NEEDLE FUNDING BAN MAY SOON END

Shift in Congress Stirs Hope Among D.C. AIDS Officials

Nearly a decade after it was first imposed, a unique congressional
ban limiting the District's effort to fight AIDS could be lifted and
the city again allowed to use local tax dollars for needle-exchange programs.

The ban's changed prospects owe to the changed balance of power on
Capitol Hill, particularly in the House of Representatives, which has
attached the prohibition year after year to legislation governing the
District's budget. With Democrats now in control and support growing
to give the city a vote in Congress and greater autonomy generally,
health advocates are optimistic that the restriction could be history by fall.

"The moment may have come. The stars may have aligned," said Walter
Smith, executive director of the nonprofit DC Appleseed Center for
Law and Justice.

The District has among the worst rates of HIV-AIDS infection in the
country -- with intravenous drug users accounting for about one-third
of new AIDS cases annually. But it is the only city prohibited from
spending its own funds to provide clean syringes to addicts. "There
is a connection between those two facts," Smith said, "and it is time
to uncouple it."

The first hurdle will come today as a key House subcommittee takes up
the appropriations bill that includes the city's spending plan. Its
chairman, Rep. Jose E. Serrano (D-N.Y.), said he and his colleagues
should not be telling the District what to do with its money.

"I don't appreciate the fact that so many people throughout the last
few years have used the D.C. appropriations bill . . . as the
punching bag or the battleground for so many social issues," Serrano
said in an interview late last week.

Yet his opposition goes beyond political philosophy to public health
and how best to attack the epidemic. The effectiveness of
needle-exchange programs has been proven nationally, Serrano said:
"This is where people who are really hurting go for help." Although a
reversal of Congress's past action is not a certainty, he said he is
ready to push the issue.

"This is one I'm really concerned about," he said.

Despite the controversy over such programs, more than 210 are in
place in 36 states. About half receive local or state funding,
according to the North American Syringe Exchange Network.

Proponents, armed with a significant body of research, say that
giving clean needles to addicts saves lives by decreasing the shared
use of potentially contaminated syringes and, therefore, the
transmission of HIV and other blood-borne diseases such as hepatitis.
They say the interaction with users also draws them into treatment
and counseling -- without encouraging greater drug use, as critics maintain.

Congress first targeted the District in 1998, when opponents of
needle-exchange programs not only strengthened a ban on federal
financing but also barred using the city's resources on such efforts.
The next year, it appeared the language might be dropped. But when
the D.C. budget reached the House floor, conservative Republicans
again added a rider.

Until now, there had been little hope of a different outcome.

"This is the worst example of political disempowerment and abuse of
the city," said Del. Eleanor Holmes Norton (D-D.C.). "It's a
life-and-death matter and a public health matter. There is no
question that countless deaths have occurred because of this attachment."

Norton began lobbying her party's leadership early this year and
expressed confidence last week that its majorities in the House and
Senate will allow the District to resume public funding of its one
local needle-exchange program. She can point to significant backing
within the city. Serrano and Sen. Richard J. Durbin (D-Ill.),
chairman of the subcommittee that initially handles the D.C. budget,
received a letter last month endorsed by representatives of more than
two dozen medical, public health, social service and philanthropic
organizations.

"Please help us battle the HIV/AIDS epidemic in the District," it urged.

J. Channing Wickham, who signed the letter as executive director of
the Washington AIDS Partnership, sees the timing as propitious.
Between increasing acceptance of home rule and the accumulated
medical evidence, he said, "all signs are very, very positive."

The ban's prime author, Rep. Todd Tiahrt (R-Kan.), remains on the
Appropriations Committee. His position has not changed, and despite
the new political equation, he will probably try once more to
constrain District funds, spokesman Chuck Knapp said.

"We hope it passes," Knapp said, "but realistically it's a different
political environment."

Mayor Adrian M. Fenty (D) already has pledged to direct dollars
toward needle-exchange programs if the ban is removed, a commitment
he reiterated in a statement Friday. The lack of city financing has
hamstrung the small nonprofit group that drives into sometimes-bleak
neighborhoods five days a week in search of those in the grips of
heroin and other drugs.

"It has restricted our growth," said Paola Barahona, who has been
executive director of Prevention Works! since its start nine years
ago in response to the federal stricture. Even so, the privately
funded organization passed out more than 236,000 needles last year.
That count meant regular contact with about 2,000 users, many of them
women. Statistics indicate that 40 percent of women living with AIDS
here were exposed to the virus through injecting drugs.

"We're talking about people who are missed by all other health
outreach programs," Barahona said. And numbers, she added, "that are
just the tip of the iceberg."