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www.amfar.org
<br />Federal Funding for Syringe Services Programs:
<br />Saving Money, Promoting Public Safety, and Improving Public Health4
<br />3. The federal funding ban
<br />undermines local control and
<br />decision-making
<br />The federal government is by far
<br />the largest funder of HIV prevention
<br />services. Federal prevention funding
<br />adheres to recognized principles of
<br />federalism, providing essential health
<br />assistance while leaving it to states
<br />and localities to use limited federal
<br />dollars to address needs and priorities
<br />that are locally determined. While
<br />the federal ban was lifted, federal
<br />dollars were used to support SSPs
<br />in California, Connecticut, Delaware,
<br />Illinois, Massachusetts, Minnesota,
<br />New Jersey, New Mexico, New York,
<br />Puerto Rico, Vermont, and Washington.42 SSPs operate in
<br />186 cities and a quarter of those surveyed in 2011 were run by
<br />state or local health departments.43, 44 Authorities in jurisdictions
<br />across the country have demonstrated that they believe SSPs
<br />promote public health and other local objectives. However,
<br />under current law, they are not allowed to decide for themselves
<br />whether federal funds they receive should be used to meet
<br />these objectives.
<br />While research consistently has found
<br />SSPs to be a cost-effective, evidence-
<br />based intervention, the federal funding
<br />ban continues to force localities facing
<br />difficult budgetary times to make a
<br />tough choice: if they wish to use limited
<br />state and local dollars to fund SSPs,
<br />they must do so at the expense of
<br />other important, public health programs
<br />dependent on local and state financing.
<br />In the brief two-year period during
<br />which federal funding became available
<br />for SSPs, the majority of programs
<br />that received federal support used
<br />those funds just to maintain or expand
<br />existing services; only 14 percent of
<br />programs that received federal SSP
<br />funding in 2011 were able to use
<br />that funding to add new services.45
<br />4. SSPs promote public
<br />safety
<br />SSPs reduce circulation of
<br />contaminated syringes, collecting
<br />used syringes in puncture-proof
<br />containers. By discarding used
<br />syringes according to hazardous
<br />waste disposal procedures,
<br />SSPs keep contaminated in-
<br />jection equipment off the streets,
<br />protecting the public from potential
<br />exposure to infectious needles.
<br />SSPs actively encourage participants to return as many used
<br />syringes as possible.46 Research indicates that the majority
<br />of syringes distributed by SSPs are in fact returned.47, 48 In
<br />Baltimore, SSPs helped reduce the number of improperly
<br />discarded syringes by almost 50 percent.49 In Portland, Oregon,
<br />the number of improperly discarded syringes dropped by almost
<br />two-thirds after the implementation of an SSP.50 In 2008-2009,
<br />in Miami—where there are no syringe exchange programs—
<br />eight times more syringes were disposed of improperly than in
<br />San Francisco, where syringe exchanges are available.51 Safe
<br />disposal was much greater in San Francisco, even though the
<br />estimated number of injection drug users in San Francisco is
<br />more than twice the number in Miami.
<br />Keeping contaminated equipment off the streets improves
<br />public safety. SSPs reduce the risk that people—including
<br />children playing in parks, people
<br />putting trash in public trash cans,
<br />and medical personnel responding
<br />to emergencies—will accidentally
<br />come into contact with used and
<br />potentially dangerous needles
<br />and syringes.
<br />
<br />Law enforcement and public-safety
<br />personnel, who are often exposed to
<br />needlesticks on the job, are perhaps
<br />the most notable public safety
<br />beneficiaries of SSPs. In San Diego,
<br />nearly 30 percent of police officers
<br />surveyed had been stuck by a needle
<br />at least once, with more than 27
<br />“In the cities that have adopted
<br />needle exchange programs,
<br />there is a dramatic reduction in
<br />needle sticks to firefighters who
<br />crawl on their hands and knees
<br />through smoke-filled rooms to
<br />search for victims.”
<br />—Charles Aughenbaugh, Jr.,
<br />President, New Jersey Deputy
<br />Fire Chiefs Association, Retired
<br />Deputy Fire Chief, March 2011
<br />SSPs operate in 186 cities. Authorities
<br />in jurisdictions across the country have
<br />demonstrated they believe SSPs promote
<br />public health.
<br />“Clearly needle exchange
<br />programs work. There is no
<br />doubt about that.”
<br />—Anthony Fauci, M.D., Director,
<br />National Institute of Allergy and
<br />Infectious Diseases, National
<br />Institutes of Health. Testimony
<br />before the U.S. House
<br />of Representatives Committee
<br />on Oversight and Reform,
<br />September 16, 2008
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