1997-1998: AIDS activists (ACT UP) demand federal funding for needle exchange programs

When Bill Clinton began his first term as President of the United States in 1993, the cumulative number of individuals affected by the AIDS epidemic stood at 360,000 cases. By his second term, this count had grown to over 580,000. Although the number of AIDS deaths saw its first dip in 1996, likely due to the development of anti-HIV combination therapies, the number of new cases remained constant at about 40,000 annually since 1992 until 2003.

Many AIDS activists and researchers pinned the lack of progress in transmission rates on the Clinton administration’s unwillingness to federally fund needle exchange programs. Since Clinton took office, an estimated 10,000 people were infected directly or indirectly by dirty needle sharing.

However, the unwillingness to fund needle exchange programs went beyond Clinton’s administration. Since 1988, Congress had passed at least seven statutes prohibiting the use of federal money for syringe distribution programs. In 1992, Congress had granted then Secretary of Health and Human Services Donna Shalala the authority to lift the federal funding ban on needle exchange programs only if scientific research showed the programs reduced HIV transmission without increasing drug use.

The Foundation for AIDS Research (amfAR) released the results of its four-year study on New York City needle exchange programs in 1996. The foundation’s results showed that syringe distribution programs reduced HIV infections by two-thirds and provided access to other health care services. Despite the report, the Clinton administration neither lifted the ban nor recognized the results.

In June 1997, the NY AIDS Coalition to Unleash Power (ACT UP) began its 18-month campaign to fight for federal funding of needle exchange programs with a march of 1,000 people at Bill Clinton’s Birthday Celebration in Manhattan. The protest was a coalition effort with ACT UP Philadelphia and other harm reduction programs, including the 80+ needle exchange programs that existed across the country at the time. These programs operated through state, municipal or private funding.

ACT UP activists officially formed the National Coalition to Save Lives Now! (NCSLN), the coalition organization that would head the national campaign for federal funding of needle exchange programs. On 17 September 1997, NCSLN organized a rally at the headquarters of the Department of Health and Human Services in DC. Hundreds of AIDS activists carried symbolic tombstones or signs that read “Moral Backbone for Clinton” or “Moral Backbone for Shalala.” These banners supplemented the twelve foot monolith, or “moral backbone,” that thirteen activists tried to carry into the building to deliver to Shalala. Law enforcement arrested those thirteen for their efforts. Speakers at the rally included Denise Paone, the Assistant Director of Research at Beth Israel Medical Center’s Chemical Dependency Research institute and Keith Cylar, the co-Executive Director of Housing Works, a NYC nonprofit that worked to fight the crises of AIDS and homelessness.

Despite the Clinton administration’s inaction and outright refusal of federal funding, needle exchange operations continued. AIDS organizations distributed materials and information on prevention tactics, including proper syringe disposal and AIDS resources.

By mid-October, several members of Clinton’s 30-member Presidential Advisory Council on AIDS threatened mass resignation in protest of the White House’s refusal to fund needle exchange programs. Robert Fogel, a Clinton ally, led the threat of resignation which highlighted divisions within the Clinton administration.
Following the Council’s announcement of its support for needle exchange programs, activists interrupted the speeches of White House officials on three occasions. The first took place on 21 October 1997, when two activists interrupted a New York awards ceremony sponsored by the AIDS Action Foundation for former White House aide George Stephanopoulos, who supported the ban. Three weeks later, Stephanopoulos changed his position and gave his support for needle exchange programs.

The second interruption took place two weeks later at a Manhattan rally for mayoral candidate Ruth Messinger. Activist John Riley interrupted Clinton’s speech supporting Messinger’s campaign asking, “What about the lives of thousands of injection drug users endangered by your Administration’s refusal to lift the ban on needle exchange funding? When are you going to act to save lives?” Riley was immediately ejected from the event.

