NEWSMAKER: DR. SATCHER
April 29, 1998
Although it acknowledged that needle exchange programs help slow the spread of HIV, the Clinton administration has decided not to lift the federal funding ban on such programs. Following a background report on the needle exchange debate, Surgeon General David Satcher discusses this and other medical issues facing the nation.
A RealAudio version of this segment is available.
April 29, 1998
An interview with Surgeon General Satcher.
April 17, 1998
The debate over medical marijuana in California.
December 1, 1997
Assessing the fight against AIDS.
December 17, 1996
President Clinton announces an AIDS action plan.
September 17, 1996
Heroin once again in on the rise.
Browse the NewsHour's health coverage.
A Department of Health and Human Services fact sheet on needle exchange.
KWAME HOLMAN: There are more than a hundred programs in this country through which users of illegal intravenous drugs can exchange used needles for clean ones. The aim of the programs is to prevent needle sharing, a practice that can spread disease, including HIV, the virus that causes AIDS.
Forty percent of the 650,000 AIDS cases in this country are linked to IV drug use.
Federal government studies estimate 40 percent of the 650,000 AIDS cases in this country are linked to IV drug use. Since they began 10 years ago, needle exchange programs have operated with the help of local, state, and private funding, but no federal funds. Last October, the House of Representatives voted to ban local communities from ever using federal funds for needle exchange programs. But a compromise with the Senate said the president could lift that ban if he could certify with scientific evidence, that such programs reduced the rate of HIV infection, without encouraging drug use. Within the White House, top officials lobbied the president on both sides of the issue.
Health and Human Services Secretary Donna Shalala said evidence showed needle exchange programs did work and urged the ban be lifted. But Drug Policy Chief Barry McCaffrey said such programs promoted drug use and urged the ban be left in place. President Clinton's decision came down somewhere in the middle and early last week he sent out Secretary Shalala to announce it. Scientific studies, she said, did indeed show needle exchange programs are effective in slowing the spread of HIV. However, the ban on the use of federal funds for such programs would not be lifted.
SEC. DONNA SHALALA: Federal money doesn't pay for everything that's important in this country. And in this case the administration made the decision not to make this an eligible activity under prevention funds. But we didn't reduce prevention funds. Prevention funds are still there. The most important message today is that the science is now there so that local communities ought to look at their strategies, and they can then consider using a needle exchange program as part of that overall strategy.
KWAME HOLMAN: Nonetheless, House Republicans immediately accused the president of waffling on the issue.
REP. NEWT GINGRICH: This headline is devastating. This headline says to every young person who is not sure, well as long as your needle is clean, what's a little heroin or cocaine among friends? This is a terrible mistake. I hope the president would withdraw it. If he doesn't, I can assure you we will schedule a repudiation of this position. We will move a bill to strongly send the signal to every young American, do not use drugs.
SPEAKER: HR 3717 a bill to prohibit the expenditures of federal funds for the distribution of needles and syringes for the hypodermic injection of illegal drugs.
KWAME HOLMAN: Today, House Republicans brought to the floor a bill to ban permanently the use of federal funds for needle exchange programs. Rules Committee Chairman Gerald Solomon led the effort.
Rep. Solomon: "...needle exchange programs do not save lives; they destroy lives."
REP. GERALD SOLOMON: Mr. Speaker, needle exchange programs do not save lives; they destroy lives. They destroy hope. They destroy opportunity. They ruin families, and they ruin communities, and in some cases they are actually destroying a nation like the Netherlands and like Switzerland. We cannot let that happen in this country.
KWAME HOLMAN: Speaking up for needle exchange programs and against the legislation was a small but equally passionate group of Democrats, led by California's Nancy Pelosi.
REP. NANCY PELOSI, (D) California: The leading scientists in this country have examined the evidence and determined that needle exchange programs again help stop the spread of HIV infection and do not--I repeat--do not encourage drug use. You think we're having a meeting of the Flat Earth Society. How can we turn our back to the science?
KWAME HOLMAN: But throughout today's debate members disagreed about the science behind needle exchange programs, so the issue became what would be the best federal public policy.
REP. MARK SOUDER, (R) Indiana: Do we really want this to happen? A woman gets raped in the street by a heroin addict. What are we going to tell her when she finds out that the needle that enabled that addict to get the heroin and then get him on the street to rape her came from her tax dollars, and the tax dollars of America?
REP. TOM DAVIS, (R) Virginia: You send the wrong signal when you tell people it's illegal but we're going to give you a clean needle to pursue this illegal habit. And I think it looks terrible from a public policy objective to have the government really funding these programs and encouraging the use of illegal drugs.
REP. JOHN MICA, (R) Florida: This message needs to be heard by our Health & Human Services Secretary Shalala. This message needs to be heard by President Clinton's new surgeon general, Satcher. How inconceivable it is that our new surgeon general as his first and premier action in that position has recommended and promoted this free drug needle exchange.
REP. JIM McDERMOTT, (D) Washington: Now, how do these programs work? In Tacoma and Seattle, they have a table where somebody sits and somebody has to bring a needle and they get a clean needle. Now, I don't know how that's going to encourage the use of drugs. Are you suggesting that high school kids are going to come and say, well, I got a needle, give me a clean one so I can go find some drugs to use?
REP. SHEILA JACKSON LEE, (D) Texas: The needle exchange program has nothing to do with supporting the illegal use of drugs. It's plain common sense, folks. People who use drugs are addicted; they're sick; they need intervention; they need prevention; they need treatment. The use of clean needles saves lives. It prevents the spread of HIV. It keeps from killing your children, your wives, your husbands, your family members, Americans.
Rep. Kennedy: "Let's do what the scientists tell us to do. Let's reduce AIDS. Let's support needle exchange programs."
REP. PATRICK KENNEDY, (D) Rhode Island: I know it's easy for you to go back to your districts and say, hey, I don't want to support these needles, you know. Hey, that's an easy copout. That's a copout--when we have the science that says we're preventing AIDS from being spread, we ought to follow our evidence. I thought that's the reason we came to the Congress is because we know the evidence. We've been up here. We've been studying the facts. The Congress has been advised by the National Institutes of Health, which advised the Congress, what to do in the public's health interest, to say needle exchange programs reduce the incidences of AIDS. I don't think there's any debate about this whatsoever. Let's do what the scientists tell us to do. Let's reduce AIDS. Let's support needle exchange programs. Let's oppose this bill.
KWAME HOLMAN: When the vote was taken, 140 members, including 11 Republicans, did oppose the ban on federal funding of needle exchange programs. But support for the ban was overwhelming, more than enough votes to override a presidential veto. The bill now goes to the Senate.