Expert panel strategizes to repeal the federal ban on funding for syringe exchange

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The following guest blog post is by Yale University senior Helen Jack, originally from Hanover, New Hampshire. She is currently studying biology and international studies, but will soon head to Oxford as an international Rhodes Scholar. Jack attended a panel presentation Wednesday at Yale discussing the recently reinstated ban on federal funding for domestic syringe exchange programs, and the bill’s accompanying report discouraging their use in international contexts.  

(From left) Elaine O'Keefe of the Center for Interdisciplinary Research on AIDS, Shawn Lang from the Connecticut AIDS Resource Coalition, and Allan Clear from the Harm Reduction Coalition speak at an event on syringe exchange policy Wednesday at Yale University. (Photo Credit: Orit Abrahim/Yale)

“The federal ban on needle exchange funding is institutional stigma,” said Allan Clear, executive director of the Harm Reduction Coalition, to an audience of nearly 100 students and community members at a Yale University auditorium Wednesday night. By reinstating the federal ban on funding for syringe exchange programs, Clear said the government sends the wrong message: that there must be something fundamentally wrong with syringe exchange programs and the injection drug users (IDUs) they serve. As a result, the ban not only takes money away from life- and cost-saving programs, but also increases the already debilitating stigma toward drug users. This stigma, Clear said, takes away their self-worth and creates barriers to healthcare and other social services.

Clear shared the stage with Shawn Lang, director of public policy for the Connecticut AIDS Resource Coalition, and Elaine O’Keefe, executive director of the Center for Interdisciplinary Research on AIDS (CIRA) at Yale. Leif Mitchell, the assistant director of CIRA’s Community Research Core, moderated the discussion. The panelists represented three areas that must come together for the ban to be overturned: history, advocacy and research. Clear discussed lessons in perseverance and persuasion from early syringe exchange activists, Lang shared details of state and national advocacy efforts around increasing access to syringe exchange, and O’Keefe explained how science and research have been used to show that syringe exchange programs decrease the spread of HIV and other blood-borne diseases without increasing drug use.

“The bottom line in all this is it saves lives. Period,” Lang said, then backed up her claim with recent research findings. In 2002, injection drug use accounted for 42 percent of new HIV infections in Connecticut. By 2009, after syringe exchange programs were scaled up, only 12 percent of new infections were due to injection drug use. While the public health community understands the evidence-based effectiveness of syringe exchange, many policy makers remain unconvinced about the value of these programs.

While the remarks of the panelists focused on domestic syringe exchange, the ban also impacts international programs. A report accompanying the bill expresses the intent of Congress that federal funds should not be used for clean syringes in international contexts as well, through initiatives such as PEPFAR. Given that people who inject drugs account for 30 percent of HIV infections outside of sub-Saharan Africa, the ban undermines President Obama’s recent call for an AIDS free generation.

All three panelists agreed that activists must put pressure on elected officials to support syringe exchange – If they do not hear from their constituents, legislators will not act. A national effort is forming to work for the repeal of the ban. Building up toward a national day of action on March 20, the Harm Reduction Coalition launched a petition to urge Republican leadership in the House to repeal the ban on syringe exchange funding. Yale’s chapter of the Student Global Health and AIDS Campaign, the group that organized the panel, held a rally to call on Connecticut’s Congressional delegation to take the lead in lifting the ban.

“Why are we still coming out and talking about this?” O’Keefe asked, noting that after more than twenty years of action to gain increased government support for syringe exchange, activists still have to fight, and still have to bring scientific evidence to policy makers to explain the value of syringe exchange. But even after so many years, no one is giving up, she said.

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