WEBVTT - Episode 8: No Harm 0:00:00.440 --> 0:00:03.000 Hey, this is Leon Napok. I'm the host of Fiasco, 0:00:03.240 --> 0:00:05.640 but you may also know me from the podcasts Slowburn, 0:00:05.840 --> 0:00:09.240 Think Twice, Michael Jackson, and Backfired the Vaping Wars. I'm 0:00:09.280 --> 0:00:11.880 excited to be sharing with you the next season of Backfired, 0:00:12.000 --> 0:00:15.960 titled Attention Deficit, which is now available exclusively on Audible. 0:00:16.800 --> 0:00:20.320 Backfired is a podcast about the business of unintended consequences. 0:00:20.840 --> 0:00:23.279 In the first season, my co host Ril Pardess and 0:00:23.320 --> 0:00:25.680 I dove deep into the world of vaping and how 0:00:25.680 --> 0:00:28.400 the well intentioned quest for a safer cigarette went awry. 0:00:28.960 --> 0:00:32.879 Now we're tackling ADHD and how the push to destigmatize 0:00:32.880 --> 0:00:35.879 this hard to define childhood diagnosis has led to an 0:00:35.920 --> 0:00:38.720 explosion of stimulant use in kids as well as adults. 0:00:39.000 --> 0:00:41.560 It's a story about the promise of psychiatry to fix 0:00:41.640 --> 0:00:44.640 our brains and the power of the pharmaceutical industry to 0:00:44.680 --> 0:00:47.600 shape how we and our doctors think about what's wrong 0:00:47.640 --> 0:00:50.239 with us. To hear both seasons of Backfired, go to 0:00:50.240 --> 0:00:53.600 audible dot com slash Backfired and start a free trial 0:00:54.040 --> 0:00:59.520 that's audible dot com slash backfired. Fiasco is intended for 0:00:59.640 --> 0:01:03.520 mature audiences. For a list of books, articles and documentaries 0:01:03.560 --> 0:01:05.960 we used in our research. Follow the link in the 0:01:06.000 --> 0:01:14.520 show notes. Previously on Fiasco, AIDS is infecting more and 0:01:14.640 --> 0:01:18.640 more heterosexuals, men and women, teens and babies. 0:01:18.760 --> 0:01:22.640 The Surgeon General today prescribed education children he feels need 0:01:22.760 --> 0:01:25.039 to be yarned in school about the danger of AIN. 0:01:25.120 --> 0:01:28.440 Now many people are not receiving information that is vital 0:01:28.600 --> 0:01:30.240 to their future health and well being. 0:01:30.480 --> 0:01:33.279 Researchers say, a new class of drugs are working. 0:01:33.400 --> 0:01:35.800 A cure for AIDS may soon be a possibility. 0:01:35.880 --> 0:01:45.320 Felt like some grand act of mercy made manifest when 0:01:45.319 --> 0:01:47.800 we decided to make a season of Fiasco about the 0:01:47.800 --> 0:01:51.400 AIDS epidemic. The arrival of the Triple Cocktail in nineteen 0:01:51.520 --> 0:01:55.640 ninety six seemed like a natural place to end our story. 0:01:55.880 --> 0:01:59.200 The most optimistic note since the terrible disease was first recognized. 0:01:59.200 --> 0:02:02.360 These new so called to wonder drugs, the Triple Cocktail 0:02:02.440 --> 0:02:06.520 represented a monumental turning point, a bookend to the era 0:02:06.640 --> 0:02:08.800 when HIV meant certain death. 0:02:09.400 --> 0:02:12.079 A new combination of drugs, including a new class called 0:02:12.160 --> 0:02:13.239 proteation inhibitors. 0:02:13.600 --> 0:02:17.040 From the discovery of the earliest cases of AIDS, people 0:02:17.080 --> 0:02:20.680 had been imagining, dreaming of something like the Triple Cocktail, 0:02:21.440 --> 0:02:25.200 a medicine that could overpower the disease. It was easy 0:02:25.320 --> 0:02:27.640 to assume that the war on AIDS would be one 0:02:27.720 --> 0:02:29.760 with the development of a successful treatment. 