So far, more than half of President Bush’s proposed $3 billion global HIV- prevention crusade has funded unproven sexual-abstinence campaigns in condom- needy countries, like Uganda. Now, Bush is pushing his dangerous morality on drug users, too. Echoing the old canard that condoms encourage sex, Bushies insist that clean needles promote drug use. Not so—studies show HIV prevalence drops up to 19% without increasing drug use in needle-exchange cities. In June, however, the U.S. fought to pull syringe swaps from the UNAIDS’ global prevention guidelines, relenting only after nearly every other country objected. Fears mount that America, trounced in the U.N. arena, will now break needles alone.
The timing couldn’t be worse: Injection-drug use is fueling explosive HIV epidemics in Asia and the former Soviet Union. Even AIDS laggard China and theocratic Iran have piloted exchanges. But U.S. endorsement is essential to persuade Eastern Europe and Asia that needle exchange is politically safe. “It’s already difficult to provide prevention services for drug users,” says Zoe Hudson, senior policy analyst for the Open Society Institute, which promotes exchange programs in these regions. “If you send any message to strengthen that repression, you’ll kill programs.” The World Health Organization has called reducing risk among active users in these HIV hot spots “a public-health priority.” Bush officials, meanwhile, insist on sobriety or nothing.
Bush’s battle against harm reduction gained steam last November. That’s when a U.S. official met with the head of the UN’s Office on Drugs and Crime and convinced the UN to purge needle- exchange references from its publications. In February, antidrug warrior Rep. Mark Souder (R-Indiana) held a congressional hearing where he trashed harm reduction as an “ideological position” that “dangerous behaviors, such as drug abuse…must be accepted by society.” Souder launched an investigation into U.S. foreign aid, requesting details about any grants to groups that support needle exchange. And in March, at a UN Commission on Narcotic Drugs (CND) meeting, when Brazil and several other countries tried to introduce policy language supporting sterile syringes, the U.S. twisted arms to keep CND guidelines focused on law and order—and drug abstinence.
The U.S. defeat at June’s UNAIDS session gave syringe champions hope, at least temporarily. But on Capitol Hill, the scuttlebutt is that Souder may soon introduce an amendment modeled on Bush’s abortion gag rule that would blacklist exchange-endorsing groups from receiving a penny of U.S. AIDS funds. (Souder did not return POZ calls.) “We wouldn’t be surprised if it were proposed soon,” says Jonathan Cohen, of Human Rights Watch’s HIV/AIDS and Human Rights Program. “The fear is that money will be diverted from lifesaving programs for users toward programs that focus exclusively on abstinence from drugs.” And with that, cold turkey could get a whole lot colder.