{"id":481,"date":"2026-07-01T21:42:19","date_gmt":"2026-07-01T21:42:19","guid":{"rendered":"https:\/\/americanindustryreview.com\/?p=481"},"modified":"2026-07-01T21:42:19","modified_gmt":"2026-07-01T21:42:19","slug":"syringe-services-in-limbo-under-trump-risking-hepatitis-c-progress","status":"publish","type":"post","link":"https:\/\/americanindustryreview.com\/?p=481","title":{"rendered":"Syringe services in limbo under Trump, risking hepatitis C progress"},"content":{"rendered":"
\n

\u200b
A decade after Congress first allowed federal funding to support clean needle programs, the Trump administration is backing off that policy, potentially risking\u00a0progress made against hepatitis C, a deadly but curable virus mostly spread by people who inject drugs.<\/p>\n

Read more States at heart of the Revolution plan 250th events sans Trump<\/a><\/p>\n

The administration\u00a0now says funding can no longer support the programs such as paying the people who distribute syringes, framing it as \u201cenabling\u201d drug use.\u00a0<\/p>\n

The change is part of the administration\u2019s broader rejection of a public health approach aimed at reducing the harms of drug use through measures like syringe services, test strips, as well as efforts to connect people with food, housing and medical care.<\/p>\n

What could follow is a spike in preventable infectious diseases like hepatitis C, which countries like England are on the way to eliminating as a public health threat by 2030 \u2014 in part by expanding access to testing and clean needles for people who inject drugs, public health advocates say.<\/p>\n

\u201cLimiting access to test strips, as well as clean syringes, puts American lives at risk,\u201d a group of senators led by Sen. Edward J. Markey, D-Mass., said in a letter to the Substance Abuse and Mental Health Services Administration in response to the change.<\/p>\n

While Congress first banned the use of federal funds to purchase syringes in the 1980s, it loosened that restriction in 2016 to allow funding for syringe services programs \u2014 such as staffing, facilities, and other operating costs \u2014 but not for buying needles themselves.<\/p>\n

The administration\u2019s actions prohibiting federal funding for those services \u201cflies in the face of Congressional intent, undermining the programs designed to prevent outbreaks in the communities most vulnerable to them,\u201d the lawmakers said.<\/p>\n

The shift comes despite a Trump administration vow to eliminate hepatitis C as part of its goal of \u201cending chronic disease,\u201d the strongest endorsement yet of a goal the United States signed onto in 2016.<\/p>\n

Hepatitis C still kills more than 11,000 people a year in the U.S., despite the availability of a cure that has been on the market for more than ten years.<\/p>\n

The administration committed to reducing cases of the disease as recently this month as it sought public comment on programs to battle addiction, while\u00a0noting within the same document\u00a0it was\u00a0\u201cending support for harm reduction, including syringe services.\u201d<\/p>\n

\u201cSyringe services will have to make some hard choices,\u201d like reducing services or hours, said Regina LaBelle, director of the Addiction and Public Policy Initiative Georgetown University and former acting director of the White House Office of National Drug Control Policy under the Biden administration. \u201cI\u2019m very, very concerned about more outbreaks because we know that syringe service programs are effective in reducing blood borne diseases. It could potentially have a devastating impact in areas of the country.\u201d<\/p>\n

Research has shown syringe services reduce infectious diseases like hepatitis C and HIV by 50 percent while also increasing the likelihood someone will get treatment for substance use disorder.<\/p>\n

But federal support for syringe services has long run hot and cold.<\/p>\n

\u2018Strictly prohibited\u2019<\/h2>\n

Recent communications from the Substance Abuse and Mental Health Services Administration, the primary behavioral health grant making agency,\u00a0states that grantees are \u201cstrictly prohibited\u201d from using federal funds, directly or indirectly,\u00a0to support harm reduction efforts that \u201cfacilitate illegal drug use.\u201d That includes\u00a0purchasing, distributing or supporting the \u201cprovision of drug paraphernalia.\u201d<\/p>\n

The result is a landscape of confusion, where states and programs remain unclear about how they can spend any federal funding they get. Some organizations are now are trying to find separate funding to pay for staff to distribute syringes, according to people familiar with the situation.<\/p>\n

An agency\u00a0spokesperson did not respond to questions about whether grantees could still pay for services with separate funding.<\/p>\n

\u201cThey\u2019re really wondering how it is they\u2019re going to be able to keep their doors open,\u201d said Drew Gibson, director of advocacy at AIDS United, a nonprofit organization that works to end the HIV epidemic. \u201cI think a lot of harm reduction organizations are starting to reevaluate how they pursue federal funding in terms of what they\u2019re able to do with the money if they get it and whether the juice is worth the squeeze.\u201d<\/p>\n

Additionally, the Trump administration\u2019s new political review of discretionary grants has slowed funding to states for substance use response and disease prevention, leaving harm reduction groups and others working to prevent HIV and hepatitis C facing delays and funding uncertainty.<\/p>\n

In a recent notice to harm reduction grantees obtained by CQ Roll Call, the Minnesota Department of Health said it does not currently have the funds to continue supporting syringe service programs while it awaits funding decisions from the federal government.<\/p>\n

