to do what he pledged as a candidate and let science lead
HIV prevention.

Many lives are at stake. They should take priority over politics.