0:02:30.240 --> 0:02:34.040 I've really had about as close to a miraculous recovery, 0:02:34.200 --> 0:02:37.960 certainly more so than I ever imagined I would see. 0:02:38.120 --> 0:02:41.880 But the Triple Cocktail did not end the epidemic. While 0:02:41.880 --> 0:02:45.119 it helped people who were already sick, new people kept 0:02:45.160 --> 0:02:48.600 getting infected, about fifty thousand the year after the Triple 0:02:48.600 --> 0:02:52.400 Cocktail became available, in fifty thousand more the year after that. 0:02:53.720 --> 0:02:57.119 In the decades since the treatment was introduced, nearly one 0:02:57.200 --> 0:03:00.480 million people in the United States have been diagnosed with HIV. 0:03:01.840 --> 0:03:05.200 And So, in this final episode of Fiasco, season five, 0:03:05.960 --> 0:03:07.760 I want to get into some of the reasons why 0:03:07.840 --> 0:03:11.239 the epidemic is still with us. What needed to happen 0:03:11.320 --> 0:03:14.079 that didn't, and what could have been done that wasn't. 0:03:17.840 --> 0:03:21.480 I want you to believe that we can make America 0:03:21.560 --> 0:03:22.040 work again. 0:03:22.120 --> 0:03:24.200 To tell this part of the story, I want to 0:03:24.240 --> 0:03:27.240 go back to the early nineties, when a Democrat from 0:03:27.360 --> 0:03:30.840 Arkansas was running for president and promising a new approach 0:03:30.919 --> 0:03:31.919 to the AIDS crisis. 0:03:32.080 --> 0:03:34.880 I think most Americans still don't know how many people 0:03:34.920 --> 0:03:36.520 are out there who are HIV positives. 0:03:36.720 --> 0:03:40.040 If nothing else, Bill Clinton was willing to talk about HIV. 0:03:41.040 --> 0:03:45.560 Unlike his Republican predecessors, Clinton seemed less inclined to minimize 0:03:45.720 --> 0:03:46.800 or ignore the problem. 0:03:47.000 --> 0:03:50.280 The president should type responsibility or the problems of the 0:03:50.320 --> 0:03:53.600 country and be honest enough to say, we might not 0:03:53.720 --> 0:03:55.040 solve them in a year or two, we may not 0:03:55.120 --> 0:03:56.920 solve them all in four years, but at least we're 0:03:56.960 --> 0:03:58.200 going to roll off our sleeves. 0:03:57.880 --> 0:03:58.440 And go to work. 0:03:58.560 --> 0:04:03.840 Let's get to work, Clinton for people for a change. 0:04:03.920 --> 0:04:07.720 At this point, scientists were still years away from developing 0:04:07.760 --> 0:04:11.360 what became the triple cocktail, but that didn't mean there 0:04:11.400 --> 0:04:15.520 was no progress to be made. After all, treating people 0:04:15.520 --> 0:04:19.000 who already had HIV was only one front in the 0:04:19.040 --> 0:04:22.839 war on AIDS. The other was preventing people from getting 0:04:22.920 --> 0:04:25.880 it in the first place, and that was hard for 0:04:25.960 --> 0:04:29.279 reasons that had nothing to do with science or medical research. 0:04:32.080 --> 0:04:35.919 By the time Clinton took office, public health experts already 0:04:35.960 --> 0:04:38.480 had a bunch of good ideas for how to prevent 0:04:38.640 --> 0:04:43.240 more people from getting infected. Those ideas all had one 0:04:43.360 --> 0:04:49.200 thing in common. They required talking openly, explicitly and pragmatically 0:04:49.400 --> 0:04:54.120 about how HIV was spread, and because that meant talking 0:04:54.160 --> 0:04:58.240 about sex and drugs, it ensured that AIDS would continue 0:04:58.320 --> 0:05:02.440 haunting the country and threatening people's lives long after the 0:05:02.480 --> 0:05:09.080 medical mystery was effectively solved. I'm Leon Nafok from Audible 0:05:09.120 --> 0:05:13.120 Originals and Prologue Projects. This is fiasco. 0:05:14.480 --> 0:05:17.320 Anytime you're talking about sex and drugs. 0:05:17.400 --> 0:05:18.440 It's a moral issue. 0:05:18.520 --> 0:05:21.800 We need to crack down on drug abuse, not promote 0:05:21.839 --> 0:05:22.919 more drug addiction. 0:05:23.080 --> 0:05:25.239 But we don't want people to use drugs. Well, that's great, 0:05:25.520 --> 0:05:26.920 there's no easy way to do that. 0:05:27.120 --> 0:05:31.200 We had a strategy that would save people from getting infected. 0:05:30.880 --> 0:05:33.239 And the question is why aren't they acting. 0:05:35.760 --> 0:05:39.680 On this week's season finale, a new administration promises to 0:05:39.760 --> 0:05:44.039 turn the page on the HIV AIDS epidemic and instead 0:05:44.120 --> 0:05:51.640 gets wrapped up in old arguments about sex, drugs, and morality. 