DEADLY IGNORANCE

THE BUSH administration is quietly extending a policy that undermines the
global battle against AIDS. It is being pushed in this direction by
Congress, notably by Rep. Mark Edward Souder (R-Ind.). But some
administration officials zealously defend this policy error, claiming
scientific evidence that doesn't exist.

The administration's error is to oppose the distribution of uncontaminated
needles to drug addicts.

A large body of scientific evidence suggests that the free provision of
clean needles curbs the spread of AIDS among drug users without increasing
rates of addiction.

Given that addicts are at the center of many of the AIDS epidemics in
Eastern Europe and Asia, ignoring this science could cost millions of lives.

In Russia, as of 2004, 80 percent of all HIV cases involved drug injectors,
and many of these infections occurred because addicts share contaminated
needles.

In Malaysia, China, Vietnam and Ukraine, drug injectors also account for
more than half of all HIV cases.

Once a critical mass of drug users carries the virus, the epidemic spreads
via unprotected sex to non-drug users.

The administration claims that the evidence for the effectiveness of needle
exchange is shaky.

An official who requested anonymity directed us to a number of researchers
who have allegedly cast doubt on the pro-exchange consensus. One of them is
Steffanie A. Strathdee of the University of California at San Diego; when
we contacted her, she responded that her research "supports the expansion
of needle exchange programs, not the opposite." Another researcher cited by
the administration is Martin T. Schechter of the University of British
Columbia; he wrote us that "Our research here in Vancouver has been
repeatedly used to cast doubt on needle exchange programs. I believe this
is a clear misinterpretation of the facts." Yet a third researcher cited by
the administration is Julie Bruneau at the University of Montreal; she told
us that "in the vast majority of cases needle exchange programs drive HIV
incidence lower." We asked Dr. Bruneau whether she favored needle exchanges
in countries such as Russia or Thailand. "Yes, sure," she responded.

The Bush administration attempted to bolster its case by providing us with
three scientific articles.

One, which has yet to be published in a peer-reviewed journal, was produced
by an author unknown to leading experts in this field who is affiliated
with a group called the Children's AIDS Fund. This group is more renowned
for its ties to the Bush administration than for its public health rigor:
As the Post's David Brown has reported, it recently received an
administration grant despite the fact that an expert panel had deemed its
application "not suitable for funding." The two other articles supplied by
the administration had been published in the American Journal of Public
Health. Although each raised questions about the certainty with which
needle-exchange advocates state their case, neither opposed such programs.

Evidence that the administration does not cite leaves little doubt about
the case for needle exchange.

A study of 81 cities published in 1997 in the Lancet, a medical journal,
found that in cities without needle-exchange programs, HIV infection rates
among injection drug users rose by nearly 6 percent per year; by contrast,
cities that had introduced free-needle programs witnessed a decrease in
infection rates of about the same magnitude. Elias A. Zerhouni, the
director of the National Institutes of Health, wrote last year that
exchange programs "can be an effective component of a comprehensive
community-based HIV prevention effort," and a World Health Organization
technical paper agreed that the provision of clean needles and syringes
should be "a fundamental component of any comprehensive and effective
HIV-prevention programme." Addressing legitimate methodological questions
about the research favoring needle exchange, the WHO reasonably concluded
that incomplete scientific evidence does not confer the freedom to ignore
the knowledge we do have.

Respecting science does not appear to be the administration's priority,
however. Not only is it refusing to spend federal dollars on needle
exchange, but the administration also is waging a campaign to persuade the
United Nations to toe its misguided line. The U.N. Office on Drugs and
Crime, which is heavily reliant on U.S. funding, has been made to expunge
references to needle exchange from its literature, and the administration
is expected to continue its pressure on the United Nations at a meeting
that starts March 7. The State Department's new leadership needs to end
this bullying flat-earthism. It won't help President Bush's current effort
to relaunch his image among allies.

And it's almost certain to kill people.