In his 2010 budget, President Obama failed to deliver on his
commitment to end the ban on federal funding of needle exchange
services–an action he promised to take before and after the
election and one that would help protect the health and save the lives of tens
of thousands of injection drug users–in the U.S. and around the
Every year since 1988, Congress has tucked the ban into the Labor HHS
appropriations bill with a provision stating that "no funds appropriated
in this Act shall be used to carry out any program of distributing sterile
needles or syringes for the hypodermic injection of any illegal
These words have meant that communities across the U.S. are limited in how they can
fight HIV among some of their most vulnerable residents. Technically, they do
not apply to any funding not covered by the Labor HHS bill. However,
bureaucrats administering U.S.
foreign assistance have felt constrained by this language and have cautiously
decided to apply it to all foreign assistance. The harm caused by these words
goes beyond HIV as well, as needle exchange programs are also an important tool
in fighting viral hepatitis.
Given President Obama’s strong support for needle exchange
programs and the Administration’s commitment to invigorating the federal
response to the HIV/AIDS epidemic, we hoped that the President would seize this
first opportunity for lifting federal restrictions on this lifesaving
prevention strategy by removing this provision from his FY10 budget request to
Congress. Sadly, it remains. Denying people at risk for HIV a proven
prevention intervention is a denial of their basic human rights and it was certainly
a surprise to find it still in the budget.
The President has repeatedly expressed his support for lifting the ban,
pledging during the campaign, the transition, and after the inauguration to
take action on this issue. Within 24 hours of his inauguration, the White
House website stated clearly: "The President also supports lifting the
federal ban on needle exchange, which could dramatically reduce rates of [HIV]
infection among drug users."
While we are disappointed by the inaction on needle exchange funding in
the President’s budget, the prospects of lifting the federal ban have not
been defeated. We and our allies on this issue will continue working with the
Administration and Congress to remove the obstacles to the implementation of needle
exchange programs in communities devastated by HIV.
The President must now move past simply being clear in his support for
ending the federal ban and insist that Congress not include the restriction in
the appropriations legislation they send him. The Administration must also
work with Congress to pass the Community AIDS and Hepatitis Prevention Act , and
direct HHS and State to remove all non-legislative barriers for funding of needle
While there is a lot the Obama Administration needs to do, they alone are
not responsible for paving the way for federal support of needle exchange
programs. We know the importance of scaling up these programs in the US and
elsewhere and we must now reach out to Members of Congress to ensure that they
also allow science to guide their judgment on this issue. They, too, have
an important role to play in lifting the ban and we must see to it that they
act with due haste.