0:05:55.120 --> 0:05:59.719 Ricky Blutenthal was living in Oakland, California, studying sociology at Berkeley, 0:06:00.000 --> 0:06:03.599 and he came face to face with HIV. The year 0:06:03.800 --> 0:06:04.719 was nineteen ninety. 0:06:05.240 --> 0:06:07.440 I was getting a PhD because I was interested in 0:06:07.480 --> 0:06:12.040 the problems of what we were then calling interstiti black people. 0:06:12.720 --> 0:06:15.719 Blutenthal had started his research with a focus on gangs 0:06:15.760 --> 0:06:18.920 and drug distribution. Now he was part of a team 0:06:19.000 --> 0:06:21.800 that was studying the prevalence of HIV in people who 0:06:21.960 --> 0:06:25.320 used drugs in the Bay Area. Their data collection effort 0:06:25.480 --> 0:06:28.520 was centered on a neighborhood about twelve miles outside Oakland 0:06:28.680 --> 0:06:30.200 called the Iron Triangle. 0:06:31.000 --> 0:06:33.760 And it's called Iron Triangle because it's there's a triangle 0:06:33.839 --> 0:06:37.080 formed by rail lines that cut through the community. It's 0:06:37.120 --> 0:06:39.640 like a very common thing that happens to historic African 0:06:39.640 --> 0:06:43.080 American neighborhoods, where they get split up and divided by 0:06:43.480 --> 0:06:44.920 undesirable infrastructure. 0:06:45.640 --> 0:06:49.480 Blutenthal knew that racial disparities and health outcomes were structural 0:06:50.120 --> 0:06:53.840 and that if properly understood, they could be undone. By 0:06:53.880 --> 0:06:57.440 studying drug use and HIV and the Iron Triangle, he 0:06:57.480 --> 0:07:00.960 saw an opportunity to use social science to actually help people. 0:07:01.680 --> 0:07:05.600 I had an advantage in that, you know, I'm African American, 0:07:05.680 --> 0:07:09.360 so I felt comfortable working in the community and being 0:07:09.400 --> 0:07:12.880 respectful engaged with people. So I didn't come in with 0:07:12.960 --> 0:07:17.280 a lot of hard attitudes about any of it, about 0:07:17.320 --> 0:07:21.560 drug use, about HIV, and so that gave me a 0:07:21.640 --> 0:07:24.320 chance to learn and then try to be responsive to 0:07:24.360 --> 0:07:25.800 the problems people were confronting. 0:07:26.760 --> 0:07:30.400 As part of the study, the researchers administered HIV tests 0:07:30.440 --> 0:07:33.440 to lots and lots of people who used injecting drugs. 0:07:34.440 --> 0:07:36.800 At one point, it fell to Blutenthal to give a 0:07:36.840 --> 0:07:38.800 group of study participants the results. 0:07:39.320 --> 0:07:41.600 You know, I had like a series of seven or 0:07:41.640 --> 0:07:45.239 eight counseling results that I had to share, and everyone 0:07:45.360 --> 0:07:54.040 was positive, and I just started crying. Remember, you know, 0:07:54.080 --> 0:07:57.480 this was a context of you know, it was five 0:07:57.560 --> 0:08:01.640 years before we had effective treatments for HIV, so essentially 0:08:01.680 --> 0:08:06.680 we were handing what felt like death sentences. I mean 0:08:06.880 --> 0:08:11.120 it chacks me up now, you know. And it was 0:08:11.160 --> 0:08:14.200 one of those moments where you you know, your rubber 0:08:14.240 --> 0:08:17.840 meets the road, right, you know, you have to decide 0:08:19.000 --> 0:08:20.560 are you going to do something about it. 0:08:22.960 --> 0:08:25.800 What Blutenthal decided to do about it was help start 0:08:25.800 --> 0:08:29.280 a program in Oakland where people who used injecting drugs 0:08:29.320 --> 0:08:33.320 like heroin could obtain clean syringes for free instead of 0:08:33.320 --> 0:08:37.160 sharing contaminated ones with other people. It was a model 0:08:37.200 --> 0:08:40.520 that first gained traction in the Netherlands and crossed over 0:08:40.640 --> 0:08:42.520 into the United States in the mid eighties. 0:08:42.960 --> 0:08:45.640 There are some cities where groups of individuals have set 0:08:45.720 --> 0:08:47.040 up privately run exchanges. 