Both chambers of Congress recently approved a measure that will allow federal funding for needle-exchange programs in a move considered a major boost to the fight against HIV/AIDS.
The $1.1-trillion Consolidated Appropriations Act, which funds six federal agencies and other programs, is now awaiting President Obama’s signature.
The House of Representatives originally approved an amendment to the spending bill this past summer that lifted the more-than 20-year ban on federal funding of exchange programs — which allow intravenous-drug users to obtain clean syringes to prevent the spread of diseases such as HIV — but the Senate version of the spending bill that passed in July maintained the ban.
A conference committee of House and Senate leadership was convened to draft a final version of the appropriations measure, which removed the ban, and which the House approved Dec. 10 and the Senate followed three days later.
Kaytee Riek, director of organizing for Health Global Access Project and ACT UP Philadelphia member, said the lifting of the ban will have tangible results, including here in Philadelphia.
“In Philadelphia, we have a needle-exchange program that does an excellent job with the resources that they have, but they’re not able to fully meet the need of injection-drug users in Philadelphia because of the ban on federal funding,” Riek said. “But now with federal funding being allowed, the syringe-exchange program can really expand to meet the needs of injection-drug users and can, in turn, lower infection rates.”
When the House first moved to strike the ban in the summer, it also included a stipulation that exchange programs funded by the federal government cannot be set up within 1,000 feet of any venue in which children gather, such as schools, universities, playgrounds, video arcades, youth centers or in places where events sponsored by such organizations take place — a provision that HIV/AIDS activists said made it nearly impossible for such programs to be instituted in urban areas, where HIV/AIDS infections are highest.
“Thank goodness that was taken out, but if it had been included, it would mean that we would’ve been able to have a needle-exchange program pretty much operating in the Delaware River. That would be the extent of the kind of program we could have had in Philadelphia,” Riek said. “Fortunately, the Senate and the House saw that this was unacceptable and just a different form of the ban.”
The bill includes language that enables local law-enforcement and health officials to determine if a program site is “inappropriate,” which Riek said she didn’t consider being an issue.
“The important thing is that this does not require the syringe exchange to check in first. It’s the other way around,” she said. “The syringe-exchange program can establish a site and if there’s an objection, then the Health Department or the police come in. But syringe exchanges don’t just open up sites wherever; there’s usually already a negotiation with police and health departments because that’s the nature of HIV prevention — you work with a lot of different agencies to make sure where the constituencies are who would best be served by such programs.”
House Speaker Nancy Pelosi (D-Calif.) hailed the lifting of the ban in a statement released after the House vote last week.
“The scientific support for syringe exchange could not be more clear,” she said, noting that the National Institutes for Health has long held that syringe-exchange programs are effective at reducing the number of new HIV infections without increasing the use of illegal drugs.
Besides NIH, other medical groups such as the Centers for Disease Control, the World Health Organization, the Institute of Medicine, the American Medical Association, the American Pediatric Association and the American Public Health Association have all endorsed such initiatives.
“Sound science is an essential component of good public-health policy, and science must come first in our public-health policy decisions,” Pelosi said. “Injection-drug use is linked to 12 percent of new HIV infections, as well as most hepatitis-C infections. Lifting the ban on federal funding for syringe exchange is a big victory for science and for public health.”
In addition to the lifting of the needle-exchange ban, the spending measure also ended the prohibition on the use of federal funds for costs associated with domestic-partnership registration and benefits and included $5.57 billion for global HIV/AIDS initiatives, a boost of about $200 million from the last fiscal year.
The bill also cut federal funds for abstinence-only sex education and lifted a restriction that barred Washington, D.C., from using federal funds for abortions and allowed the district to hold a voter referendum on medical marijuana legalization.
Jen Colletta can be reached at [email protected].