IDEOLOGY AND AIDS

The Bush administration has contributed to suffering and death through the
so-called global gag rule, which prohibits Washington from giving money to
any group that performs - or even talks about - abortions. Organizations
that provide desperately needed family planning and women's health services
have lost their financing. Now there are moves in Congress and inside the
administration to apply a similar rule to needle exchange programs. That
would be an even more deadly mistake.

Allowing drug users to trade used needles for clean ones gets dangerous
needles off the street and minimizes needle sharing. A proven weapon
against AIDS transmission, it has not been shown to increase drug use, and
indeed may reduce drug addiction by providing a way to talk to drug users
and lead them to treatment. It is endorsed by virtually every mainstream
public health group.

Getting users into drug treatment is the best way to keep them safe. But
the push for treatment - which is expensive and difficult - should come
with needle exchanges.

Drug use is not a significant source of AIDS infection in Africa. In parts
of Asia, the former Soviet bloc and Eastern Europe, needles are the major
source of infection; three-quarters of all newly infected people in Russia
are intravenous drug abusers, as are half of those newly infected in China.
These are just the places where the AIDS epidemic is likely to explode
next. A bumper poppy crop in Afghanistan will worsen the outlook, producing
cheap heroin that could turn opium smokers into heroin injectors and thus
fuel the epidemic.

Opponents of needle exchanges, mainly among the religious right, argue that
the practice muddies the message that illegal drug use is unacceptable, and
keeps drug abusers from suffering the consequences of their addiction. By
this twisted logic, doctors should refuse to treat lung cancer in smokers.
In any case, AIDS infections from sharing needles are not limited to drug
users. They infect sexual partners, spreading the epidemic through societies.

While Washington does not buy syringes for needle-exchange programs, it
does give money to groups that use other people's money to administer
needle exchanges. But some conservatives are attempting to stop even that.
The assistant secretary of state for international narcotics and law
enforcement, Robert Charles, warned the United Nations Office on Drugs and
Crime, which currently holds the rotating chairmanship of the joint program
Unaids, that the organization should not work on needle exchange issues and
should remove positive references to them from its Web site, which it did.

Representatives Mark Souder of Indiana and Tom Davis of Virginia, both
Republicans, have asked the United States Agency for International
Development for details on all financing for programs in which any group
strongly advocating needle exchanges also participates. These lawmakers
claim that a U.N. drug agency report attacks needle exchange as encouraging
drug use. In fact, the report makes no such accusation and endorses needle
exchanges.

In the Senate, a member of the staff of Sam Brownback, the Kansas
Republican, has compiled a grossly inaccurate chart of programs financed by
the Global Fund to fight AIDS, Tuberculosis and Malaria that is subtitled
"Immoral, Illegal (with bilateral funds) or Inconsistent with U.S. Foreign
Policy." Needle exchanges rank high. At the moment, Mr. Brownback's office
says he does not intend to attempt to block these programs. But some newer
right-wing lawmakers are considering it.

So far, attempts to eliminate needle-exchange programs overseas seem to
have limited support. Many administration officials and conservatives in
Congress do not want to see crucial AIDS prevention measures derailed or
American support withdrawn from such organizations as the Global Fund. One
important test will be what the administration does in early March at the
annual meeting of the United Nations Commission on Narcotic Drugs. Last
year, United States representatives there attacked the scientific evidence
in favor of needle exchanges as unconvincing. This year, the United States
should refrain from such attacks - and members of Congress should call off
their budding witch hunt.

Washington's antipathy toward needle exchanges is a triumph of ideology
over science, logic and compassion. The United States should help pay for
these important programs. If it cannot bring itself to do so, it should at
least allow the rest of the world to get on with saving millions of lives.