0:08:47.320 --> 0:08:49.160 Me a heroin addict is a bad nothing. 0:08:49.400 --> 0:08:52.040 I don't really feel I want to get AIDS to say, 0:08:52.600 --> 0:08:53.880 the clean needles work for me. 0:08:55.000 --> 0:08:58.679 The premise of needle exchange was straightforward. When people who 0:08:58.720 --> 0:09:02.600 are using drugs together syringes, they end up sharing blood 0:09:03.640 --> 0:09:06.680 and if one of those people has HIV, the rest 0:09:06.840 --> 0:09:10.920 are at extreme risk for getting it to The reason 0:09:11.040 --> 0:09:14.000 so many people were sharing syringes was that they were 0:09:14.080 --> 0:09:17.200 hard to get, and the reason for that goes back 0:09:17.240 --> 0:09:20.280 to the War on drugs, which began under Richard Nixon 0:09:20.360 --> 0:09:21.600 in nineteen seventy one. 0:09:22.120 --> 0:09:26.680 America's public enemy Number one in the United States is 0:09:26.960 --> 0:09:30.679 drug abuse. In order to fight and defeat this enemy, 0:09:30.960 --> 0:09:35.040 it is necessary to wage a new, all out offensive. 0:09:35.760 --> 0:09:38.680 Nixon's offensive led to a host of new laws around 0:09:38.679 --> 0:09:41.240 the country aimed at making it harder for people to 0:09:41.400 --> 0:09:42.040 use drugs. 0:09:42.559 --> 0:09:45.160 There was a bit of a cannabis or marijuana panic 0:09:45.360 --> 0:09:48.959 in the late seventies, so the Department of Justice developed 0:09:49.120 --> 0:09:53.480 a model drug paraphernalia law that was really focused on cannabis. 0:09:53.640 --> 0:09:56.920 Marijuana has become so widespread that virtually anyone is likely 0:09:57.000 --> 0:09:58.920 to be a user upon its site. 0:09:59.000 --> 0:10:00.840 There was no such thing a safe. 0:10:00.520 --> 0:10:03.640 Marijuana, So they wanted to get rid of roach clips 0:10:03.880 --> 0:10:06.600 and shut down the smoke shops. But in the course 0:10:06.640 --> 0:10:09.520 of doing that they added other things, right, and one 0:10:09.520 --> 0:10:11.440 of those other things they added was syringes. 0:10:12.160 --> 0:10:16.360 Selling syringes became illegal in most states, and some states 0:10:16.440 --> 0:10:21.280 even banned possession before long. Syringes were extremely hard to 0:10:21.280 --> 0:10:24.480 come by, and those who needed access to them multiple 0:10:24.520 --> 0:10:29.040 times a day started sharing them with each other. Unsurprisingly, 0:10:29.400 --> 0:10:33.280 that had some major health consequences, and as heroin use 0:10:33.440 --> 0:10:36.840 rose over the course of the seventies, some injecting drug 0:10:36.920 --> 0:10:39.439 users in New York City started coming down with a 0:10:39.520 --> 0:10:44.880 respiratory disease nicknamed junkie pneumonia. Others developed a condition that 0:10:44.960 --> 0:10:48.040 was referred to as the dwindles because the people getting 0:10:48.120 --> 0:10:52.160 sick looked like they were wasting away. More recent research 0:10:52.240 --> 0:10:55.760 has revealed that these conditions were most likely caused by aids, 0:10:56.320 --> 0:10:59.240 which circulated among drug users in New York for years 0:10:59.280 --> 0:11:03.200 before crossing over into other populations. As you heard in 0:11:03.200 --> 0:11:06.559 our first episode, researchers only identified it as a new 0:11:06.600 --> 0:11:10.120 disease in nineteen eighty one, after it started showing up 0:11:10.200 --> 0:11:11.080 in gay men. 0:11:11.720 --> 0:11:15.520 In the United States, the focus was on sexual minority men, 0:11:16.160 --> 0:11:18.600 and for good reason. The problem we had then we 0:11:18.679 --> 0:11:21.760 still have a problem now, which is that people who 0:11:21.800 --> 0:11:26.439 inject drugs aren't a particularly sympathetic group, and unlike sexual 0:11:26.480 --> 0:11:30.200 minority men, they're not able to mobilize politically at the 0:11:30.240 --> 0:11:30.920 same level. 0:11:32.840 --> 0:11:36.120 The earliest needle exchange activists in the US knew that 0:11:36.160 --> 0:11:40.040 what they were doing was illegal. They were distributing drug paraphernalia. 