Yesterday, we gathered with a group of other students on Yale’s central quad to rally for the rights of drug users. We held signs reading, “Ban the Ban!” and “Clean Needles Save Lives!” One girl even dressed up as a needle. Passersby took photos or stopped to collect the small flyers we were handing out. Others just stared or hurried to the other side of the quad. A local newspaper sent reporters to take photos and write a story about our rally to end the federal ban on syringe exchange funding.
Syringe exchange programs (SEPs) allow injection drug users to trade used needles for sterile needles. Giving drug users access to clean needles protects them and those around them from HIV and other blood-borne diseases. Epidemiologic studies have shown that the presence of an SEP in a community does not increase drug use and reduces transmission of HIV. According to a study published in Social Science and Medicine in 2002, HIV prevalence steadily decreased by about 5.8% in cities with SEPs, and increased by about the same amount in cities that lacked the programs.
Congress initially lifted the 20-year ban on federal funding for syringe exchange in December 2009 due to enormous pressure from numerous policy advocates, including Physicians for Human Rights. Unfortunately, syringe exchanges were once again stripped of federal funding through the introduction of language in the Consolidated Appropriations Act, 2012—the federal budget for fiscal year 2012. House Republicans acted to reinstate the ban, and Democrats and the Obama administration failed to react. On December 23, 2011, while most of the country’s attention was elsewhere, the ban was signed into law.
The decision to ban federal funding for syringe exchange was not driven by economic concerns—syringe exchange is one of the most cost-effective ways to reduce HIV transmission. It was motivated by our society’s discrimination against drug users, a population that the government has deemed unworthy of health. We are all entitled to human rights, regardless of our race, ethnicity, gender, sexual orientation, or whether or not we use drugs.
The federal ban on syringe exchange funding violates the right to health, exposing drug users, their sexual partners, and, by extension, the entire community to increased HIV risk. Every nation in the world signed at least one treaty recognizing health-related rights—the US must not ignore this right. Yet the ban could also be considered a mechanism for cruel, unusual, or degrading treatment and for punishment given without due process. While drug use is illegal, it should be punished through established legal process and after a fair determination of guilt, not through denying drug users access to evidence-based health services and increasing their risk of disease.
As pre-medical students, future doctors, we feel that advocacy is an essential part of our work. We currently lack the medical skills to heal individuals, but we can raise our voices to help end systemic barriers to health. Once we earn medical degrees, we aim to continue being advocates, building on the strategies we have already learned and using insight into the challenges confronting patients to bring issues to the attention of policymakers. With advocacy around harm reduction and drug use, in particular, the voices of medical providers and public health professionals are crucial. The public health and medical communities must emphasize that programs like syringe exchange are evidence-based and use their positions of authority and understanding of drug use to reduce the debilitating stigma toward drug users.
It is time for everyone to take action. Repeal of the federal ban on syringe exchange funding will take the same fortitude and determination that it required in 2009. We must urge our members of Congress and President Obama to ensure that the ban is not included in the fiscal year 2013 budget. We can do this using many tools of activism: gathering signatures on a petition to Republicans in the House of Representatives, bringing media attention to the federal ban, holding lobby meetings, and raising awareness in our community.
