For 20 years, American governments across the political spectrum have ignored a mountain of evidence showing that needle exchanges and other safe injecting programmes are the single most effective HIV prevention tool we have. But just before Christmas, with a minimum of fuss, Congress dropped the ban on federal funding for needle and syringe programmes.
The change, buried in a massive budget bill passed by Congress in mid December and and since signed into law by President Obama, passed with very little comment in the blogosphere. But it has the potential to revolutionise HIV prevention in many parts of the US as well as in other countries. US cities and states have been allowed to provide injectors with clean needles if they (the cities and states) paid for them themselves, but in conservative states it has often been hard to get local politicians to come up with the cash. Similarly, nothing is stopping countries outside the US funding their own harm reduction programmes, but the yeay or nay of the world’s largest funder of HIV programmes can have a huge effect on what local governments choose to do (and not to do!)
Perhaps people didn’t notice the good news about harm reduction because they were caught up in the histrionics of the Drug Warriors in New York City, who are apoplectic that the health department is handing out perfectly sensible advice on how to shoot up safely.
Dubbed “Smack for Dummies” by the New York Post, the pamphlet has the Warriors fretting that young mothers might come across it in a clinic waiting room, read the instructions on keeping your veins healthy, and think: “Hmm, that looks easy. Maybe I’ll try shooting up before I pick the kids up from playgroup this afternoon”.
I’m glad to say that Mayor Bloomberg and the NY health department are both standing firm.
Also in the deluge of good news from Washington — the omnibus spending bill does not earmark any money for abstinence-only sex ed programmes that we know don’t work.
While colleagues at USAID say they haven’t had any official word on the implications of the bill for HIV funding in other countries, everyone’s optimistic that the common sense, so late to arrive, will be quickly exported.