0:11:40.640 --> 0:11:43.120 Their hope was that local governments would see the good 0:11:43.160 --> 0:11:47.080 in it and potentially even take over the exchanges themselves, 0:11:47.640 --> 0:11:50.120 but that wasn't going to happen without a struggle. 0:11:50.679 --> 0:11:53.680 Handing out needles is illegal throughout most of the country. 0:11:53.840 --> 0:11:58.040 Many people believe that keeps attics addicted. To many politicians 0:11:58.040 --> 0:12:02.680 and government officials, change sounded a lot like enabling drug use. 0:12:02.880 --> 0:12:06.160 It sends a terrible message that we are encouraging people, 0:12:06.440 --> 0:12:09.040 or we are at least accepting the fact that these 0:12:09.080 --> 0:12:11.920 people are are drug users and not doing very much 0:12:11.920 --> 0:12:12.679 to get them offer. 0:12:12.880 --> 0:12:14.240 It's almost like throwing in the town. 0:12:14.800 --> 0:12:18.280 In nineteen eighty eight, President Reagan signed a law that 0:12:18.400 --> 0:12:22.319 banned federal agencies from providing funding for needle exchange programs. 0:12:23.000 --> 0:12:26.720 Here is Reagan's Surgeon General see Everett Coop explaining the 0:12:26.760 --> 0:12:28.240 politics around the decision. 0:12:28.679 --> 0:12:32.400 It's very difficult even with people who are quite reasonable 0:12:32.520 --> 0:12:36.640 about the problems associated with AIDS, they can bring themselves 0:12:36.679 --> 0:12:40.240 to countenance a program that seems to aid and a 0:12:40.280 --> 0:12:44.560 bet an illegal and an mral practice, namely IVY drug abuse. 0:12:46.200 --> 0:12:49.120 The funding ban put a very low ceiling on how 0:12:49.160 --> 0:12:53.160 widespread needle exchange could become. According to the text of 0:12:53.160 --> 0:12:57.040 the law, the ban could be overturned, but not until 0:12:57.080 --> 0:13:00.280 there was definitive evidence that needle exchange reduced the bread 0:13:00.280 --> 0:13:06.600 of HIV without simultaneously increasing drug use. As public health 0:13:06.640 --> 0:13:11.320 experts set about conducting that research, small locally funded exchanges 0:13:11.480 --> 0:13:17.200 continued to pop up around the country. The program, co 0:13:17.280 --> 0:13:21.240 founded by Ricky Bluthenthal, was among them. In nineteen ninety two, 0:13:21.600 --> 0:13:24.000 he and his team set up shop in West Oakland, 0:13:24.440 --> 0:13:27.800 near an area where drugs were sold. They were supported 0:13:27.800 --> 0:13:31.760 by tiny grants from community organizations and sourced their supplies 0:13:31.800 --> 0:13:34.839 from another more established exchange in the Bay Area. 0:13:34.960 --> 0:13:38.000 So we just set up a table. We have educational 0:13:38.040 --> 0:13:42.800 information condoms, clean cotton, and then there'd be a big 0:13:42.840 --> 0:13:46.000 red bucket to collect the use syringes in, and then 0:13:46.040 --> 0:13:48.479 we'd have our cases of clean syringes. 0:13:49.160 --> 0:13:52.280 That was the system. Bring used syringes, toss them in 0:13:52.320 --> 0:13:54.920 the big red bucket, and leave with one clean syringe 0:13:54.960 --> 0:13:58.000 for each one you brought with you. Bluthenthal and his 0:13:58.040 --> 0:14:01.040 team distributed thousands of syringes during the first few months 0:14:01.040 --> 0:14:03.840 of the Oakland program. Through it all, they got no 0:14:03.960 --> 0:14:07.520 support from any government agency. In fact, they did their 0:14:07.559 --> 0:14:11.160 work knowing they could be arrested at any time. Until 0:14:11.200 --> 0:14:14.800 government officials at the local, state, and federal levels embraced 0:14:14.800 --> 0:14:18.760 need to exchange, that would be the status quo. Then 0:14:19.080 --> 0:14:22.520 Bill Clinton became president, and suddenly there was reason to 0:14:22.560 --> 0:14:25.760 hope that needle exchange could come out from the shadows. 0:14:26.720 --> 0:14:29.960 I was born in a little town called Hope, Arkansas. 