This document summarizes efforts to end the ban on federal funding for syringe service programs (SSPs) in the United States. Advocates from 18 organizations came together to develop new advocacy strategies and materials informed by harm reduction approaches, updated data, and perspectives from new partners. The new data showed that SSPs save money by reducing healthcare costs and increasing access to addiction treatment. While progress has been made in lifting the ban, advocates will need to continue efforts to maintain funding and ensure proper implementation.

1. HIV PreventionConference Abstract
Ending the Ban on Federal Fundingfor Syringe Service Programs: newenvironments, newdata, new
messages,newmessengers
Issue
Fundingandpolitical supportcontinuetobe issuesforsyringe servicesprograms(SSPs),perhapsmost
prominentlybecause Congressrestoredthe banonthe use of federal fundingforsyringe service
programs(SSPs) in2011. However,the needforsuchservicesisgreaterthanevergiventhe epidemicsof
HIV,viral hepatitis,opiate overdose,andprescriptiondrugmisuse withitsconcomitantincrease in
heroinuse.
Setting
Aftera two-yearreprieve,Congressrestoredthe 21-yearbanon the use of federal fundingforSSPs.
Thiswas bothsurprisinganddiscouraginggiventhatsyringe accessisamongthe mosteffectiveand
well-researchedmethodsof HIV preventionavailable. Mythsand misunderstandingsstillpersistdespite
abundantand unambiguousdataabout theirsuccess.The restoredbanhashad a chillingeffectonother
funderswhomisperceivedthe reinstatementasan indictmentof effectiveness.Giventhe demandsof
service provision,individualsandprogramsoftendonothave the capacity to developand testadvocacy
materialsandapproaches.
Project
In response,advocatesfrom18national organizationshave come togethertore-evaluate efforts,taking
a harm-reductionapproachinadvocacystrategies,meetingpolicymakers“where theyare at”.New
partners,newmessagesandnewdatainformedthisresponse.ItinvolvedabroaderlookbeyondHIV to
include viral hepatitis,prescriptiondrugmisuse,drugoverdose,accesstoaddictiontreatment,health
disparities,costsandcost-effectiveness,publicsafety,andlocal perspectives.A collectionof “readyto
use”materialshave beendevelopedandsuccessfullyutilizedtomeetthisneed.
Results
We have data that didn'texisttwoyearsago,reinforcingandrenewingsupportforSSPs.We now know:
-EverydollarinvestedinSSPsresultsinsevendollarsinsavingsinHIV treatment. -SSPsalsoreduce other
healthcosts(researchinprogress).
-SSPsclean-upneighborhoodsbyensuringthatusedsyringesare safelydisposed.
-SSPsreduce hepatitisC.
-SSPsare 25% more effective inservingasabridge to treatmentforsubstance use disorderthanothers
inthe field.
-African-Americansare 11X and Latinosare 5X more likelytocontractHIV viainjectiondruguse.
-Local enablinglegislationisnotrequiredforSSPstoreceive publicfunding.
-The largestsource of fundingispublic(state andlocal).

2. -There isincreasedsupportforSSPsamonglaw enforcementandfaithcommunities.
LessonsLearned
The largestmisperceptionaboutliftingthe banisitscost (there isnone). Itisa pointthat needstobe
made everytime andat the verybeginningof anyinteraction.
Traditional supportersfoundthe new data,particularlythe disparitydata,helpful,reinvigorating
interestandenthusiasmwhichhaswanedoverthe years.
Those whohad not supportedsyringe exchange previouslyfoundthe cost-effectivenessdata,law
enforcementsupport,bridge todrugtreatmentdata,andthe states' rightsargument,mostcompelling
(inthat order).
Highturnoverincongressand amongcongressional staff meansthateffortsmustbe continuous.
The misunderstandingsandnuancesinvolvedrequire aspecificconversationonthistopic,ratherthan
merelyincludingitona listof advocate concerns.
Many have foundour approacheshelpfulintheiradvocacyatthe local level.
Where we are now
An outbreakof HIV inrural Indianalinkedtoinjectionof prescriptionpainmedicineledtoaregional
change in SSPlaws(Indiana,Kentucky,Ohio).Lawmakersfromthese stateswhohadpreviouslyopposed
liftingthe banhave nowallowedlanguageforapartial liftinthe AppropriationsCommitteesof both
housesof Congress.Thisisthe firstchange inthe law since 2011. Our nextchallengesare:
1. Maintainingthe language inthe budget,howeveritispassed(omnibus, continuingresolution,
etc).
2. Ensuringimplementationisclear,timely,andlogisticallyaccessible.