The mayor’s misguided decision on syringe exchange

Right out of the box, Mayor Cherelle L. Parker has made a terrible mistake that sets us back more than three decades.

Her budget proposal includes not one city dollar for syringe exchange, the first effective HIV prevention strategy our city has had. In 1992, Mayor Ed Rendell, working with ACT UP and other activists, declared a public health emergency and started Philadelphia’s exchange program.

A study by George Washington University estimated that 10,000 HIV infections were averted in the 10 years that followed. The Philadelphia Department of Public Health reports that this study and more than 100 others support the effectiveness of syringe exchange programs.

From my years as an ACT UP activist in the early ‘90s through my experience in the health department’s HIV program and directing the city’s public health preparedness, I know that cutting off a successful, evidence-based health program will only lead to a reemergence of preventable conditions.

The availability of clean syringes has been essential for removing injection drug use as the leading risk for HIV infection in Philadelphia. Syringe exchange has also limited hepatitis B and C transmissions. The program has been shown to be a bridge to substance use treatment. Exchange programs do not increase crime.

Of course, syringe exchange does not eliminate the billion-dollar illegal drug industry that has been in Kensington for decades, nor does it avert overdoses.

It does not provide housing.

It does not address the many quality-of-life problems the mayor rightly seeks to address in that strife-torn neighborhood.

The city must look at the root causes: Unfettered drug trafficking. Lack of sufficient accessible, trauma-informed, and evidence-based drug treatment and mental health programs. Lack of housing resources. Lack of job training and placement programs.

People don’t go to Kensington for clean syringes; they go there to get drugs. No one wants to see people living on the street or overdosing on the street. I hope we all want to provide full opportunities for health for people suffering from addiction. Eliminating syringe exchange funded with taxpayer dollars will not accomplish any of this.

Let’s be clear: The program depends on city funds, and Mayor Parker should know this. Charitable contributions provide only a fraction of what is needed to prevent the spread of HIV, hepatitis, and other infectious diseases related to injection.

People don’t go to Kensington for clean syringes; they go there to get drugs.

Federal funds cannot be used to purchase syringes, for purely political reasons. In fact, federal HIV prevention guidelines require syringe services in mandated local HIV prevention plans, and the Centers for Disease Control and Prevention provides guidance for setting up such programs.

Philadelphia was ahead of the curve in providing city funds for syringe exchange. Past mayors, managing directors, and health commissioners protected this funding that fills gaps in other sources. As a result, new HIV infections among people who inject drugs rapidly decreased until 2016. More recently, an HIV outbreak among people who inject drugs was identified in 2018. This was controlled by outbreak response activities that included increasing city funding for syringes.

The loss of access to clean needles will lead to an increase in HIV and viral hepatitis infections that will result in costly treatment and, sadly, death for those unable to access care.

We have plenty of expertise in our city — in government, in academic institutions, and with community stakeholders that could provide informed policy options to address the interwoven problems in Kensington.

I’m left wondering who has the mayor’s ear, if not these experts.

Coleman Terrell retired in 2022 from the Philadelphia Department of Public Health, where he served as the director of HIV health services.