Clinton was interrupted again six days later on 8 November during his speech to the Human Rights Campaign, an LGBT civil rights advocacy group that gave Clinton major financial support during his re-election campaign in 1996. During this speech, activists interrupted Clinton three separate times. Each protestor demanded an explanation of the administration’s refusal to give needle exchange programs federal funding; after each protest, the demonstrator was removed from the event. Dinner attendees tackled and hit one activist.

On 17 March 1998, members of the Presidential Advisory Council on AIDS held a press conference to once more express frustration with the Clinton administration’s policy on syringe distribution programs. The Council called on Secretary Shalala to recognize the six federally-funded reports, including one conducted by the National Institutes of Health, that supported the efficacy of needle exchange programs without an increase in drug use. The resolution approved by the Presidential Council stated, “The administration’s current policy on needle-exchange programs threatens the public health, and directly contradicts current scientific evidence.”
During the course of the next month, public confidence that Secretary Shalala would lift the ban grew significantly. On 16 April 1998 CNN published an article titled “Federal Funds Likely For Needle Exchange” that illustrated the public’s expectation of federal funding for needle exchange programs.

However four days later, on 20 April 1998, Health and Human Services Secretary Shalala agreed that needle exchange programs help prevent AIDS, but refused to the lift the 1988 ban under the grounds that those programs might encourage drug use. According to John Riley, one of the leading activists behind the needle exchange movement,, many activists believe the White House planned the original news conference planned to announce federal funds, but President Clinton influenced by the input of Secretary of the Office of National Drug Control Policy, Barry R. McCaffrey, changed his mind last minute.

On 25 May 1998 Steve Michael, the founder of the DC chapter of ACT UP, died due to AIDS related pneumonia. To fulfill his last wishes, friends and family of Michael arranged a political funeral to take place on 4 June 1998. One hundred people attended the half-mile procession to the White House. Friends and family of Michael gave eulogies that both honored his life and his efforts to the AIDS movement, but also denounced the Clinton administration. The funeral included Michael’s open casket in which his body wore a white ACT UP t-shirt. Steve Michael’s political funeral differed from the 1992 and 1996 Ashes Action funeral demonstrations, where protesters chanted and threw ashes and fake blood onto the White House fences. Steve Michael’s procession was silent and, comparatively, much calmer.

The last major demonstration took place on 21 July 1998. Ten activists occupied the office of Presidential AIDS Policy Coordinator Sandra Thurman in Washington, D.C. The activists demanded that Thurman issue a public statement to condemn President Clinton’s decision to maintain the needle-exchange funding ban, insist President Clinton publicly oppose any bill or amendment that would revoke Secretary Shalala’s authority to lift the ban, and announce her support for the removal of Barry McCaffrey as Secretary of the ONDCP. Within the twenty minutes before security enforcement removed and arrested them, the activists hung a banner from Thurman’s office window that read, “Clinton: Clean Needles Save Lives,” , plastered the walls and windows with posters denouncing Clinton’s AIDS policies, and chained themselves to Thurman’s desk.

Although the demonstrations of the late 1990’s failed to lift the 1988 ban on federal funding for needle exchange programs, the campaign garnered a lot of media coverage on the issue. ACT UP member, John Riley, stated, “We didn’t win completely on that, but we made some progress, and at least some municipalities and state governments had a little more courage to fund needle exchanges, not to the extent that they needed to be.” After prompting the Clinton administration to recognize the scientific research that supported the effectiveness in reducing HIV transmission without increasing drug use, lower level governments were more encouraged to support needle exchange programs. In 2009, the federal government lifted the ban , but Congress reinstated it two years later when Republicans reclaimed control of the House.

Research Notes

Influences:
Past ACT UP demonstrations greatly influenced this campaign. In particular, the Ashes Action demonstration in 1992 influenced the direction and desired ambiance at Steve Michael's political funeral.
Other campaigns took place during the same time period, but were directed at state and municipal governments.

Sources:
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Name of researcher, and date dd/mm/yyyy:
Juli Pham 22/02/2017