Reinstating The Federal Ban on Syringe Exchange Funding is Murderous

Most Tuesday evenings, I stand in an alley behind the grocery store with a Buddhist monk and a few other volunteers, handing sterile syringes to people as they drop their old syringes into the bright red biohazard bucket. I’ve been doing this for fifteen years, almost as long as Congress insisted that federal taxpayer dollars couldn’t be used to purchase the syringes we exchange.

Two years ago, determined policy advocates convinced the Democratic leadership that they had the votes to undo this costly decision. People across the country met with their representatives, having sometimes difficult conversations, educating them about the research, the weight of the evidence, and the impact of HIV and hepatitis in their communities. And science carried the day, with Congress voting to lift the ban. Since then, federal funding has been used to create new programs and expand existing ones, reaching communities that never had sterile syringe access. It’s gone to substance misuse treatment programs and health clinics and HIV organizations, giving people who inject drugs better tools to protect their health.

Now that all comes to an end, as Congress just voted to reinstate the absurd ban on federal funding for syringe access programs. I hope that those programs will find ways to raise the funds to keep going. Harm reduction advocates are experts at making a few dollars stretch a very, very long way. These are difficult economic times, and some of the programs will likely close, leaving people who inject drugs with few other avenues to protect their health and that of their family members and colleagues.

Reinstating the ban is murderous. It’s saying that people who use drugs should contract fatal and expensive diseases and die. Allowing the ban to go through is shameful. The leadership who allowed this to go forward, knowing that the research is unanimous, knowing that these programs protect our communities, knowing that they bring people into health care and substance misuse treatment, are also at fault. This is very literally a life or death decision, and the cry of “blood on their hands” is appropriate, for both the Republicans who insisted on this and the Democrats who let it happen.

I appreciate the leadership that led to the ban being lifted two years ago. But this is a truly shameful moment, when we go backward, instead of forward, and let a politics of ignorance, of stigma, of hate, win out over compassion, science, and a desire for a healthy community. 

For the first time since I got involved in HIV/AIDS work more than 20 years ago, there’s a sense that the end is in sight, that we’ll be able to end this epidemic through a combination of treatment and prevention. We talk about “getting to zero.” There’s a new feeling of hope. All of which depends on us deploying everything against this disease. Syringe access programs are one of the single most effective and cost-efficient HIV prevention interventions we know of. They also link people to health care, connect people to detox, reduce syringes tossed in the trash, and reduce drug use overall. We will not end this disease if people who inject drugs are written off. All the anti-virals in the world are useless if people aren’t engaged in health care and syringes are still a whole lot cheaper than protease inhibitors. 

Every Tuesday night, I get to see the people who come to the exchange. Some are homeless; some live in condos nearby. They show up on bikes, on foot, by bus. Some want to chat for a while or tell us a new joke and some just want to get what they need and leave. They come to get new syringes for a lot of reasons, but the biggest one is that they want to stop the transmission of HIV and hepatitis C in our community. I only wish that this Congress shared their concern.