Annals of Health Law
ACHIEVING AN AIDS-FREE GENERATION
the Attorney General.5 Nixon then established the Drug Enforcement
Administration in 1973 to enforce federal laws and to consolidate many
organizations already attempting to combat drug use.6 Nixon’s “War on
Drugs,” continued by subsequent administrations, employs a punitive
approach that treats drug users as criminals for possessing and using drugs
and drug paraphernalia.7 The approach has been largely unsuccessful: forty
years later, drug abuse remains a pervasive and important problem.8
The punitive model persists and negatively impacts efforts to prevent HIV
transmission among IDUs in several ways.9 It erects barriers to access clean
needles and syringes that make it challenging for IDUs to follow prevention
measures. Its imposition of criminal penalties may inhibit IDUs from
admitting their drug use, which gives rise to their HIV risk, and, thus, from
getting accurate prevention information and help. This model predates the
Acquired Immune Deficiency Syndrome (“AIDS”) epidemic, caused by
HIV, which was first recognized in the U.S. in five men originally diagnosed
with pneumonia in 1981.10 Since then, more than half a million people have
died from AIDS in the U.S. alone,11 and more than one million are living with
5. Id. §§ 812, 871.
6. Thirty Years of America’s Drug War, FRONTLINE, http://www.pbs.org/wgbh/
pages/frontline/shows/drugs/cron/ (last visited Mar. 4, 2013).
7. President Richard Nixon first introduced the phrase “War on Drugs” in the 1970s. The
effort instigated decades of stringent drug laws largely enforced against drug users rather than
transporters and distributors. The “War on Drugs” is now considered to have failed at
preventing illicit drug use. GLOBAL COMM’N ON DRUG POLICY, WAR ON DRUGS: A REPORT OF
THE GLOBAL COMMISSION ON DRUG POLICY 4 (2011); Amy Windham, Zero Tolerance, in 4
ENCYCLOPEDIA OF DRUGS, ALCOHOL, AND ADDICTIVE BEHAVIOR 317–18 (3d ed. 2008).
8. In 2011 alone, the FBI reported over 1.5 million arrests for drug abuse violations.
Uniform Crime Reports: Estimated Number of Arrests, United States, 2011, FED. BUREAU OF
INVES TIGA TION, http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2011/crime-in-the-u.s.-
2011/tables/table-29 (last visited Mar. 4, 2013).
9. INT’L FED’N OF RED CROSS & RED CRESCENT SOCIETIES, SPREADING THE LIGHT OF
SCIENCE 1 (2003). According to International Federation of Red Cross and Red Crescent
Societies President Juan Manuel Suárez del Toro Rivero, “political imperatives, donor
demands, and ignorance and fear continue to impede the work of preventing and alleviating
suffering and protecting human dignity.” Id.
10. See M. S. Gottlieb et al., Pneumocystis Pneumonia—Los Angeles, 30 MORBIDITY &
MORTALITY WKLY. REP. 1 (1981).
11. CTRS. FOR DISEASE CONTROL & PREVENTION, HIV SURVEILLANCE REPORT:
DIAGNOSES OF HIV INFECTION AND AIDS IN THE UNITED STATES AND DEPENDENT AREAS,
2008, at 69 (2010), available at http://www.cdc.gov/hiv/surveillance/resources/reports
/2008report/pdf/2008SurveillanceReport.pdf; NAT’L INST. OF ALLERGY & INFECTIOUS
DISEASES, U.S. DEP’T OF HEALTH & HUMAN SERVS., UNDERSTANDING THE IMMUNE SYSTEM:
HOW IT WORKS 33, 48 (2007), available at http://www.niaid.nih.gov/topics/immuneSystem/
Documents/theimmunesystem.pdf; Ctrs. for Disease Control & Prevention, Thirty Years of
HIV—1981–2011, 60 MORBIDITY & MORTALITY WKLY. REP. 689 (2011) [hereinafter CDC,
Thirty Years of HIV]. HIV causes AIDS by destroying cells in the body that make up and