Mayor Parker proposes cutting nearly $1 million in syringe exchange funding for Prevention Point

Mayor Cherelle L. Parker’s administration wants the city to cut nearly $1 million of funding to Prevention Point, a large social services organization in Kensington, as part of her promise to end the city’s financial support of programs that provide sterile syringes to people who use drugs.

Yet health experts in her own administration acknowledged that research shows syringe exchanges effectively prevent the spread of HIV and other bloodborne illnesses — and that they’re preparing for a spike in disease.

“There will be decreased syringe distribution and an increase in HIV cases as a result,” Kathleen A. Brady, the city’s director of HIV Health, said during a City Council hearing about the department’s budget Monday. Interim Health Commissioner Frank Franklin added: “We are clear and anticipate there may be some spikes, so we have plans for that.”

The news comes as Parker’s administration has placed an intense focus on ending the open-air drug market in Kensington, where sprawling homelessness, addiction, and violence driven by the drug trade have been commonplace for years. The mayor has proposed a five-phase process to address the conditions in the neighborhood, including arresting people for drug possession and prostitution.

Prevention Point last year received nearly $7.2 million in city funding for services that include operating a homeless shelter and providing health-care services to people in addiction. The city’s Health Department paid about $900,000 of that for “risk reduction services,” including Prevention Point’s syringe exchange program, the oldest and largest in Philadelphia.

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Budget documents show that Parker is proposing the city cut that $900,000.

Prevention Point declined to comment Monday. Public health researchers and physicians sharply criticized the move, pointing to research that shows syringe services reduce the transmission of infections and bloodborne diseases like HIV and hepatitis.

The Centers for Disease Control and Prevention say syringe services can reduce new cases of HIV and hepatitis C by about 50%. A 2019 study using mathematical modeling estimated that Prevention Point’s opening in 1992 prevented more than 10,000 new cases of HIV in the city over 10 years.

“This is an incredibly shortsighted, antiscientific policy,” said Ayden Sheim, an assistant professor of epidemiology at Drexel University who researches harm reduction and drug use.

But Prevention Point has proved controversial in a neighborhood where residents have for years expressed frustration with open drug use and discarded syringes on sidewalks, in the street, and littered through public spaces.

City Councilmember Quetcy Lozada, who represents parts of Kensington, advocated for the city to cut funding to the organization, saying it has “negatively affected the community.”

Parker has said that syringe exchanges are “an important part of the harm reduction strategy,” but that philanthropies or private business should fund them.

“While I’m the mayor, I will fight tooth and nail to make sure that not one city dollar is invested in the distribution of clean needles,” Parker said during her budget address last month. “We can’t afford here in the city of Philadelphia to appropriate our very scarce resources to do it.”

Sheim said in an interview that treating HIV and hepatitis costs far more than preventing it. He noted that city officials, in budget testimony, set goals to reduce new HIV infections and to eliminate new hepatitis B and C infections by January.

“It makes it very clear they’re not serious about those goals whatsoever,” he said. “Their actions are not demonstrating that they care about the health of people who use drugs.”

Syringe exchange services are illegal under state law but have operated in Philadelphia for more than three decades, since former Mayor Ed Rendell issued an executive order to allow their operations as a way to address high rates of HIV infections among people who injected drugs.

Because of that legal ambiguity, Prevention Point can’t receive state funding. And though federal funding can be used to operate syringe exchanges, it can’t pay for syringes themselves. The group’s interim lead executive officer Silvana Mazzella said in a statement last month that any loss of city funding would mean “a lifesaving program would have to be funded privately, which would be extremely challenging to do every year.”

Brady, from the city’s Health Department, said during the Council hearing Monday that the city does not expect philanthropic and private donations for syringe exchange would make up the deficit.

Ronald Collman, the director of the University of Pennsylvania’s Center for AIDS Research, said he understands Philadelphians’ concerns about the opioid epidemic and the quality of life issues it presents, and appreciates that Parker is addressing them.

But cutting funding to syringe exchanges will cause more suffering that is not limited to people with active drug addictions, he said.

“People who inject drugs don’t just associate with other people who inject drugs,” he said. “If we have an explosion of HIV in the injection drug-using population, even if you don’t care about those people, that is then going to radiate outwards into the broader Philadelphia community.”

And Maggie Lowenstein, an assistant professor of medicine at the University of Pennsylvania and an addiction medicine physician, said she often encounters patients who use harm reduction services like syringe exchange to access drug treatment and other health care.

“We really run the risk of losing ground on some of these diseases, but also losing access to an important avenue for treatment,” Lowenstein said.

Parker’s position is a departure from her predecessor, former Mayor Jim Kenney, whose administration increased city funding to Prevention Point through his eight years in office.

In 2016, Prevention Point received about $730,000 a year from the city, most of which was for syringe exchange services and other efforts to reduce HIV infection rates.

Since then, funding to Prevention Point has steadily increased through its contracts with five city departments. Its largest contract is with the Office of Homeless Services, which has paid Prevention Point more than $1.5 million per year since the 2019 fiscal year to operate a shelter.

Parker has proposed keeping funding for Prevention Point’s shelter flat compared to the current fiscal year, when it’s expected to spend $2.4 million supporting the shelter.

The administration will negotiate its $6.29 billion budget with City Council through the coming weeks, and they must come to an agreement by the end of June, when the current budget expires.

Parker is likely to see some resistance from Council on her proposed cut to Prevention Point, particularly from four progressive members who have advocated for the city to spend more on harm reduction-oriented approaches.