Beth Levin of Georgetown
University School of Medicine and Bill McColl of AIDS United discussed
ending the US federal funding ban on syringe programmes in a session on "Advancing HIV and Hepatitis Prevention for
Drug Users." Levin explained that the ban – first implemented more than 20 years ago – was lifted in 2009
but reinstated by Congress in 2011.
According to Levin 8% of
new HIV infections – or 11 per day – are attributable to sharing drug
injection equipment, with a disproportionate number of cases occurring among
African Americans and Latinos. Studies indicate that sterile syringe
availability has reduced HIV among people who inject drugs by 80% – second
only to the success of using antiretrovirals to prevent mother-to-child HIV
Lifting the federal funding
ban would cost nothing in and of itself – it would simply allow local and
state governments to use existing funds to cover syringe programmes. Experts
estimate that every $1 spent on syringe programmes would lead to $7 in savings on
HIV treatment costs, with the biggest savings accruing
to Medicaid and Medicare (public insurance programmes for low-income and seniors,
In addition to preventing
HIV and HCV infections, syringe exchanges can also serve as a bridge to bring
people into substance use treatment and the broader healthcare system, and can
encourage safe disposal of used syringes as users return them to the program.
"It is a myth that syringe exchange is controversial," Levin said, noting that
such programmes currently exist in more than 30 states. "There is widespread
local acceptance – everyone else is on board except for the feds."
McColl said that nearly
half of all syringes distributed through existing programmes are paid for by the Syringe Access Fund, which will soon lose a substantial portion of its
"Private funding alone
cannot by itself solve the issue of syringe access for people who inject
drugs," McColl stressed. "It is unacceptable that people think that's
how it should be done."
Levin and McColl explained
that the federal omnibus budget bill currently under consideration includes
consensus House and Senate language that would allow funding for syringe access
programmes in areas where there is a risk of HIV and HCV outbreaks.
becoming legal we gain financial stability and the ability to do more data and
evaluation," Laura Thomas of the Drug Policy Alliance said during a
roundtable discussion of harm reduction advocates. "Supervised injection
facilities are the next place we're going to go."
Legalised pharmacy sales are also an important
component. "Even if every county had a syringe exchange, that would not be
enough," said Alessandra Ross of the California Department of Public Health. "Pharmacies are there, they're
open at 2 am, and pharmacies are going to support a lot of people in a lot of
Several speakers at the
conference noted that the Indiana outbreak has called attention to the risk of
injection-related HIV and hepatitis C beyond the stereotypical urban
communities of colour and provides an
opportunity to push for policy change – but the window may be brief.
"Our secret weapon is quiet white suburban
parents, grandmas, and law enforcement officers," said Mona Bennett of the
Atlanta Harm Reduction Coalition.
The CDC estimates that at least 200
communities in 26 states are vulnerable to injection-related HIV and
HCV outbreaks like the one in Indiana, CDC
director Thomas Frieden said in his closing talk at the conference,
emphasising, "We must make syringe exchange available where it's not