Needles and politics

The Presidential Council on HIV/AIDS is absolutely right — President Clinton’s reluctance to allow federal funds to be used for programs that exchange a drug addict’s dirty syringe for a clean one is pure politics.

Which is why the council’s furious assault on the boss Tuesday was so uncalled for and so potentially damaging to its own cause. Of course it’s politics. What else could the use of taxpayers’ money (putting it as bluntly as the conservatives who control Congress put it) to provide free needles for junkies possibly be?

According to numerous scientific studies, there is no question that dirty needles now are the primary cause of new HIV infections, leading to the infection of the user’s unprotected sex partner and of the doomed babies that too often result. There also is no question, based upon studies of needle exchange programs, that such programs substantially reduce the spread of the disease.

But there also is no question that Congress, after a slow start a decade ago, has been extraordinarily generous in the fight against AIDS — more than $5.3 billion for research, victim assistance and prevention education last year. But Congress has made it abundantly clear that no federal money will be used to buy needles until it can be proved that free needles do not lead to an increase in drug use.

Studies strongly suggest they do not. The correlation may well be no stronger than that between free matches and smoking. That’s not the point.

The point is that Congress, and the American public, can be fickle. The 33,000 AIDS deaths last year was a dramatic drop of more than 10,000 from the year before. The vast majority of new cases are showing up among those who indulge in the riskiest behaviors (and the innocent bystanders they infect). The strong support for AIDS funding today could evaporate overnight with one false step.

One powerful senator just waiting for that stumble is North Carolina’s Jesse Helms. When Congress passed the Ryan White Comprehensive AIDS Act in 1995, Helms nearly succeeded with amendments that would have blocked federal funds from organizations that provide services specifically targetted at homosexuals and drug users. He’ll try again if sufficiently outraged.

Instead of pushing for federal needle programs and giving Helms and his conservative cohort the opening they desire, the president’s council should focus its attention instead upon the states and the private sector.

Laws that restrict the distribution of syringes are state laws. A handful of states have repealed those laws and now allow needles to be distributed under controlled conditions. Other states should do the same.

An enormous amount of money, hundreds of millions, is raised each year in the private sector for AIDS. It should not be difficult for the nation’s extensive network of AIDS organizations to set aside enough money for needle exchanges and to operate those exchanges through groups totally discrete from those receiving federal funds.

The president’s council is right in theory but wrong in reality. The reality is that, while AIDS prevention education is having a tremendous effect in reducing new cases, there still is no vaccine or cure. Millions of Americans, hundreds of millions of human beings worldwide, are infected with a disease that, for now, is always fatal. The billions of taxpayer dollars that could change their fate must not be placed at risk. Needle exchanges can be handled another way. That’s politics.