It was Bill Clinton’s personal decision last spring to ignore both the overwhelming scientific evidence and the advice of his own hand-picked medical professionals that needle-exchange programs (NEPs) are essential to cut the rate of new HIV infections. Every day, eight people are infected with HIV directly or indirectly by contaminated needles, but since five of them are African American or Latino, Clinton’s attitude can be summed up by the scene from The Godfather in which a Mafia don, discussing smack distribution, opines: “Keep it among the dark people, the colored. Let them lose their souls.”
The fight over lifting the ban is not about money—even though, in the $200 billion transportation pork barrel cooked up by Clinton and Congress, there’s more money for new parking lots than the government spends on AIDS prevention. As the mayors of Detroit, Seattle, New Haven, Baltimore and San Francisco pointed out in a letter to Clinton urging him to repeal the ban, “We are simply asking that the federal government allow local governments the discretion to use existing federal funding for HIV prevention to support needle programs in our cities [to combat] a public health problem that has disproportionately devastated minority and poor communities, a national trend we see reflected in our own cities.”
Clinton’s ostrichlike choice to ignore the obvious was a direct consequence of his administration’s militarization of the war on drugs, for, as an April 23 Washington Post story by John F. Harris and Amy Goldstein made eminently clear, the deciding voice in continuing the ban was that of Clinton’s drug czar, Gen. Barry McCaffrey. That Clinton’s notorious tergiversations over his draft-dodging left him feeling politically vulnerable and thus easily rolled by the generals was evident from his first days in office, when he kowtowed to the Pentagon’s denizens and instituted the disastrous “Don’t Ask, Don’t Tell” policy for gays and lesbians in the armed forces. In that instance, the issue at bottom was the constitutional principle of civilian control over the military, although flaunted for crass electoral calculations. His last election now behind him, Clinton is still a patsy for anyone with stars on his shoulders.
With all the science against him, McCaffrey’s moralizing arguments could unearth only one piece of “evidence” that NEPs increase drug use—a Canadian study of swap programs in Vancouver and Montreal. But in an April 9 New York Times Op Ed piece, the study’s authors—the University of Montreal’s Julie Bruneau, MD, and the University of British Columbia’s Martin Schechter, PhD—blasted McCaffrey for having “misrepresented our research.” Pointing out that the programs they studied operate only in inner-city neighborhoods where users are “at greatest risk of infection” and “engage in the riskiest activities,” they concluded that preventing reuse of syringes in the two cities would require 10 million clean needles a year instead of the two and a half million now provided. Their study is thus an argument for more, rather than fewer, needle exchanges.
Even before the House of Representatives, aping Clinton’s obscurantism, voted on April 29 by 287 to 140 to reinstitute the legislative ban on federally funded clean needles, McCaffrey was leaking information and advice to the House Republican leadership, according to the Post. By delaying the House vote—on McCaffrey’s counsel—until after Clinton’s decision, Newt and his familiars cut the heart out of the opposition: 74 Democrats followed their president into the darkness of ignorance and voted for the ban. The ban’s strongest opponents in the Senate—John Kerry and Ted Kennedy—got sandbagged when the GOP successfully attached a catch-all amendment banning NEPs funding to unrelated tobacco legislation. But with the tobacco bill now dead, Senate Republicans are expected to use a similar maneuver around some other bill to pass the ban.
Although many of the nation’s prominent black leaders have finally woken up to the scourge of AIDS in their communities and largely condemned Clinton’s decision, the pandemic of Bubbaphilia infecting the white, middle-class gay community and its institutional leadership has sapped public protest of the Clinton ban (and the congressional action it motored) of any force. Instead of wasting precious resources on another same-sex march on Washington—-a pleasant parade predestined to political impotence—the top-heavy DC-based gay groups should devote a lot more of their millions to bottom-up organizing that can target individual legislators and candidates (particularly Democrats in marginal seats).
The liberal punditocracy was for the most part silent on the clean-needles ban—with two honorable exceptions. The New York Times’ Frank Rich savaged Clinton’s hypocrisy in apologizing for U.S. indifference to genocide in Rwanda while caving in to the know-nothings on the plague of needle-spread HIV here at home, and Boston Globe syndicated columnist Ellen Goodman recanted her initial opposition, citing scientific evidence as her reasoning.
Yet no one has so far drawn the most important strategic conclusion: To stop the dying, the federal government must take the billions now spent on the war on drugs’ failed interdiction efforts and spend them on NEPs and on treatment programs of proven effectiveness in getting people off the needle. If Clinton and his dauphin, Al Gore, cannot be pressured to make that shift, they should sleep with the fishes.