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Entries in Mark Dybul (1)

Sunday
Feb012009

All Talk, No Clean Needles? The Obama Administration, Drugs Policy, and AIDS Prevention

Much praise has been given, quite rightly, to President Obama's new tone on US co-operation in international health and social programmes, such as his revocation of Ronald Reagan's "gag order" on American organisations assisting with health and family planning efforts.

Yet, whatever the good intentions, the Obama Administration already faces a serious test within its own ranks. State Department officials at a United Nations drugs conference in Vienna have been blocking any reference to "harm reduction" because the phrase might refer to proposals for the exchange of used needles and syringes. The proposals are supported by most delegations at the conference, including the European Union.



The White House website sets out Obama's position as "lifting the federal ban on needle exchange, which could dramatically reduce rates of infection among drug users." There has been no move, however, to change the current policy, and the State Department's officials are studiously adhering to it. The situation is further complicated because the State Department's global AIDS coordinator, Dr Mark Dybul, was forced to resign on 22 January, as he was a Bush appointee, and no replacement has been named.

A draft version of the UN declaration, dated 15 January, included language to "develop, review and strengthen" drug-treatment programs to include "harm reduction measures aiming at preventing and reducing the adverse health, social and economic consequences of drug use and dependence". The US, joined by Russia, Japan, and Colombia, insisted the language be removed. The clause was moved into a footnote but that was also rejected by the US.

The matter is urgent because the draft is to be ratified by the UN General Assembly Special Session on Drugs on 12-13 March.

There has been some public movement in the US on the issue. On Wednesday, three members of Congress asked Susan Rice, the US Ambassador to the UN, to act, and The New York Times had an editorial on Saturday calling for quick action by Obama. The story, however, has had little circulation in other media.