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Letter in Washington Post Regarding Effectiveness of Needle Exchange Programs

This letter, by Health Research Group Director Sidney Wolfe, M.D., appeared in the Washington Post on February 27, 1997.

An NIH Consensus Conference's recent scientific conclusion about the effectiveness of needle-exchange programs in reducing the spread of diseases such as AIDS referred to the "dangerous chasm" between this finding and public policy in the United States. The Post's Feb. 15 editorial: "Needles and Classroom Candor ,"while stating that "government policies that reject these findings and ignore these preventive steps must be changed," did not mention that although Congress imposed the ban on use of federal funds to pay for needle-exchange programs, further legislative action is not required to allow funding but merely a finding by the secretary of health and human services that needle-exchange programs reduce AIDS transmission and do not increase drug use.

NIH's recent statement was not the first time a government agency or a government-funded study has concluded that needle-exchange programs can decrease the spread of infection without increasing drug use, and thus recommended that the ban prohibiting use of federal funds be lifted. The National Commission on AIDS (1991), the University of California (1993), the Centers for Disease Control and Prevention (1993) and the Institute of Medicine of the National Academy of Sciences (1995) all reached the same conclusions.

If the medical and scientific evidence is so clear, why does the ban persist? It is increasingly obvious that the "dangerous chasm" between science and policy emanates from policies set in the White House's Office of National Drug Control Policy, whose simplistic mantra of "no drugs" is incompatible with federal funding of needle-exchange programs. A statement on needle-exchange from the drug policy office dated Jan. 31 said that it "will not advocate a Federal policy that is centered on government provision of the tools to support addiction." The statement went on to explain that "needle exchange is neither an adequate substitute for drug treatment nor a preferred means of facilitating entry into drug treatment." There are more than enough official scientific opinions to enable Health and Human Services Secretary Donna Shalala to save thousands of lives by decreeing that the politically motivated anti-scientific ban of federal funding of needle-exchange programs - the "dangerous chasm" has ended.

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