Needle Exchange Programs

Introduction

In the modern era, health systems and health policies across the EU have become more interconnected than at any other time in history. This is the case because of a number of factors, including the increased mobility of patients and professionals around the EU, growing common public expectations across Europe, greater dissemination of new medical technologies and techniques, and the enlargement of the union itself. This increased interconnection raises many health policy issues, including those related to the quality of, and access to, cross-border care; information requirements for patients, health professionals and policy makers; the nature of cooperation on health matters among the member nations; and the ability to reconcile national policies with the obligations of the EU's internal concerns (Lurie, 60).

Rights to healthcare are recognized in the Charter of Fundamental Rights of the EU, and high-quality health services have become a priority issue for European citizens. The European Court of Justice has made it clear that treaty provisions on free movement apply to health services, regardless of how they are organized or financed at the national level. However, many health-care stakeholders have asked for greater clarity with regard to what community law means as it applies to health services. The European Commission therefore continues to develop a community framework for safe, high quality and efficient health services by reinforcing cooperation between member states and by ensuring equal application of Community law to health services and healthcare (Heinzerling, 67).

Discussion

In general, the commission sets the standard for health functions based on a foundation of legal certainty and the pledged support of member states. Legal certainty is critical tenet of the process as it serves to significantly boost the confidence of citizens as well as national and local health professionals. Across Europe, there has traditionally been a need to address the wider application of European Court of Justice rulings regarding treaty provisions on the free movement of patients, professionals and health services. This focuses in particular on cross-border care, although cross-border care has consequences for all health services, whether provided across borders or not. Of equal import is the support for member states in areas where European action can add value to national action on healthcare services (Bluthenthal, 38).

Needle exchange programs (NEPs) consist of two components: (1) the collection and safe disposal of used syringes and (2) the provision of sterile syringes to individuals. NEPs were developed to prevent the spread of human immunodeficiency virus (HIV) and viral hepatitis (HBV and HCV) among injection drug users (IDUs), most of whom inject heroin, methampheta-mine, or cocaine. NEPs prevent the spread of HIV, HBV, and HCV by removing from circulation potentially contaminated syringes and replacing them with sterile syringes. Most NEPs also provide other disease prevention supplies, such as condoms; infectious disease testing and counseling; and access to other medical and social services, including substance abuse treatment. NEPs can operate in a variety of settings, including pharmacies, street and alley sites, mobile vans, substance abuse treatment centers, and hospitals (Drucker, ...