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www.amfar.org Federal Funding for Syringe Services Programs: Saving Money, Promoting Public Safety, and Improving Public Health2 However, without federal funding, these SSPs are only able to provide sterile syringes for fewer than 3 percent of all injections estimated to occur each year.25 SSPs that receive state or local government funding distribute more sterile syringes and offer HIV tests more often than those that do not receive government funding.26 Federal support could amplify this increase in service capacity. In short, the federal funding ban on SSPs undermines national efforts to prevent new HIV infections. If the country is to realize the goal of an AIDS-Free Generation, coverage for these highly effective programs will need to increase. SSPs save lives and money, protect law enforcement and local communities, and support national efforts to reduce substance abuse Banning federal support for cost-effective needle exchange programs is contrary to the public interest. Although such programs were controversial when they first emerged in the 1980s, nearly three decades of experience has generated substantial support for the approach from local governments, public health officials, and scientific organizations. The public health benefits of SSPs have been well documented, but these programs generate other benefits that may be less familiar. 1. SSPs save public resources The lifetime cost of treating an HIV-positive person is estimated to be between $385,200 and $618,900.27 As HIV-positive IDUs are often uninsured or reliant on public sector programs (such as Medicaid, Medicare, and Ryan White) for their care, taxpayers bear the lion’s share of treatment costs associated with new infections related to injection drug use.28, 29 HIV is not the only costly infection associated with injection drug use. HCV costs hundreds of millions of dollars annually to treat.30 Needle sharing during injection drug use is the primary driver of hepatitis C infection in the U.S., with an estimated 50–80 percent of drug users becoming infected with HCV within five years of their first drug injection.31 A study of IDUs in New York City found that from 1990-2001, as SSPs grew substantially, HCV prevalence declined from 90 to 63 percent.32 With individual needles and syringes costing less than 50 cents,33 it is far cheaper to prevent a new case of HIV than to assume many years of treatment costs. According to a recent analysis, expanding SSP coverage to 10 percent of all consequences.13, 14, 15 SSPs have helped New York City—where 50 percent of all IDUs were living with HIV in the early 1980s— approach the elimination of new drug-related transmissions, saving federal and state taxpayers millions of dollars in treatment costs averted.16, 17, 18 SSPs make neighborhoods safer (for police, sanitation workers, and the general public) by supporting the safe disposal of potentially infectious needles and syringes.19, 20 SSPs also facilitate recovery from drug abuse by linking drug users to treatment services.21 Federal funds currently cannot be used to support syringe services programs In 2009, Congress removed a 21-year prohibition on the use of federal funds to support SSPs.22 Two years later, however, Congress re-imposed the ban on federal funding for SSPs.23 In 2013, even as injection drug use continues to contribute substantially to the spread of HIV, federal public health funds are unavailable for syringe exchange. SSPs are not illegal throughout most of the country, and more than 200 SSPs are currently operating in 34 states, the District of Columbia, and the Commonwealth of Puerto Rico.24 SSPs have helped New York City—where 50 percent of all IDUs were living with HIV in the early 1980s—approach the elimination of new drug-related transmissions. New York Harm Reduction Educators operates mobile syringe exchange sites that provide lifesaving services in communities throughout New York City.