Sign the Position Statement

Position Statement on U.S. Congressional ban on the use of federal funds to support syringe exchange programs

We, the undersigned, condemn the December 2011 reinstatement of the U.S. Congressional ban on the use of federal funds to support syringe exchange programs (SEPs). The ban on U.S. federal funds for SEPs was enacted in 1988, but had been repealed by Congress in 2009, after 8 U.S. federally funded reports and a plethora of international research consistently showed that SEPs can reduce syringe-sharing, HIV prevalence and incidence and are cost-effective. 

Furthermore, there is overwhelming consensus on a core package of comprehensive HIV prevention services for people who inject drugs, which includes SEPs in addition to drug treatment (including medication-assisted treatment for opioid dependence), HIV testing and counseling, antiretroviral therapy for HIV-positive people who inject drugs, prevention and treatment of sexually transmitted infections, condom programs for people who inject drugs and their sexual partners, targeted information, education, and communication for people who inject drugs and their sexual partners, vaccination, diagnosis, and treatment of viral hepatitis, and diagnosis and treatment of tuberculosis.  Denying SEPs access to U.S. federal funds, severely limits the provision of these other critical services that usually are offered at SEPs and will prevent the US from reaching its national and international targets on HIV prevention. 

After nearly three decades of extensive research, there is no convincing scientific evidence that SEPs are accompanied by serious negative consequences, including increased illicit drug use, crime, injection frequency, multi-person use of contaminated syringes, initiating of drug use, recruiting of new drug injectors, or discarding of syringes in public places. Instead, there is convincing scientific evidence that SEPs have been associated with cost-effective reductions in and cessation of injection drug use and increased enrollment in drug treatment programs. 

The reinstated ban on U.S. federal support for SEPs directly conflicts with current policies of the U.S government, including PEPFAR, the President’s National HIV/AIDS Strategy, the U.S. Surgeon General’s Office and the Office of National Drug Control Policy.  This policy change will undermine the recent call from the Obama Administration for an AIDS-free generation, and is a major setback for HIV prevention both domestically and globally.  The ban will also prevent HIV prevention researchers from meeting their ethical obligation to provide trial participants with best standard of care.  Given that people who inject drugs account for 30% of global HIV infections outside of sub-Saharan Africa, we urge the U.S Congress to immediately repeal the U.S. ban on the use of federal funds to support SEPs, which we consider a deadly public policy. 

Judith D. Auerbach, PhD, Independent Science and Policy Consultant, San Francisco, CA, USA

Carlos Caceres, MD, PhD, Professor of Public Health, Cayetano Heredia University, Lima, Peru

Chris Collins, Vice President and Director, Public Policy, amfAR, The Foundation for AIDS Research

Julie Davids, Coordinator, HIV Prevention Justice Alliance (HIV PJA); Director of National Advocacy and Mobilization, AIDS Foundation Chicago,  Chicago, IL, USA

Wafaa El-Sadr, MD,MPH  Director, ICAP Columbia University, Professor of Epidemiology and Medicine

Gregg Gonsalves, International Treatment Preparedness Coalition and Yale University

Catherine Hankins, MD MSc FRCPC, Independent Consultant and Honorary Professor, London School of Hygiene and Tropical Medicine

Susan Kippax, PhD, Professor, University of New South Wales, Sydney, Australia

Ariel R. King, MPH, MBA, PhD, SAHARA and President, Ariel Foundation International, USA & Switzerland

Salim S. Abdool Karim, Pro Vice-Chancellor (Research), University of KwaZulu-Natal, South Africa

Leandro Kahn, Fundacion Huesped, Argentina

Joep M.A. Lange, MD, PhD, Professor of Medicine, University of Amsterdam and Executive Scientific Director, Amsterdam Institute for Global Health and Development

Dora Mbanya MD; PhD; FRCPath Faculty of Medicine & Biomedical Sciences University of Yaounde, Cameroon

Cheikh Ibrahima Niang, SAHARA, Universite Cheikh Anta Diop, Dakar, Senegal

Jeffrey O'Malley, Director, HIV Group, United Nations Development Programme (UNDP)

Gita Ramjee, HIV Prevention Research Unit, Durban, South Africa

Thomas M. Rehle, MD, MPH, PhD, Professor of International Health, Human Sciences Research Council, Cape Town, South Africa

Steffanie A. Strathdee, PhD, University of California San Diego, CA, USA

Todd Summers, Washington, DC

Placide Tapsoba, MD, MPH ;  Country Director; Population Council - Ghana

Mitchell Warren, Executive Director, AVAC, New York

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Stephanie Platis,
Feb 7, 2012, 6:35 PM