Emails between the mayor's office and health department officials on the subject of making crack pipes available to drug users as an HIV prevention tool reveal a city family that is fractured and overly concerned about the reaction from conservative media outlets. That's surprising given that San Francisco is not known for backing down on issues just because it might supply right-wing pundits with material to fuel their fake outrage. In fact, the phrase "San Francisco Values" has been proudly used by politicians here as a way to champion equality, fairness, and the "San Francisco way." There wouldn't have been the "Winter of Love" 10 years ago if then-Mayor Gavin Newsom had listened to then-Governor Arnold Schwarzenegger, who actually said on Meet the Press that he feared riots breaking out because gay and lesbian couples were marrying.
The city's long-standing reputation for forward thinking informed our groundbreaking response to the AIDS epidemic from the beginning. Decades ago when President Ronald Reagan wouldn't even utter the word, city leaders developed a model program that brought together practicing doctors and their patients and enlisted nonprofit agencies to fill the void with untold number of volunteers and donors.
What happened to that spirit?
We're not sure, in part because Health Director Barbara Garcia and mayoral spokeswoman Christine Falvey won't answer our questions. But ever since we broke the story last month that the HIV Prevention Planning Council expressed support for exploring the possibility of distributing small crack pipes to drug users, City Hall and the Department of Public Health have clamped down. We still haven't received a direct answer as to why Garcia and Mayor Ed Lee oppose the idea.
Without their clarification, opposition seems rooted in fears about how Fox News will report on the issue, as evidenced by Falvey's January 24 email to Garcia and other health department staffers. "Can you clear up with KPIX �" don't want any Fox News SF Headlines on this," Falvey wrote, referring to a story local station KPIX was following up on after the Bay Area Reporter's initial article. When have San Francisco leaders worried about what Fox News thought about anything? And why should this be a litmus test for public policy?
We're not talking about Golden Gate Park becoming a crack haven. We're talking about a relatively small number of drug users obtaining clean pipes to help stop transmission of the HIV virus. San Francisco already provides clean syringes to drug users �" the needle exchange program is now a routine part of the San Francisco AIDS Foundation's work and has helped countless people over the years �" and harm reduction advocates say crack pipes should be provided as well. SFAF distributes crack kits at its syringe sites, and so is already leading on the issue. While the kits don't contain a pipe, they do include sterile water, caps that can help protect people's lips, and other equipment, and are paid for with a mix of public and private dollars.
Rather than obsess over what Fox News thinks, officials should frame the issue as it is: a public health need. Preventing HIV saves the city hundreds of thousands of dollars in treatment costs. At a minimum, the HPPC should proceed with gathering data on crack pipe distribution, which has been done in other cities. Unfortunately, data isn't available on its effectiveness in these cities, so perhaps San Francisco can take the lead by developing a pilot program and tracking the data.
Previous city officials weren't afraid to try new strategies when confronted with public health emergencies. Today's leaders must be equally progressive and willing to try new programs. San Francisco has demonstrated fearlessness in the past and there is no reason to stop now.