The worldwide hepatitis and HIV/AIDS epidemics are overwhelming. Globally, 200 million people -- more than three percent of the world's population -- are infected with hepatitis C, and nearly 33 million people are reported to be living with HIV. The global situation often overshadows the need to also address these diseases domestically. An estimated 3.2 million Americans have chronic hepatitis C infections, costing the country an estimated $15 billion annually in health care costs. Approximately 8,000 - 10,000 people die every year from hepatitis C related liver disease. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. In 2006, there were approximately 19,000 new hepatitis C virus infections in this country. This number is believed to be conservative, since many Americans are unaware they are infected. An additional 800,000 to 1.4 million people are estimated to have chronic viral hepatitis B infection in the United States. This number is also likely to be an underestimate because most people who are infected do not know they have the disease until they show symptoms of illness. An estimated 1.0 to 1.2 million Americans are living with Human Immunodeficiency Virus (HIV) and/or Acquired Immunodeficiency Syndrome (AIDS). There are an estimated 56,300 new cases of HIV diagnosed in this country every year. More than 583,000 Americans have died of AIDS since 1981. In Fiscal Year 2007, total federal spending on HIV/AIDS-related medical care, research, prevention, and other activities in the United States was $23.3 billion. One of the most effective, scientifically-based methods for reducing these diseases -- needle exchange programs -- has become embroiled in politics, based on some long-held misperceptions, creating a serious challenge for the medical community and policymakers. This paper examines the scientific basis for removing existing federal restrictions on needle exchange programs.
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