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Trump nominates needle exchange advocate for US Surgeon General
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President Donald J. Trump has nominated Jerome M. Adams, MD, MPH, who has advocated for needle exchange programs, to be the next U.S. Surgeon General.
Adams has served as Indiana State Health Commissioner since 2014 and held the position when then-Indiana Gov. Mike Pence, now the U.S. vice president, authorized a needle exchange program to stop an HIV and hepatitis C outbreak in the southern part of the state that was primarily linked to IV drug use of opioids.
Michael Fraser, PhD, executive director of the Association of State and Territorial Health Officials, called Adams “a true public health leader.”
“Dr. Adams understands the health care landscape, has first-hand experience dealing with serious public health issues, and will be a strong advocate for state public health, bringing a unique and valuable set of skills to the nation’s health care system,” Fraser said in a statement.
Pence reportedly struggled over his decision in March 2015 to allow a needle exchange program to help contain an unprecedented HIV outbreak in Scott County. Adams said Pence “wanted to make sure if he went this route it was absolutely necessary.”
“I believe he was praying on it up until the final decision,” Adams told The New York Times last year.
Just days before his nomination this week to be surgeon general, Adams penned an editorial in which he discussed the benefits of needle exchange programs, which he said save lives and money.
According to Adams, since 2015, 219 people in Scott County have been diagnosed with HIV, including 95% who are coinfected with HCV. He said the toll would be worse if not for the needle exchange program.
“Syringe exchanges aren’t pretty. They make people uncomfortable. But the opioid epidemic is far uglier,” Adams wrote in the editorial, which was published June 22.
Adams said studies have shown that needle exchange programs decrease rates of drug use and that the program in Scott County led to significant reductions in injection-related risky behaviors.
“We need every tool at our disposal to fight this epidemic,” he wrote. “No matter how uncomfortable syringe service programs make us, they are proven to save lives, both by preventing the spread of diseases like HIV and hepatitis C and by connecting people to treatment that can put them on a path to recovery.”
According to his biography on the Indiana State Department of Health website, Adams has been invited to testify before both houses of Congress and has been a presenter or participant in health care discussions at the White House, CDC, HHS and the National Academy of Sciences. If he is confirmed by the U.S. Senate, he would serve a 4-year term as surgeon general.
“As Indiana State Health Commissioner, Dr. Adams has advocated strongly for physicians to play a leading role in reining in the opioid epidemic, fought to reduce infant mortality, and pushed for a needle exchange program to tackle his state’s HIV outbreak," the AMA said in a statement. “Dr. Adams, an AMA member, will bring unique experience and energy to this office. We look forward to his prompt consideration by the Senate.”
The Trump administration asked the previous surgeon general, Vivek H. Murthy, MD, MBA, to resign in April. Rear Admiral Sylvia Trent-Adams, PhD, RN, has been serving as acting surgeon general since Murthy’s departure. – by Gerard Gallagher
References:
Indiana State Department of Health. Indiana syringe services programs save lives, money. 2017. http://www.in.gov/isdh/files/ADAMS%20SYRINGE%20.pdf. Accessed June 30, 2017.
The New York Times. Mike Pence’s response to HIV outbreak: prayer, then a change of heart. 2016. https://www.nytimes.com/2016/08/08/us/politics/mike-pence-needle-exchanges-indiana.html?mcubz=2&_r=0. Accessed June 30, 2017.
Perspective
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Andre Melendez, MD
As Indiana’s health commissioner, Dr. Adams’ advocacy of syringe exchange programs (SEPs) has been instrumental in curtailing not only the HIV epidemic in Scott County, but also in preventing infections statewide by the implementation of programs across eight counties. His evidence-based approach highlights that SEPs save lives by preventing transmission of diseases like HIV and HCV and by increasing access to health care. As nominee for U.S. Surgeon General, we hope that he will continue his support of SEPs.
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