Recognizing that HIV and hepatitis were both spreading at alarming rates among IDUs, public health officials in the Netherlands and Australia begins experimenting in the mid-1980s with programs to supply addicts with clean needles in exchange for their used ones, and to assure them that they would run no risk of arrest or harassment by police in the course of making these exchanges. While opposed by some on the grounds that it seemed to be condoning drug use, needle exchange programs (NEPs) quickly proved to be an effective means of reducing the incidence of blood-borne diseases in both countries and have been widely recognized as a valid part of a good public health policy and practice in many other parts of the world. In such programs, addicts receive a clean needle for every used one they turn in, thus limiting careless or dangerous disposal of needles. In some locales, syringes can also be easily obtained from pharmacies or even from vending machines. These are not only more convenient, but encourage the use of clean needles by IDUs who may be reluctant to signal their addiction by going to an NEP.
A ten-year government assessment of the results in Australia, published in October 2002, estimated that NEPs had resulted in the avoidance of 25,000 cases of HIV and 21,000 cases of hepatitis C over the decade of the 1990s, with a financial savings of something between $2.4 and $7.7 billion. (At the time, the Australian dollar was valued at approximately $0.55 U.S., for converted figures of approximately $71.8 million and $1.3 to $4.1 billion.)
Going beyond Australia, researchers for the report examined data from 103 cities worldwide, amounting to an aggregate of 778 years of experience with NEPs. They found that cities with NEPs experienced an average annual decrease in HIV cases of 18.6%; cities without such programs had an average 8.1% increase. The contrast between Australia and the United States is particularly striking. According to Alex Wodak, M.D., a key figure in persuading Australian governments to support needle exchange programs and other methods of making clean needles available to users, “In the year 2000, there were 14.7 new AIDS cases for every 100,000 Americans compared to just 1.1 new AIDS case for every 100,000 Australians. The proportion of new AIDS cases attributed directly or indirectly to injecting drug use in the United States is estimated as between one third to one half —compared to just 5 percent in Australia.”
Awareness of such experience and research findings has led authorities in numerous European countries and cities to follow suit. Hundreds of needle exchange programs operate in Great Britain, Germany, Spain, and other parts of Europe, and vending machines dispense clean needles in dozens of European cities. The Canadian federal government also began funding NEPs in 1989, as part of a comprehensive effort to reduce HIV infection.
Expert Verified
Link
