WWW.
Needle exchange programs rely on local support after the feds bail on fu n d in g
BY AMANDA WALDROUPE
S T A F F W R IT E R
or the second time in two years, Congress is
reversing its policy on federal funding for
syringe exchange programs, leaving many in
health care business wondering how far local
money can continue to carry the harm reduction
programs.
While Portland and Multnomah County’s needle
exchange clinics don’t expect a direct hit from the
federal funding ban, shrinking state and local
dollars are another issue altogether.
Kathy Oliver, the executive director of Outside
In, a Portland-area homeless youth agency
operating a needle exchange that is frequently
used by young injection drug users, worries in
particular about $63,000 in one-time money from
the City of Portland that may be cut this year.
The total budget for Outside In’s needle
exchange clinic is $190,000, meaning the money
from the city represents a pretty hefty chunk of
change (much of the rest of the clinic’s budget
comes from Multnomah County). The elimination
of it would mean more than cutting administrative
waste or other ways of not harming the clinic’s
efficacy.
“We would have to cut staff, cut hours,” Oliver
says.
Oliver says she is “cautiously optimistic” that
the city funding will be preserved. When the
Portland Housing Bureau eliminated funding for
the clinic in its 2011 budget proposal, despite the
fact that the clinic had received city dollars since
Vera Katz was mayor, Mayor Sam Adams put the
$63,000 back into the city’s budget. “He is an
advocate for the program,” Oliver says.
Kim Toevs, director of Multnomah County’s
HIV/STD/Hep C program, is less fearful that
F
funding for the county’s four clinics will be cut.
Much of the budget for the county’s c lin ic s — c lo s e
to $260,000 - comes from state and county
general fund dollars. “Oregon has been proactive
and forward thinking for many years about needle
exchange,” she says.
Syringe or needle exchange clinics are walk-in
facilities that provide clean needles to people,
mostly injection drug users. According to the
North American Syringe Exchange Network, there
are at least 221 needle exchange programs in 33
states and Washington D.C. Needle exchange
clinics have relied on private donations or money
from local governments to fund their operation.
For 21 years, Congress has banned federal
agencies from funding needle exchange clinics.
In December 2009, President Barack Obama
signed a law lifting the ban on federal funding. The
Obama administration’s position is that needle
exchange clinics are an evidence-based practice
that lowers the transmission of HIV and other
infections among injection drug users.
The decision was supported by multiple
comprehensive studies, including eight federally
funded research reports that concluded that
syringe exchange programs, as part of a
comprehensive HIV prevention strategy, “are an
effective public health intervention that reduces
HIV transmission without increasing the use of
illicit drugs. Research has also shown that syringe
exchange programs are important in preventing
the transmission of hepatitis B and C.” That’s
according to the information Congress reviewed
when it overturned the ban in 2009.
The Community AIDS and Hepatitis Prevention
Act, which overturned the ban, also cited data from
81 cities across Europe, Asia, and North America
that found that, “on average, HIV prevalence
a m o n g in j e c t io n d r u g
u s e r s in c r e a s e d
b y
E -Q
percent per year in the 52 cities without syringe
exchange programs and decreased by 5.8 percent
per year in the 29 cities with syringe exchange
programs.”
“I think there’s still a lot of stigma around
" I t Is a step back In tbe barm redaction m o d e l In
Oregon webre been re a lly fortunate that we liaoe
great organisations and counties and a state that
supports It/"
— J U L IE E A G E R -M E S U E A M
P A R T N E R S H IP S P R O J E C T
people who inject drugs,” says Julie Lager-
Mesulam, director of the Partnerships Project
which promotes HIV advocacy and services. Lager-
Mesulam said the ban ignores the harm reduction
benefits of the exchange and instead adopts a
posture of punishing the user.
“It is a step back in the harm reduction model.
In Oregon we’ve been really fortunate that we have
great organizations and counties and a state that
supports it,” Lager-Mesulam said.
Toevs says the county never applied for federal
funding. She says lifting the ban was particularly
helpful to communities where there is demand for
needle exchange clinics, but a lack in local funding
and political will to implement such a program.
Congress put the ban back in place in its budget
bill in December. Putting the ban back in place is
widely seen as a partisan issue, with Republicans
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