Coronavirus Czar’s Record on HIV in Rural Indiana
Mike Pence’s stall on needle exchange services compounded 2015 transmission crisis
BY PAUL SCHINDLER
At a February 26 press
conference where Donald
Trump struggled
to reassure Americans
that there was little to worry about
in the emerging coronavirus crisis
— in good measure by contradicting
the federal government public
health offi cials who also spoke —
the president tapped his number
two, Vice President Mike Pence, to
spearhead federal efforts to avert a
major outbreak in the US.
But on issues ranging from
smoking risks to Planned Parenthood
funding — and nowhere more
than in his response to a sharp
spike in HIV transmissions in rural
Indiana — Pence has proved
himself no friend of sensible public
health measures.
In late 2014, when the vice president
served as governor of Indiana,
a cluster of HIV diagnoses became
evident in Scott County, a rural
area near the state’s southeast
corner. According to a study by
epidemiologists at Yale University
published in the British medical
journal The Lancet, between the
fall of 2014 and the early spring of
2015, 215 HIV infections occurred
in a county that typically saw fi ve
per year. The cause for the outbreak
was needle sharing among
injection opioid users.
Scott County was a vulnerable
locale from a public health perspective,
and not only because
it is heavily rural. According to a
Huffi ngton Post story from 2016,
the only HIV testing facility in
the county, run by Planned Parenthood,
was shuttered when the
women’s health care agency closed
its local offi ce. Two years before,
Pence, then a Republican member
of the House of Representatives,
President Donald Trump, speaking to the press in the White House Briefi ng Room on February 26, announced
Vice President Mike Pence would oversee the nation’s response to the coronavirus.
had voted to cut funding for
Planned Parenthood.
Faced with a health crisis fueled
by needle sharing, the obvious solution
was to provide clean needles
through an exchange program
such as those that had dramatically
cut HIV infection rates among
injection drug users throughout
the country.
But Pence objected to the idea.
“I don’t believe effective antidrug
policy involves handing out
drug paraphernalia,” he told the
Indianapolis Star in early 2015 as
bipartisan calls for a needle exchange
program began. Ed Clere,
a Republican member of the Indiana
House of Representatives,
was among the leading voices who
joined with public health experts
in urging the intervention.
Only when 75 of what the Lancet
found to be a total of 215 infections
had been diagnosed did Pence
➤ CORONAVIRUS & HIV, from p.4
Cuomo’s decision to exploit prison labor to push
back the imminent public health crisis presented
by COVID-19 while doing absolutely nothing
for incarcerated people across the state,”
VOCAL-NY and a slate of other organizations
WHITE HOUSE PHOTO/ D. MYLES CULLEN
change course. After speaking to
public health offi cials, including
some in New York familiar with the
effi cacy of needle exchange in curbing
infections here, Pence became
convinced of the science. He then
took two days to “pray” on the matter,
according to a 2016 New York
Times story. Finally, on March 26,
after being told by the Scott County
sheriff that needle exchange was
needed, the governor announced a
30-day needle exchange program
limited to Scott County.
Still, many in Indiana, including
the Scott County sheriff and Beth
Meyerson, co-director of the Rural
Center for AIDS/ STD Prevention
at Indiana University, even while
lauding Pence for his “fl exibility,”
said far more needed to be done
in getting resources to the county.
And Meyerson warned that with
the opioid epidemic growing, more
rural areas in the state were likely
noted in a joint written statement. “We demand
Governor Cuomo use his clemency power to
release incarcerated New Yorkers who are particularly
vulnerable to the coronavirus, including
older people, pregnant women, people with
serious illnesses and compromised immune
systems.”
HEALTH
to be hit.
In time, Indiana enacted a more
fl exible response to providing needle
exchange services, allowing localities
to demonstrate need based
on new HIV and hepatitis C diagnoses.
Clere, the GOP state representative,
told The New York Times a
year later, “It was disappointing
that it took so much effort to bring
the governor on board.”
The Lancet was more pointed in
its assessment, fi nding that initiation
of a needle exchange program
earlier could have reduced new HIV
infections in Scott County to as few
as 56, versus the 215 that the Yale
study found had occurred.
Gregg Gonsalves, a longtime
HIV activist who was one of the
Yale epidemiologists on the study
published by The Lancet, told the
Washington Post that Pence’s response
to the Scott County crisis
was “a textbook case for how not
to do it. It was a total collapse of
public health leadership and a dereliction
of duty in Indiana. They
could have avoided this epidemic
if science took the lead instead of
ideology.”
Gonsalves tweeted that appointing
the vice president to lead the
coronavirus effort “speaks to a
lack of seriousness by the White
House.”
HIV and women’s healthcare are
not Pence’s only blind spots when
it comes to public health.
In 2016 Vox reported that,
in 2000, in his fi rst run for the
House, Pence wrote, “Despite the
hysteria from the political class
and the media, smoking doesn’t
kill.” Thirty-six years before that,
the US Surgeon General’s Offi ce
published its fi rst warning that
smoking was linked to lung cancer
and heart disease.
In a particularly odd departure during a
March 10 WAMC radio interview in Albany, the
governor appeared to make light of the crisis
by taking on his 2018 Democratic primary opponent.
“What if we had Governor Cynthia Nixon today?,”
he asked before laughing.
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