Pubdate: Sat, 26 Feb 2005 Source: New York Times (NY) Copyright: 2005 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) 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. - --- MAP posted-by: Richard Lake