In December, Congress took another step long demanded by AIDS activists, lifting the ban on federal funding for needle exchange programs. Instituted by a clause in appropriations legislation, this policy was in place for two decades despite a considerable body of evidence showing that needle exchange reduces transmission of blood-borne diseases such as HIV and hepatitis B and C, without promoting injection drug use.

This past July, Democrats in the House of Representatives removed the relevant clause from the proposed Labor and Health and Human Services appropriations bill for fiscal year 2010. Republicans attempted to add an amendment severely restricting where needle exchange programs could operate, but this effort was defeated. The U.S. House of Representatives and Senate passed a joint omnibus spending bill without the needle exchange funding prohibition and President Obama signed the legislation in December, putting an end to the ban.

Liz Highleyman ( is a freelance medical writer based in San Francisco.