Commentary & Opinion
Kaiser Daily HIV/AIDS Report Summarizes Opinion Pieces Discussing Needle Exchange as HIV Prevention Method
March 8, 2005
The U.N. Commission on Narcotic Drugs, the U.N. policy-making agency on drug-related issues, on Monday in Vienna, Austria, began reviewing and analyzing international drug policy and is scheduled to discuss how to combine the war against drugs with HIV/AIDS prevention methods, the AP/Officer.com reports (AP/Officer.com, 3/7). Some congressional Republicans have been working to prevent federal funding from going to groups that advocate needle-exchange programs to reduce the spread of HIV among injection drug users, with Reps. Mark Souder (R-Ind.) and Tom Davis (R-Va.) leading the effort. Sen. Sam Brownback (R-Kan.) last month in a memo to his political allies outlined a strategy seeking a ban on USAID grants going to any organizations that do not completely support President Bush's views on certain issues, including drug use. USAID policy already prohibits federal funding from going to needle-exchange efforts. However, more than 300 scientists, policy analysts and human rights and HIV/AIDS advocates from 56 countries last week signed an open letter urging delegates attending the UNCND meeting to resist U.S. pressure to withdraw from needle-exchange programs. "Strategies that attempt solely to achieve abstinence from drug use do not constitute an acceptable alternative to programs, such as syringe exchange, that help active drug users protect themselves from HIV/AIDS," the letter states (Kaiser Daily HIV/AIDS Report, 3/4). Several newspapers and journals have published editorials and opinion pieces in response to the issue, some of which are summarized below.
Canadian Medical Association Journal: The "soaring" number of HIV/AIDS cases among injection drug users is "in large measure the byproduct of a law-enforcement approach to drug policy," a CMAJ editorial says. Such policies "deepe[n] the social isolation" of injection drug users and present "barriers to harm-reduction strategies," such as needle-exchange programs and opioid substitution therapy, which aim to reduce harmful effects from injecting drugs, according to CMAJ (Canadian Medical Association Journal, 3/1).
Chicago Tribune: Although needle-exchange programs are "effective" in curbing the spread of HIV and other bloodborne diseases, "resistance in Washington to such efforts has been strong," a Tribune editorial says. The efforts by some members of Congress to "cut off American support" for international initiatives administering needle-exchange programs are a "blow to worldwide efforts to contain the epidemic," the editorial says. Although needle-exchange programs are "imperfect solution[s]," they "lessen the chances" of HIV transmission among injection drug users, as well as to their sexual partners and children. More importantly, "clean needles offer the hope of breaking the chain of contagion" and are an "essential item to fight the spread of AIDS here and abroad," the editorial concludes (Chicago Tribune, 3/8).
- Richard Elliott et al., Canadian Medical Association Journal: The UNCND meeting and other upcoming meetings will indicate whether member nations can "rise to the challenge of mitigating the negative health impacts of global drug control treaties or whether timidity in the face of ideological bullying will prevail," Elliott, director of legal policy and research at the Canadian HIV/AIDS Legal Network, and colleagues write in a CMAJ opinion piece. Canada, which has implemented a "wide range of harm-reduction measures," should play the role of a "strong global advocate for harm reduction" at the UNCND meeting, the authors conclude (Elliott et al., Canadian Medical Association Journal, 3/1).
- Arieh Neier, International Herald Tribune: Millions of people "at risk" of HIV infection, particularly in Asia and the former Soviet Union, will "pay the price" if the Bush administration successfully "override[s] the best available evidence in deciding how best to fight HIV related to drug use," columnist Neier writes in a Herald Tribune opinion piece. The U.N. Office of Drugs and Crime -- which includes UNCND and to which the United States is the largest donor -- "is caught between the rock of American intransigence on drug policy and the hard facts that show needle exchange and other harm-reduction strategies to be effective," Neier says, concluding that UNCND needs to provide "unanimous commitment to deploying the tools, including needle exchange, known to reduce HIV among drug users, not the American policy of scuttling prevention methods proven to save lives" (Neier, International Herald Tribune, 3/5).
- Mike Trace/Ruth Runciman, Guardian: Harm-reduction policies that do not "demand abstinence," such as needle-exchange and drug treatment services, have made the United Kingdom a "world leader" in keeping HIV prevalence among injection drug users low, Trace, chair of the Beckley Foundation's International Drug Policy Consortium, and Runciman, chair of the British not-for-profit group National AIDS Trust, write in an opinion piece in London's Guardian. The HIV prevalence rate among injection drug users in the United Kingdom has remained below 1% since the early 1980s, and similar policies in other countries have had "positive results," according to Trace and Runciman. Conversely, the "tactic of applying pressure to national governments and international agencies to pursue policies preferred by U.S. conservatives" is "[d]isturbin[g]," Trace and Runciman write, concluding, "If the outcome [of the UNCND meeting] is a retrenchment from the progress made in recent years by U.N. agencies, this would represent a victory of moralism and financial muscle over evidence and tolerance" (Trace/Runciman, Guardian, 3/3).
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Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.