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Dems Question Efforts to Block AIDS Measure

Image has not been found. URL: /wp-content/uploads/2009/01/syringe-nick-atkins-photography.jpgFlickr: Nick Atkins Photography

Bush-era envoys to the United Nations are trying to block global efforts to promote HIV/AIDS-prevention programs such as needle exchanges, according to health and human rights advocates who supplied documents of the negotiations. The envoys’ opposition runs directly counter to the stated position of President Obama, who supports lifting a ban on clean-syringe programs that’s existed in the United States for 20 years.

The saga unfolds as the members of the United Nations are busy drafting a non-binding declaration of global drug-policy goals for the next decade. Although a number of countries — many in the European Union — are pushing hard to include language promoting “harm reduction measures,” including syringe-exchange programs shown to prevent needle-born illness, the U.S. representatives have already lobbied that provision out, according to health and human rights groups familiar with the negotiations.


Illustration by: Matt Mahurin

The U.S. opposition is consistent with current federal policy, which prevents federal funding for needle exchange programs. But it remains curious because Obama supports a repeal of that ban.

The White House Website outlines Obama’s position directly, proclaiming that the president “supports lifting the federal ban on needle exchange, which could dramatically reduce rates of infection among drug users.”

The episode has attracted the attention of some congressional Democrats. In a Jan. 28 letter to U.S. Ambassador to the United Nations Susan Rice, Reps. Henry Waxman (D-Calif.), Barbara Lee (D-Calif.) and Jose Serrano (D-N.Y.) cite “an apparent disconnect in U.S. policy” as it pertains to efforts to promote needle exchange to fight HIV/AIDS.

“We understand that the U.S. delegation in Vienna has been actively blocking the efforts of some of our closest allies — including the European Union — to incorporate in the declaration reference to harm reduction measures, such as needle exchange,” the Democrats wrote. They’re urging that the delegation “should immediately be given new instructions from the highest levels of the new Administration.”

In an op-ed published this week, Allan Clear, executive director of the Harm Reduction Coalition, an advocacy group, provided one explanation why the U.S. ban has extended to the UN declaration despite Obama’s opposition to it.

“Our current U.S. delegation is primarily made up of State Department bureaucrats soldiering in the war on drugs,” Clear wrote. “They promote policies that have had dramatic negative consequences (intended and unintended) on the lives of drug users, their families and their communities but very little impact on reducing drug supply, consumption or cultivation.”

In a Jan. 1 letter to Obama, a group of 65 health groups and human rights advocates echoed that description. “”

There’s not much time for the Obama team to act. The official U.N. meeting to finalize the draft — dubbed the U.N. General Assembly Special Session on drugs — will take place on March 12 and 13.

The State Department did not return calls for comment.

The U.S. ban on federal funding for needle exchange programs went into effect in 1988 and has been renewed each year since then as part of the appropriations process. Supporters of the ban argue that needle exchanges encourage drug use, and therefore Washington has no business funding them. Many opponents also reject the thought that taxpayers should subsidize the habits of drug users. After all, they argue, criminals should be imprisoned, not treated with government gifts.

But health and human rights groups reject those claims, arguing that if the government can’t prevent the use of drugs, it should at least take steps to ensure that the process is safe.

Many members of the medical community support needle-exchange programs. In 1998, Donna Shalala, health secretary under the Clinton administration, commissioned a report finding that such programs help prevent needle-born diseases while doing little to encourage drug use.

At the time, The San Francisco Chronicle quoted Harold Varmus, then-director of the National Institutes of Health and an author of the study, saying that, “An exhaustive review of the science indicates that needle exchange programs can be an effective component of the global effort to end the AIDS epidemic. Recent findings have strengthened the scientific evidence that needle exchange programs do not encourage the use of illegal drugs.”

No matter. Despite the report, the Clinton White House continued to deny federal funding for the syringe program, in effect extending the ban.

It seems poised to be extended overseas. A Jan. 15 draft version of the U.N. declaration includes language to “develop, review and strengthen” drug-treatment programs to include “harm reduction measures aiming at preventing and reducing the adverse health, social and economic consequences of drug use and dependence.” The U.S. representatives — along with those from Russia, Japan and Colombia — insisted the language be removed, according to John Walsh, senior associate for drug policy at the Washington Office on Latin America, a human-rights group.

Countries in support of harm reduction then moved the clause into a footnote. That, too, was rejected by the United States, Walsh said.

Supporters of the provision are wondering why the language — which is non-binding — remains so controversial. “We find it hard to understand how the U.S. delegation could object to language which would not obligate any country to adopt particular policies with which it disagrees,” the House Democrats wrote in their letter to Rice.

Even if the language is nonbinding, Walsh said, including it is an important way to signal that there’s no stigma attached to those programs.

“By excluding [the language],” Walsh said, “it says that the conventions don’t permit it. It castigates it. It makes it seem that there’s something wrong with doing it.”

Waxman, Lee and Serrano have already reintroduced legislation this year to eliminate the U.S. ban on needle exchange programs. With Obama in the White House and the Democrats controlling larger majorities in both congressional chambers, advocates are hopeful for success in 2009.

“This year, we have reason to think it might get somewhere,” Walsh said.

Whether the same will be true on the global stage is yet to be seen.

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