Meanwhile, Centers for Disease Control and Prevention staff said in emails that funding \u201cmay not support harm reduction efforts that a reasonable person might conclude primarily serve to facilitate or promote illegal drug use\u201d while highlighting things the administration supports including naloxone, which reverses opioid overdoses.<\/p>\n

It\u2019s part of a misunderstanding of what syringe programs do, said Paul LaKosky, executive director of the Dave Purchase Project, the North American Syringe Exchange Network and the Tacoma Needle Exchange.<\/p>\n

\u201cWhile syringe exchange is the basis of what we do, it\u2019s the least of what good syringe exchange does,\u201d he said.<\/p>\n

Read more When Washington politicians can\u2019t go home again<\/a><\/p>\n

Many programs are staffed with people who\u2019ve experienced drug addiction and work to build trust in a community of people who may be suspicious of the health care system. Syringe services can help bridge the gap to\u00a0other services, including hepatitis C testing and\u00a0drug treatment.<\/p>\n

The World Health Organization, which established the 2030 elimination goal, says syringe services are a key part to eliminating hepatitis C as a public health threat. It recommends countries make available 300 syringes per drug user per year.<\/p>\n

\u201cYou need to have that alongside any implementation plan,\u201d\u00a0said Stuart Smith, director of community services for the England-based Hepatitis C Trust, a nonprofit helping move the country toward ending the virus as a public health threat by 2030.\u00a0\u201cYou need to be giving them clean equipment so they\u2019re not just perpetuating the cycle.\u201d<\/p>\n

In England, free syringes can be found at pharmacies,\u00a0at most drug treatment centers and can be ordered by mail. \u201cPeer workers\u201d who have had hepatitis C also deliver syringes.<\/p>\n

Still, access is a concern even in England, mainly due to funding issues. In downtown Birmingham,\u00a0hepatitis C cases and reinfections spiked when the two biggest pharmacies shut down their syringe programs. The city council then contracted with the Hepatitis C Trust to deliver syringes and other harm reduction supplies out of a van at a downtown park, homeless shelters and other places people who use drugs hang out.<\/p>\n

These efforts also involve\u00a0testing for hepatitis C using Cepheid\u00a0rapid point-of-care machines, which\u00a0get results within an hour, and connecting people to treatment quickly.<\/p>\n

\u201cWe\u2019ve got to try and fill that gap. People are going to use drugs. You need to make sure they do it safely,\u201d said Paul Huggett, a manager with The Hepatitis C Trust in Birmingham.<\/p>\n

Testing lag<\/h2>\n

Federal government investment in syringe programs has been scarce in the United States, where many operate on shoestring budgets and acquiring equipment like a Cepheid machine is often out of reach.<\/p>\n

Instead, many programs rely on antibody tests, which can show whether someone has ever been exposed to hepatitis C but cannot determine if the infection is active.<\/p>\n

Others use dried blood spot tests, which can detect active infections but often take several days to get results from a lab.<\/p>\n

That lag can make it harder to move people into care, said Jack Martin, a founder of Southside Harm Reduction Services in Minneapolis. The organization runs a syringe program, offers antibody hepatitis C testing, connects people to treatment, and provides basic services such as food and clothing.<\/p>\n

\u201cIt just creates a lot of work to be able to get people into treatment, or be able to do follow-up testing,\u201d Martin said. \u201cIt\u2019s kind of a hard position to be in. Getting the message that you may have hepatitis C is difficult to navigate, especially when it\u2019s as common as it is.\u201d<\/p>\n

A Cepheid machine would allow the program to test people and connect them to treatment during the same visit.<\/p>\n

\u201cIt just seems like such a great solution,\u201d he said. \u201cIt\u2019s so much better than the hepatitis C testing flow we have now.\u201d<\/p>\n

In 2021, Congress under Democratic control authorized $30 million for harm reduction programs, including syringe services. That funding expired at the end of 2024.<\/p>\n

House Republicans in the fiscal 2027 Labor-HHS funding bill committee report said the measure would not fund any \u201charm reduction activities\u201d and commended the Trump administration\u2019s \u201cshift away from harm reduction activities that facilitate illicit drug use.\u201d<\/p>\n

But the same bill includes a long-standing policy allowing funds to support a syringe program if the CDC determines a state or community is at increased risk for the spread of HIV or hepatitis due to injection drug use. The rider still prohibits federal fund\u00a0for direct purchase of syringes.<\/p>\n

Advocates\u00a0have come close to getting that ban removed from spending legislation, said Chad Sabora, a harm reduction expert. But it fell through amid attacks on harm reduction and syringe services.\u00a0<\/p>\n

\u201cGetting people to accept something so simple and accepted in every other sovereign nation \u2014 like syringe service\u00a0\u2014 will take years. It\u2019s absurd how hard we have to fight for these services,\u201d Sabora said. \u201cIt may not be the avenue they chose, but it gives them the results they\u2019re looking for, like less disease and more treatment.\u201d<\/p>\n

This report is part of a series made possible by a reporting fellowship sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.<\/em><\/p>\n

Read more SCOTUS term marked by shifts to the right, some checks to Trump<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

\u200bA decade after Congress first allowed federal funding to support clean needle programs, the Trump administration is backing off that policy, potentially risking progress made against hepatitis C, a deadly but curable virus mostly spread by people who inject drugs. 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