Needle in a Haystack

The president made a promise about syringe exchange.

by Isaiah Thompson

Evan M. Lopez SYRINGE SONG: HIV prevention advocates protest what they say are inadequacies in Obama's budget.

[ things obama can do better ]

A week ago, Jeffrey Crowley, director of the White House Office of National AIDS Policy, spoke to a group of HIV/AIDS prevention and treatment advocates at the 10th annual HIV Prevention and Outreach Summit, hosted by Philadelphia FIGHT, a local HIV/AIDS service organization.

It was the first time a White House representative had ever attended the event, and after years of AIDS policies sometimes influenced by conservative religious notions rather than data, many in the AIDS prevention community have looked at President Barack Obama's election as a moment of great opportunity.

Crowley was indeed received warmly. But he might have had a better reception still if he'd shown up a few weeks earlier, before Obama revealed his budget.

Following Crowley's speech, a member of the audience asked the director why the president did not ask Congress to lift a decades-old ban on the use of federal funds for syringe exchange programs — a ban which, during his campaign, Obama had said he would end.

"The president has a belief that we should lift the federal ban. ... Some people, I know, were disappointed that in the context of our budget we didn't do that," Crowley acknowledged.

"In a number of areas," he continued, "not just around syringe exchange, but choice, stem cell research — he's said we will advance our policy goals separately from the budget."

For some in the audience, the subtext was familiar and frustrating: Syringe exchange, Crowley seemed to be acknowledging, is a touchy subject — too touchy right now.

"I was furious," says Sam Sitrin, who works for Prevention Point, the nonprofit that runs Philly's only city-sanctioned needle exchange. "To say that it's too controversial to help people get services that will save their lives, it's unacceptable."

The controversy around needle exchange is endlessly frustrating for advocates, because the data is so uncontroversial. An abundance of studies have shown that needle exchange programs prevent HIV and Hepatitis C infection among needle drug users; plenty of data also shows the programs don't encourage drug use. This much has been recognized before by the White House, under President Clinton's administration, which nonetheless failed to lift the ban.

Jane Shull, executive director of Philadelphia FIGHT, acknowledges the frustration, but thinks the administration may have reason to proceed carefully.

"The Clinton administration ... tried to lift the ban on LGBTs in the military and we ended up with 'Don't Ask, Don't Tell,' which was a disaster," Shull says. She thinks Crowley's message was that the administration just needs a little more time.

"'Give us a chance to do what we need to do to lift [the ban],' — that's not what he said, but that's how I interpreted it," Shull says of Crowley's remarks.

At a rally this Tuesday, about 100 activists called on the government to lift the ban, and right two additional perceived wrongs. They want more money for Housing Opportunities for Persons with AIDS (HOPWA). Some 600 people in the region receive aid for housing through the program, says Paul Chrystie, director of communications for the city's Office of Housing and Community Development. The rental-assistance waiting list, however, currently hovers at about 150 people, and Obama flat-funded the program this year.

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"Obviously if there were more funding, we'd be able to get people off the waiting list," Chrystie says.

Activists also want the U.S. to deliver on a promise made last year for $50 billion over five years to fight AIDS, as well as tuberculosis and malaria, around the world. Obama's budget offers only about $5.6 billion of the roughly $10 billion it would take to meet that goal.

"We've come up with $9 trillion for banks, just like that," points out Kaytee Riek, rally organizer and volunteer for ACT UP.

But perhaps what's so maddening to the HIV/AIDS prevention community when it comes to syringe access is that the ban isn't about more money.

Prevention Point Executive Director José Benitez feels the impact on his organization's needle exchange program, which serves 3,700 people annually and has results to show: According to the city AIDS Activities Coordinating Office, the number of cases of HIV/AIDS likely resulting from drug use has declined significantly in Philadelphia — the only cause of infection for which this is true.

Federal funding, Benitez says, could allow programs like his to reach more people.

"It just doesn't make sense to have a policy that doesn't let us expand," he argues. "While politics are going on, there is an urgency out here to save people from new infections."

(isaiah.thompson@citypaper.net)