0:14:29.960 --> 0:14:33.760 After twelve years of Reagan and Bush, many AIDS activists 0:14:33.840 --> 0:14:35.880 thought there was at least a chance that the Clinton 0:14:35.880 --> 0:14:37.680 presidency could be different, to. 0:14:37.680 --> 0:14:40.480 Change all our people's lives for the better and bring 0:14:40.560 --> 0:14:45.160 hope back to the American dream. 0:14:45.520 --> 0:14:48.520 After he was elected, Clinton took steps to signal his 0:14:48.560 --> 0:14:52.120 commitment to public health one was to task his wife 0:14:52.240 --> 0:14:56.600 Hillary with shaping his administration's approach to healthcare. Another was 0:14:56.640 --> 0:15:00.680 to nominate an unapologetically progressive doctor named Joycelyn Elders as 0:15:00.720 --> 0:15:01.520 surgeon General. 0:15:02.240 --> 0:15:06.000 I was a sophomore in colleague when I realized that 0:15:06.080 --> 0:15:07.440 I wanted to be a doctor. 0:15:08.480 --> 0:15:12.280 Growing up in rural Shawl, Arkansas, population ninety. 0:15:12.000 --> 0:15:14.160 Nine ninety eight, when I'm in little Rock. 0:15:14.600 --> 0:15:17.560 Elders didn't know anyone who was a doctor, and she 0:15:17.640 --> 0:15:20.360 got very little health education at school, you know. 0:15:20.480 --> 0:15:24.480 For I learned the most about sex education of really 0:15:24.520 --> 0:15:28.480 more about menstruation and now was from the leaflet that 0:15:28.840 --> 0:15:31.040 co Texts put in the cotext box. 0:15:32.200 --> 0:15:35.960 Elders went to medical school and became a pediatric endochronologist. 0:15:36.760 --> 0:15:39.920 In nineteen eighty seven, while Clinton was governor of Arkansas, 0:15:40.160 --> 0:15:42.560 he put her in charge of the state's Department of Health. 0:15:43.520 --> 0:15:46.480 By that point, AIDS was affecting people of color at 0:15:46.520 --> 0:15:50.200 twice the rate of white people. Black women, in particular, 0:15:50.360 --> 0:15:53.880 were twelve times as likely to contract HIV as white women. 0:15:55.520 --> 0:15:58.320 From her position in the state government, Elders tried to 0:15:58.360 --> 0:16:01.440 do something about the disparities by pushing for comprehensive sex 0:16:01.480 --> 0:16:02.800 ad and free condoms. 0:16:03.200 --> 0:16:06.040 I began called the condom Queen, and in fact I 0:16:06.160 --> 0:16:09.120 had condom tree on my desk. 0:16:09.640 --> 0:16:11.120 Wait, what's a condom tree? 0:16:11.760 --> 0:16:16.360 Well, it was a rubber tree, a tree that the 0:16:16.440 --> 0:16:19.920 nurses made for me, the public health nurses condoms of 0:16:19.960 --> 0:16:23.720 all different colors, Christmas tree, and sat in the middle 0:16:23.760 --> 0:16:25.040 of my conference table. 0:16:25.400 --> 0:16:27.480 And so you could take what if you wanted to one. 0:16:27.560 --> 0:16:29.200 No, they couldn't take them off my tree. 0:16:29.320 --> 0:16:32.360 But then there was plenty of them sitting out in 0:16:32.440 --> 0:16:35.000 the condom bow out in the office that you could 0:16:35.000 --> 0:16:39.560 just reach in and grab them. 0:16:39.720 --> 0:16:41.800 Elders made it a point to try to reach people 0:16:41.880 --> 0:16:45.200 who had been overlooked in a lot of HIV prevention messaging. 0:16:46.000 --> 0:16:48.840 She found that most of her ideas, particularly on sex 0:16:48.920 --> 0:16:53.440 ad and the distribution of condoms, were wildly unpopular in Arkansas. 0:16:53.960 --> 0:16:58.240 Anytime you're talking about sex and drugs, it's a moral 0:16:58.320 --> 0:17:01.120 issue rather than a public health issue. 0:17:01.320 --> 0:17:06.439 And that has made doctor Joycelne Elders Arkansas's most controversial woman. 0:17:06.880 --> 0:17:09.040 That wanted to tell me how God was going to 0:17:09.119 --> 0:17:11.120 strike me dead and stuff like that. 0:17:13.200 --> 0:17:14.560 This nation, not just our exult. 