In 1992, Harvard University had the honor of hosting the International AIDS Conference. The world?s largest HIV/AIDS summit would have attracted more than 10,000 people to Massachusetts for the exchange of knowledge and ideas. However, the 1992 conference was eventually held in Amsterdam ? not Boston ? because of a 1987 law prohibiting HIV-positive individuals from entering the United States without a waiver for a visa.
Sixteen years after the Harvard debacle, the U.S. has still not hosted the International AIDS Conference, a shame considering our supposed public health prowess. Sixteen years later, this immigration restriction, crafted in homophobia and discrimination, is still in effect. Sixteen years later, progress in HIV/AIDS prevention and education ? both at home and abroad ? is shackled by the interjection of ideological views into federal policy.
Just last December, Congress lifted a nine-year ban that prevented Washington, D.C. from using local tax money on needle-exchange programs to combat the spread of HIV. However, we still prohibit the use of federal funds for any needle-exchange program, a misguided policy from 1988. We are the only country in the world to explicitly ban support for these syringe-swap programs.
Needle-exchange is a simple concept. An addict comes to a collection center with a dirty needle, swaps it for a clean syringe and gets connected to treatment options at the same time. Social service providers realize that if junkies are going to shoot up, they might as well do it with a clean needle instead of one that could spread disease from the shared syringe.
Prohibiting these services would be one thing if needle-exchange programs were failures, but in 1998, then-Secretary of Health and Human Services Donna Shalala concluded, supported by evidence from the National Institute for Health, that needle-exchange reduces HIV transmission without encouraging the use of illegal drugs.
They do encourage opening lines of communication and building trust: reaching people that probably would not have been reached by traditional educational methods. A few dollars into prevention would save hundreds in the long-term care of AIDS patients. Harm is reduced, quickly and easily. And yet, 10 years after indisputable scientific evidence, our national HIV/AIDS policy is still dictated by the moral minority who believe they can close their eyes and imagine the problem away.
Sadly, the problem of intravenous drug use and resultant HIV transmission is not going away. According to the Centers for Disease Control and Prevention, about one-fourth of the 950,000 AIDS cases in the United States involved injected drug use. The number has only grown since then and is even higher in other countries. About 30 percent of all new U.S. AIDS cases can be traced to the sharing of syringes. Needle-exchange is simply another form of preventive health care.
Needle-exchange programs are supported by medical and public health officials, including the American Medical Association and the World Health Organization. However, the Office of National Drug Control Policy refuses to support syringe-swap because it would rather focus on programs that directly fight addiction. While we should fight addiction, we can?t ignore the immediate public health risks today.
It seems that our federal government is promoting abstinence-only education for both drugs and sex. In 2003, President Bush introduced a $15 billion international AIDS package that soared through Congress. However, the president?s Emergency Plan for AIDS Relief was grounded by the tethers of in-house gag order, which prevents mention of anything but abstinence in many federally funded services worldwide.
A new bill renewing PEPFAR would authorize an additional $40 billion to combat AIDS. However, if Republicans in Congress and Pastor Rick Warren had had their way, one-third of that federal money would have gone to abstinence-only education abroad.
It?s as if Mike Huckabee sent them a memo: If your social conservative agenda is faltering here in America, why not bring it to fruition in someone else?s country? Thankfully, the current bill is not bound by this arbitrary threshold of 33 percent. Nevertheless, it still requires countries receiving U.S. aid to report if abstinence funding falls below a certain percentage.
The United States is the single largest funder of global HIV/AIDS programs. And yet, we let ideological views trump scientific evidence, and we sustain antiquated policies. Surgeon General Richard Carmona resigned in 2006 due to a gag rule from the Bush administration not to discuss comprehensive sex education. Even the ban on Washington, D.C. needle-exchange programs wasn?t lifted in its own right; it had to be snuck into an omnibus spending bill. If it had been a stand-alone initiative, odds are that it also would have been choked by congressional Republicans.
We must retool and rev up our fight against HIV/AIDS both at home and across the world. This requires us to respond to science with coherent public policy, without allowing ourselves to be limited by the so-called ?moral? demands of a fundamentalist few.
?Leadership? has been the theme of the 2007 and 2008 World AIDS Day campaigns ? it?s about time that our federal policies reflect that.
Suchita Shah ([email protected]) is a senior majoring in neurobiology.
