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United States: Expand Access to Sterile Syringes for People who Inject Drugs

Letter to the Office of National AIDS Policy on World AIDS Day

Jeffrey Crowley
Director, Office of National AIDS Policy
The White House                                                                  
Washington DC 20502

Dear Jeff:

On this World AIDS Day, we are writing on behalf of injection drug users who continue to suffer from needless, preventable HIV and viral hepatitis infection.  The enclosed Syringe Access Issue Brief authored by Human Rights Watch and the Harm Reduction Coalition highlights the urgent need for improved access to sterile syringes for the tens of thousands of people who inject drugs in the United States. We request that the Office of National AIDS Policy and the federal agencies charged with implementing the National HIV/AIDS Strategy immediately increase attention to the state laws and policies that are blocking expansion of syringe services programs (SSPs) in dozens of states.

Specifically, the enclosed Brief:

  • Summarizes the well-established data demonstrating the effectiveness of SSPs in preventing HIV and hepatitis and linking people to treatment without increasing drug use;
  • Describes the state laws and policies that prevent states from implementing SSPs despite the modification of the federal ban on funding syringe exchange;
  • Urges ONAP, SAMHSA, DOJ, ONDCP and other relevant agencies to take a much more proactive role in addressing state laws and policies that are blocking implementation of the National HIV/AIDS Strategy with regard to syringe access;
  • Recommends specific options for action, including formation of a syringe access task force within ONAP.

This call for federal oversight and action on state laws and policies is consistent with the NHAS’s commitment to “ensure that our laws and policies support our current understanding of best public health practices for prevention and treatment of HIV” and its declaration that “local governments should be encouraged to expand access to effective prevention services.” The Brief calls for an effort similar to that underway for HIV-specific criminal laws that includes federal review of state laws and policies that may undermine public health objectives, to be followed by specific recommendations for action and clear federal guidance.

Thank you very much for your consideration of this important issue. Human Rights Watch and the Harm Reduction Coalition stand ready to assist and support ONAP’s implementation of these recommendations. Please do not hesitate to call on us.


Megan McLemore
Senior Researcher
Health and Human Rights
Human Rights Watch
Daniel Raymond
Policy Director
Harm Reduction Coalition

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