0:17:14.880 --> 0:17:17.560 Sex education is chronography, and. 0:17:17.560 --> 0:17:19.600 I felt that they were concerned about what they were 0:17:19.640 --> 0:17:25.040 concerned about. What I was concerned about, the young black 0:17:25.640 --> 0:17:29.439 girls that I was seeing lost in the Delta, that 0:17:29.600 --> 0:17:35.159 was being abused because of lack of education. Nothing could 0:17:35.400 --> 0:17:38.520 keep me from worrying about it and doing everything I 0:17:38.560 --> 0:17:42.360 could to make a difference. I had trouble sleeping at night, 0:17:43.119 --> 0:17:46.080 but I was determined that we were going to do 0:17:46.359 --> 0:17:47.880 something to make a difference. 0:17:49.480 --> 0:17:52.919 Governor Clinton at least seemed to appreciate Elder's willingness to 0:17:53.000 --> 0:17:57.280 dive headfirst into controversial issues, and when he became president, 0:17:57.520 --> 0:18:00.320 he once again called on her to serve in his administration. 0:18:00.680 --> 0:18:04.800 Doctor Joycelyn Elders, the former health commissioner of Arkansas now 0:18:04.880 --> 0:18:09.080 President Clinton's choyce for Surgeon General of the United States. 0:18:09.119 --> 0:18:13.760 Almost immediately, Elders became a lightning rod for scandal. A 0:18:13.800 --> 0:18:16.600 few months into her tenure, she caused a media frenzy 0:18:16.640 --> 0:18:19.600 by suggesting that the legalization of drugs could be good 0:18:19.640 --> 0:18:20.399 for society. 0:18:20.640 --> 0:18:23.240 And I do feel that we would marketly reduce our 0:18:23.280 --> 0:18:27.800 crime rate if drugs were legalized. 0:18:27.440 --> 0:18:31.680 And conservatives immediately jumped on Elders' comments. A right wing 0:18:31.720 --> 0:18:35.880 lobbying group circulated petitions to request her dismissal. Eighty seven 0:18:35.920 --> 0:18:38.680 House members signed a letter calling on Elders to resign. 0:18:39.520 --> 0:18:41.640 Rush Limbaugh mocked her on his show. 0:18:41.600 --> 0:18:45.320 Your Time Off for a Little Comic Relief, America's number 0:18:45.320 --> 0:18:50.440 one national embarrassment speaks for herself. Here's Joycelynd Elders and 0:18:50.560 --> 0:18:52.840 her theories on legalizing drugs. 0:18:53.760 --> 0:18:56.200 Here's Elders responding to the criticism at the time. 0:18:56.840 --> 0:19:01.680 Despite many of the comments and editory and reports that's 0:19:01.720 --> 0:19:05.400 been about me, I'm still grateful because you see, if 0:19:05.440 --> 0:19:08.800 I was walking around not saying anything that was at 0:19:08.840 --> 0:19:12.120 all controversial and that was all neutral, first of all, 0:19:12.160 --> 0:19:16.520 you wouldn't write about me. Secondly, if it was something 0:19:16.560 --> 0:19:20.040 that was right and simple and easy and everybody accepted 0:19:20.080 --> 0:19:24.760 it as a matter of fact, it would already be done. 0:19:26.520 --> 0:19:29.480 Legalization may have been a pipe dream, but need to 0:19:29.520 --> 0:19:32.919 exchange was at least a somewhat more realistic policy idea. 0:19:33.640 --> 0:19:36.600 To Elders, It's potential for slowing the spread of HIV 0:19:37.040 --> 0:19:37.880 was obvious. 0:19:38.119 --> 0:19:43.720 If somebody who has HIV uses the needle and then 0:19:44.080 --> 0:19:46.960 you use the same needle because she does say you 0:19:46.960 --> 0:19:51.000 can't afford to buy them, well, then you were injecting 0:19:51.040 --> 0:19:53.800 the virus into your body and you may not know 0:19:53.880 --> 0:19:56.920 that for a year, two or ten. 0:19:57.520 --> 0:19:59.040 So that was why Baby. 0:19:58.920 --> 0:20:03.960 Bolt needle exchange program, and then that reduced a lot 0:20:04.119 --> 0:20:07.000 of the HIV spread in a community. 0:20:07.960 --> 0:20:11.840 As Surgeon General Elders says, she always supported needle exchange 0:20:12.200 --> 0:20:14.720 and understood what it meant for programs to have to 0:20:14.760 --> 0:20:17.040 operate without support from the federal government. 