Annals of Health Law
ACHIEVING AN AIDS-FREE GENERATION
left the burden of funding programs entirely to the states and private funders
for the next two decades.22
In 2009, as part of his National HIV Strategy,23 President Obama modified
the ban on federal funds for SEPs when he signed the Consolidated
Appropriations Act of 2010.24 However, the federal government failed to
allocate funding for SEPs, and existing programs continued to face
significant barriers to obtaining resources.25 Ultimately, Congress reinstated
the ban in 2011 as part of its spending plan through fiscal year 2012.26
To achieve the goal of an AIDS-free generation, the U.S. must support
SEPs legally and financially. Part I provides background on HIV
transmission among IDUs and evidence supporting the use of SEPs to curb
HIV transmission in this population.27 Part II examines state and federal laws
and policies that create legal barriers to effective SEP implementation.28 Part
III discusses the shortcomings of President Obama’s modified ban and
proposes alternative language.29 Finally, Part IV recommends specific legal
and policy changes regarding explicit authorization of SEPs—necessary to
achieve an AIDS-free generation.30
2010, that the federal government expressed any support for syringe and needle exchange
programs. Consolidated Appropriations Act of 2010, Pub. L. No. 111-117, § 505, 123 Stat.
3034, 3279 (2009).
22. Public Health Service Act, 42 U.S. C. § 300ee (2012). This Act states:
The purpose of [Subchapter XXIII. Prevention of Acquired Immune Deficiency
Syndrome,] is to provide for the establishment of education and information
programs to prevent and reduce exposure to, and the transmission of, the etiologic
agent for acquired immune deficiency syndrome . . . [but] [n]one of the funds
appropriated to carry out this subchapter may be used to provide education or
information designed to promote or encourage, directly, . . . intravenous substance
Id. § 300ee(a), (c); see also Thirty Years of America’s Drug War, supra note 6.
23. WHITE HOUSE OFFICE OF NAT’L AIDS POL’Y, NATIONAL HIV/AIDS STRATEGY FOR
THE UNITED STATES (2010), available at http://www.whitehouse.gov/sites/default/files/
24. Consolidated Appropriations Act § 505.
25. Traci C. Green et al., Life After the Ban: An Assessment of US Syringe Exchange
Programs’ Attitudes About and Early Experiences With Federal Funding, 5 AM. J. PUB.
HEALTH e9 (2012). Only three programs received federal funds, and the money did not help
to create new legally authorized programs or to enable existing programs to expand services.
Id. at e11.
26. Consolidated Appropriations Act of 2012, Pub. L. No. 112-74, § 523, 125 Stat. 786,
27. See discussion infra Part I.
28. See discussion infra Part II.
29. See discussion infra Part III.