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In case lawmakers need an extra nudge as they consider lifting the ban on federal funding for needle exchange programs, here are two fresh facts on the effectiveness of this tool in reducing the spread of HIV:

*In India, needle exchange programs have contributed to a dramatic reduction in HIV seroprevalence among injection drug users—cutting the rate from 81% to 58% over a three-year period.

*In Brazil, syringe exchange policies have led to a 62% reduction in HIV infections among injection drug users.

This data comes from a new report, “Syringe exchange programs around the world: The global context,” out this week from the Gay Men’s Health Crisis. The report says that as of 2008, there were at least 77 countries worldwide that had introduced syringe exchange programs (SEPs) to curb the spread of HIV/AIDS.

The news of how effective SEPs can be in reducing HIV infection is no surprise to those who of us advocating for evidence-based global health policies. But it comes as Congress considers overturning its ban using federal money to support needle exchange programs. A House committee approved a measure lifting the ban, albeit with so many restrictions as to make it essentially useless. A Senate panel voted to leave the ban in place. That means a full-blown congressional fight on this hot topic is in the offing.

As we’ve written here before, the ban technically only applies to domestic programs, but PEPFAR officials have extended it to international programs, so this has major implications for global HIV prevention efforts. Dr. Eric Goosby, the US Global AIDS coordinator, has strongly signaled the administration’s desire to see the ban overturned and says a move to do so in the international context is in the works. But the White House seems to be waiting for Congress to make a more definitive move on this first. Given that, this report adds some important new points to the debate.

Here’s more from the GMHC’s news release and a link to the full report.

“The newly released report highlighted five policy lessons from the review of global SEPs: (1) the importance of government sponsorship and regulatory oversight of community-organized SEPs; (2) how legal regimes can inhibit the success of SEPs in reducing HIV infection rates; (3) the ways in which successful SEPs interact flexibly with IDUs, such as by providing mobile services, syringe vending machines, or even drug rehabilitation services; (4) how countries can use SEPs to promote rehabilitation and reduce the incidence of drug use; and (5) the ways in which SEPs have thrived even in countries with strong social and religious mores opposing drug use.”

http://www.gmhc.org/policy/2009/gmhc_intl_seps.pdf

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First, a quick update on needle exchange: The Senate Appropriations subcommittee on labor, health and education programs approved a spending bill this week that leaves in place the funding ban on needle exchange programs. This means a fight in conference over the fate of that provision, since the House approved language lifting the ban, albeit with lots of restrictions on where needle exchange programs can be located. As we’ve written here before, the ban technically only applies to domestic programs, but PEPFAR officials have extended it to international programs, so this has major implications for global HIV prevention efforts.

Now, for those who didn’t get enough HIV/AIDS science or policy news at the IAS conference in Cape Town (or those who didn’t get to go in the first place), Aidsmap.com has launched an online discussion forum to further delve into questions raised at the conference. Among the topics up for debate: the implications of calls for earlier initiation of antiretroviral treatment. Click here to check out the Aidsmap forums–and make sure to cross-post comments here, so the discussion can be wide-ranging.

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