Gov. Mike Pence had a lot on his mind late last week as he tried to deflect criticism and defend his position on the controversial “religious freedom” bill he signed into law.

But it’s important not to overlook the importance of a comment he made on an unrelated matter during a Thursday press conference: “This is not a Scott County problem. This is an Indiana problem.” 

His topic was the unprecedented outbreak — now epidemic — of new cases of HIV infections in Scott County, population 24,000, in southeastern Indiana. That county’s tiny town of Austin, population 4,200, dissected as it is by the Florida-to-Chicago Interstate 65 and the masses of people and commerce that pass through and the economic good times that pass it by, made international news last week as it was declared the epicenter of a rapid rise in HIV cases never before seen in Indiana, or perhaps anywhere else. Its image was encapsulated in pictures of discarded syringes cradled in the grass, cast away by IV drug users, whose needle sharing has produced this major public health crisis.

Pence overrode a long-held political position and gave in to the medically accepted way to battle the epidemic: Distributing clean needles to IV drug users as an alternative to those drug users’ spreading infection by sharing needles to get high from the drug Opana.

“I do not support needle exchange as an anti-drug policy,” Pence said, rejecting assertions that clean needles are instead an anti-disease strategy, an anti-death strategy, and that the current emergency demands immediate remedy that clean needles can bring. Or so say the doctors at the Centers for Disease Control and Prevention and at least two medical professionals in the Scott-Clark county area.

Some may see distributing clean needles as coddling users, enabling their addictions. Instead, it can enable drug users’ recovery, as pie in the sky as that sounds. Coming to get clean needles forces users to see doctors and get treatment for HIV or other diseases. And if the user wants out — the doctor can help find a way out. Clean needles can stop the infections where they are. So say the doctors.

Pence’s emergency order to allow clean needles for 30 days in Scott County is a step in the right direction. But it also is a step that needs a longer and larger footprint and is one the state should have taken earlier.

The situation in Scott County should not have surprised Pence’s administration or its health department. In July 2012, USA TODAY reported that — already that year — 13 people in Scott County had died of drug overdoses, many involving Opana, the drug of choice involved in the current epidemic. The same drug was implicated in 19 drug overdose deaths in the tiny county.

The importance of a longer footprint on needle exchanges is that turning the epidemic around will take more than 30 days. Pence is limited by law from initially ordering more than 30 days, but he could have — should have — said that he is prepared to re-issue 30-day orders as long as it takes to get the problem under a manageable control.

The larger footprint is that counties other than Scott need to be part of needle exchange plan. 

As infection and death numbers show, Clark County, just to Scott’s south, had 12 new cases of HIV in 2014, had 292 people living in that county with HIV and had suffered 99 deaths from HIV since 1981, which would make it 11th most in the state. 

Infection does not know county lines. I-65 from Louisville to Indianapolis passes through nine counties and has more than 20 interstate exits, which provide ready access to illicit drugs and to illicit sex — maybe both from prostitutes at truck stops. One prostitute told health officials that she had sex with as many as 50 men before learning she was infected with HIV.

In fact, clean-needle programs should be set up several counties — perhaps even the top 10 in terms of new cases in 2014 and of persons living with HIV. Vigo County would be on that list: It had 11 new cases last year (sixth highest in the state) and had 274 HIV-positive residents. And in 1981-2014, Vigo had 147 deaths from HIV (fifth highest in the state).

Pence remains adamant, however, in his position on needle exchanges, saying he will veto any bill that comes to him with a wider approval for clean-needle programs. Such an amendment is likely to be offered at the Statehouse this week.

Ultimately, we hope the governor sets aside his political position and listens to the doctors who are trying to arrest this public health emergency. Hard-line politics can’t stop this epidemic. Perhaps an aggressive strategy embraced by medical professionals can.

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