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In Wake of Syringe Exchange Ban Victory, CDC, Goosby Contemplate Future Funding

December 14, 2009

Contents of a Housing Works syringe exchange kit -- hopefully soon to be more widely accessible
Contents of a Housing Works syringe exchange kit -- hopefully soon to be more widely accessible
In a long-overdue victory, Congress lifted the federal ban on syringe exchange funding, which was signed by President Obama Wednesday, opening up a world of possibilities for new sources of syringe exchange funding. So what does this new world look like?

"We see this as a moment where Congress has legitimized syringe exchange.That debate has been resolved and the science is all on our side. Congress has taken syringe exchange out of politics," said Daniel Raymond, Harm Reduction Coalition's policy director. "[But] in the short term, the immediate payoff will be modest and incremental."

With no new federal money directed towards syringe exchange this year, Raymond expects state and local health departments that "have been historically aggressive about needle exchange" will redirect existing federal prevention funding towards syringe exchange. He also said that areas that have been opposed to syringe exchange won't add exchange sites.

Centers for Disease Control and Prevention spokesperson Nikki Kay said, "The language in the [appropriations] bill does not provide increases in funding specifically for needle exchange programs. However, we are preliminarily working on guidance for our grantees on ways they may work within existing funds to support needle exchange programs."

A spokesperson for Substance Abuse and Mental Health Services Administration (SAMHSA) said redirecting money for syringe exchange within his agency was not something he was familiar with. Other potential sources for funding are Medicaid and the Office for Minority Health.

"There is no reason syringe exchange funding can't come from the broadest cross-section of agencies," said Housing Works President and CEO Charles King. "Syringe exchange is proven to prevent HIV and hepatitis C, and we need to see a broad cross-section of federal funding devoted to it."

Thinking Globally

Although the HHS ban didn't prohibit federal funding from being used, Office of the U.S. Global AIDS Coordinator Director Eric Goosby said now that the ban has been lifted he is working to redirect PEPFAR dollars to provide funding for syringe exchange.

"I've been involved in working with injection drug users for a long time, and my view is that the evidence strongly supports the value of needle and syringe programs as part of a comprehensive prevention portfolio," Goosby said in a statement to the Update. "PEPFAR is currently working with agencies across the U.S. Government to determine the best way forward in supporting this comprehensive package."

What About Ryan White Funding?

Although lifting the ban covers most, there is still a ban on syringe exchange in the Ryan White CARE Act. "Because of the timetable, we decided not to prioritize it," Raymond said. Unfortunately, the Ryan White CARE Act won't be reauthorized until 2013. The only other option in the interim is Rep. José Serrano's bill, but Raymond said, "Passing that bill isn't a big priority because 95 percent of the work has already been done through separate channels."

The Bigger Picture

Thankfully the dreadful rule that would have banned syringe exchange within 1,000 feet of any place children are present was nixed. However, states and localities have control as to if they want to direct federal dollars towards syringe exchange.

"In a state like Florida, there's lots of ingrained opposition to needle exchange. Even if the federal government handed them $10 million that wouldn't mean they would start a program," Raymond said.

The next steps for advocates are to work by a state by state level to make sure syringe exchange programs are everywhere there are injection drug users (so everywhere).

Also, advocates are under no illusion that the battle is done.

"We expect we'll need to defend this next year and for years to come," Raymond said. "But we will have the evidence to back its impact."

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This article was provided by Housing Works. It is a part of the publication Housing Works AIDS Issues Update. Visit Housing Works' website to find out more about their activities, publications and services.
See Also
Ask Our Expert, David Fawcett, Ph.D., L.C.S.W., About Substance Use and HIV
Needle Exchange & HIV/AIDS in the U.S.

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