The Plain Dealer, Cleveland, OH
Copyright 1997: The Plain Dealer

October 1, 1997, page 15B

Kenneth Vail and Dawn Day

It's time for Secretary of Health and Human Services Donna Shalala to help her home town deal with the AIDS crisis.  

Cleveland has come a long way in the last year on its own.  It now has two good, private efforts geared to slowing the spread of HIV by making clean needles available to persons who inject drugs.  But in order to reach everyone who needs help in the Cleveland metropolitan area, federal prevention dollars are urgently needed.  And, in her Cabinet position, it is within Secretary Shalala's power to release those funds to Cleveland and other cities and states across the nation that are struggling to deal with the AIDS epidemic.

According to Dr. Scott Holmberg of the Centers for Disease Control, there are 11,500 uninfected, injecting drug users in the Cleveland metropolitan area.  Cleveland's two needle exchange programs are now reaching only 500 of those 11,500 individuals.   

Nationally, 190,000 Americans are now living with injection-related AIDS, or have already died from it.  Across the United States, an estimated 1.3 million are uninfected but at risk because they are injecting drugs.

As many as 11,000 preventable HIV infections will occur by the year 2,000 if clean-needle programs are not implemented, according to an article published recently in Lancet, a respected medical journal.

Slowing the spread of HIV would obviously reduce human suffering and death from AIDS.  Slowing the spread of HIV also would also save millions in tax dollars.  It costs less than $2,000 per user per year to make clean needles available.  Treatment with the new combination drugs costs much more, between $10,000 to $15,000 per patient per year. 

Nationally, half of all new HIV infections are drug-related.  Condoms are not enough.  Education is not enough.  Clean-needle programs are essential to any AIDS prevention program in the United States.  That is the conclusion reached by independent medical experts, including the American Medical Association and the American Public Health Association.

Six federally sponsored studies and the National Institutes of Health Consensus Panel have found that clean-needle programs curb the spread of HIV and do not increase drug use.  In a letter to Congress earlier this year, Shalala reiterated these important findings.  But we are still waiting for her to release federal HIV prevention funds to do this important work.

Responding to this tragic federal inaction, we recently joined thousands of others from across the country to demonstrate at the Department of Health and Human Services in Washington, DC.  We carried symbolic tombstones for each state.  Our tombstone memorialized the 1,700 from Ohio who are living with drug-related AIDS or have already died from it.

We heard speeches; we marched; we chanted.  Twelve people were arrested after trying to carry a 12-foot "moral backbone" into Health and Human Services.  

Distinguished AIDS researcher Dr. Denise Paone said in frustration: "The single largest risk factor is the lack of political will to use public health strategies that work.  The real challenge is finding a way to get our political leaders to act."

We heard the pain of people suffering from HIV.  "It all started with a dirty needle," said Sheila Fuoco from Birmingham, Ala., a women with AIDS who was infected by her late husband, who was infected by a dirty needle.  Sheila passed the virus on to her son when she was pregnant.  She now takes the combination drugs: 28 pills in the morning, 11 at midday, and 37 in the evening.

Brian Gill of Cleveland, a drug counselor for 12 years, pointed out the obvious: "Clean needles do not spread drug use, but dirty needles spread AIDS."

Vail is the director of  Xchange Point in Cleveland. Day is the director of the Dogwood Center in Princeton, NJ.