Mayor's Office Suppressed Report on Expanded Needle Exchange

A needle exchange report was suppressed by senior advisors in the Mayor's Office of AIDS Policy, who were acutely aware of Giuliani's hostility to needle exchange programs, which he feels conflicts with his "zero tolerance" for drugs. Rather than embarrass the Mayor in the months before the election by publishing overwhelming evidence that syringe exchange programs save lives and money without increasing drug use and recommending urgent, life-saving measures that the Mayor opposes, the Mayor's Office stonewalled the report.


1/23/98 A report prepared last June by the New York City Mayor's Office of AIDS Policy Coordination and funded with Ryan White Title I dollars that called for expansion of needle exchange programs in the city was suppressed by the Giuliani Administration. The excellent 37 page report, which was leaked to the Observer found that expanding needle exchange programs (NEPs) could prevent 5,000 new HIV infections from June, 1997, to the year 2000. For every thousand infections prevented, it estimated, NYC would save some $27,250,000 annually on the City's share of Medicaid costs for HIV care.

The report recommends that the City validate the work of NEPS and actively encourage drug users to exchange needles and, through their contact with low-threshold harm reduction programs, have the opportunity to access supportive services and potentially begin to reduce or discontinue their use of drugs. It also called for the creation of formal linkages between NEPs and relevant City services and for funding from unrestricted City tax levy dollars for expanding the reach of the existing nine needle exchange programs and the creation of new ones in underserved communities. The report is also rich with important data. For example, it notes that "almost 72% of cumulative AIDS cases among women in New York City . . . are associated with injection drug use."

The report was stonewalled because of the Mayor's commitment to "zero tolerance" for drugs and his longstanding refusal to support needle exchange programs, despite over-whelming evidence that they save lives and do not increase drug use. The Observer reported that only high-level aides to the Mayor had ever seen the document: even members of the NYC HIV Health and Human Services Planning Council, under whose auspices the report was prepared, were not given copies of the document.

In a story in the New York Daily News, Giuliani denied having read the report or having suppressed it. The Mayor said that needle exchange is "something I'm skeptical about, but it doesn't mean I'm not willing to look at the argument on the other side. But I don't think it's a good idea to give people needles in order to inject heroin into their arms."

Ronald Johnson, who was the Mayor's AIDS Policy Coordinator at the time the report was prepared and is now at GMHC, had informally revealed his personal support for needle exchange programs while still in that office. He affirmed that stance in comments to Newsday after the report was leaked. However, in order to spare the Mayor embarrassment during the re-election campaign, Johnson chose not to make the report available while he was in the Mayor's office. Giuliani's re-election, it seems, was more important than "all of the human costs and loss of life associated with HIV/AIDS" that the report urged the City to prevent.

New York AIDS Issues Update 01/23/98


Harm Reduction Coalition
22 West 27th Street, 9th Floor
New York, NY 10001



Due to the large number of articles on needle exchange which have appeared in the newspapers this week and the fact that the Giuliani Administration developed a report supporting needle exchange, we believe it is extremely important to demonstrate as much support for this life-saving program as possible.

Please show your support in any way possible.

Sign and fax back the attached letter. Copy and pass this fax on to organizational supporters of needle exchange you know.

Fax back to 212-213-6582
or call Chris Lanier with any questions you may have at 212-213-6376.

[Please cut and paste and print the following letter and treat as a fax.]


Dear Mayor Giuliani:

We, the undersigned, urge you to publicly release your administration's report entitled, "Needle Exchange Programs: An Analysis of Benefits and Costs," and adopt its recommendations. Given the devastating impact of injection-related HIV on drug users and their families, particularly in New York's communities of color, we are encouraged by the development of this document. We are sure that, after serious consideration of the report, your administration will adopt these recommendations and take an important leadership role in stopping the spread of HIV in this city.

There is absolutely no evidence of any kind, among hundreds of studies of needle exchange worldwide, that needle exchange programs increase drug use or 'recruit' new users. In fact, concrete experience here in New York City suggests the opposite: New York's needle exchange efforts have provided a unique opportunity for those currently using drugs to access a continuum of health care services, including drug treatment. We are convinced that this crucial HIV prevention measure will not in any way undermine the effort to reduce illegal drug use, but will send a positive message to those communities most affected by drug use and HIV. We believe that what New Yorkers find morally troubling is the city's readiness to put up with thousands of needless deaths by its failure to support needle exchange. Expanding needle exchange services in NY will firmly demonstrate that you will not tolerate such negligence.

Seven uncontroverted federal research reports demonstrate that needle exchange programs reduce HIV transmission without increased drug use. Needle exchange, as a crucial part of an HIV prevention strategy, has been endorsed by virtually every local and national medical and public health organization. The breadth and universality of support for such programs among experts strongly recommends a fair-minded consideration of the report. The effectiveness of provision of syringe access as a component of primary and secondary prevention of HIV is now supported by the American Medical Association, the United Conference of Mayors, the National Institutes of Health, the Governor's AIDS Advisory Council of New York State, and many others. Finally, the New York City HIV Prevention Planning Group and the HIV Health and Human Services Planning Council of New York both voted unanimously to support the expansion of needle exchange.

New York City is unmatched by US cities in the virulence of its HIV epidemic. While AIDS deaths nationwide decrease, the rate of new HIV infections in New York remains intolerably high. Current needle exchange efforts only reach an estimated 25% of injecting drug users in New York. Between 65-70% of the current AIDS epidemic in NYC is related to drug use as a predominant risk factor. Additionally, 74% of female AIDS cases are associated with injecting drug use or sexual contact with an injecting drug user. Similarly, drug use is directly and indirectly implicated in 77% of AIDS cases among babiereported in NYC occurred among African American and Hispanic communities. In 1995, 80% of all new AIDS cases were among members of non-white racial/ethnic groups.

We are counting on your leadership, as are thousands of New Yorkers at risk for contracting the HIV virus. We strongly support your administration's report on needle exchange and urge you to make a decision based on the available science, rather than any unfounded assumptions about drug using behavior. We look forward to a complete and informed dialogue with your administration on this issue.






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see also:

AIDS as Social Blackmail


What You Can Do To Help Lift the Federal Ban on Funding Syringe Exchange