0:20:17.720 --> 0:20:22.600 Some communities had really gotten tiny little grants, like from 0:20:22.880 --> 0:20:26.080 churches and other places, and they were passing out train 0:20:26.200 --> 0:20:28.560 needles from the trunk ofbec car. 0:20:29.640 --> 0:20:32.679 During the campaign, Bill Clinton had indicated that he was 0:20:32.720 --> 0:20:35.480 open to lifting the Reagan era funding ban on needle 0:20:35.480 --> 0:20:38.680 exchange programs, but if the model was going to win 0:20:38.760 --> 0:20:43.080 the administration's blessing, activists would need other players in Clinton's 0:20:43.119 --> 0:20:46.680 orbit to push him on it. That included Donna Shalela, 0:20:47.200 --> 0:20:49.600 Clinton's Secretary of Health and Human Services. 0:20:50.359 --> 0:20:54.760 We saw needle exchange as a mitigation strategy to reduce 0:20:55.359 --> 0:21:02.000 the incidents of AIDS and to save lives. Excuse me 0:21:03.400 --> 0:21:05.520 if I could interrupt for one moment. I've got to 0:21:05.600 --> 0:21:10.000 let him in here. He is you should know. My 0:21:10.119 --> 0:21:14.960 dog is named Fauci. Really yeah, he's a rescue dog. 0:21:15.119 --> 0:21:15.760 Hi Fauchi. 0:21:15.880 --> 0:21:17.639 When I went to pick him up, they said he 0:21:17.680 --> 0:21:20.120 had run into an Italian restaurant and he needed an 0:21:20.119 --> 0:21:24.679 Italian name, and I said, I'll call him Fauci. Tony 0:21:24.720 --> 0:21:26.080 said he'd been called worse. 0:21:28.119 --> 0:21:31.520 Before she joined the administration, Donna Shalala had been the 0:21:31.600 --> 0:21:35.440 chancellor of the University of Wisconsin. She says the job 0:21:35.520 --> 0:21:38.240 prepared her for the pressure she faced from AIDS activists 0:21:38.280 --> 0:21:39.719 as HHS secretary. 0:21:40.160 --> 0:21:43.520 I knew that we were going to be pushed by 0:21:43.840 --> 0:21:46.919 act UP and all of the groups who were in 0:21:47.000 --> 0:21:51.320 a desperate state, So that was expected as part of 0:21:51.359 --> 0:21:51.720 the job. 0:21:51.800 --> 0:21:53.200 I was a political scientist. 0:21:53.600 --> 0:21:57.879 I have been leading major research universities, so people getting 0:21:57.920 --> 0:22:01.280 into my face was something that was expected. 0:22:03.280 --> 0:22:07.960 During Clinton's first term, Salela enraged AIDS activists by suggesting 0:22:08.000 --> 0:22:10.680 that more research was needed to determine whether the Needle 0:22:10.680 --> 0:22:15.159 Exchange Funding Band should stay in place. The administration's stance 0:22:15.200 --> 0:22:17.159 on the issue became a kind of litmus test for 0:22:17.160 --> 0:22:20.320 a lot of activists, a sign that Clinton was willing 0:22:20.359 --> 0:22:23.400 to slow walk certain policies that posed a political risk. 0:22:28.480 --> 0:22:30.879 Here is a protester confronting Clinton about it at an 0:22:30.920 --> 0:22:31.400 AIDS event. 0:22:32.040 --> 0:22:36.000 There's been steps taken here advocated to be taken, like 0:22:36.080 --> 0:22:39.440 legalizing needles have been talked about for three years? 0:22:39.800 --> 0:22:43.199 Where have you been? Didn't you listen to what we 0:22:43.240 --> 0:22:44.560 said before about what we've done? 0:22:44.680 --> 0:22:45.199 Last night? 0:22:46.200 --> 0:22:49.640 Skeptics of needle exchange continued to insist there wasn't enough 0:22:49.720 --> 0:22:52.840 empirical evidence that the model worked and that it didn't 0:22:52.880 --> 0:22:56.720 result in more people using drugs, But the opposition was 0:22:56.760 --> 0:23:00.560 often about more than just data. For many, was rooted 0:23:00.600 --> 0:23:04.360 in a fundamental concern at the core of American drug policy. 0:23:05.760 --> 0:23:09.560 Agreeing to provide people with drug paraphernalia would mean acknowledging 0:23:09.600 --> 0:23:12.720 that the zero tolerance, just say no approach to drugs 0:23:12.760 --> 0:23:16.760 didn't work. It would basically mean throwing out the philosophical 0:23:16.880 --> 0:23:18.680 underpinnings of the whole drug war. 0:23:19.119 --> 0:23:22.000 There's no question that the right signal for the government 0:23:22.040 --> 0:23:24.240