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Jacques Chirac, the right-wing mayor of Paris, came under increased
pressure last week to allow automatic syringe dispensers to be installed
in some parts of the city in an attempt to stem the spread of HIV among
drug users. Chirac has stubbornly refused to allow syringe dispensers in
Paris, despite the fact that pilot programmes with the machines in other
towns are proving successful. About half of the intravenous drug users in
France live in or around Paris.

Last week, Simone Veil, minister for Social Affairs, announced a new
programme to fight the spread of HIV and other diseases among drug users.
The programme is the government’s response to criticism that France is trailing
behind other European countries in this area. Estimates of the number of
intravenous drug users in France range from 100 000 to 300 000, of whom
25 to 30 per cent are HIV positive and 70 per cent have hepatitis C.

Included in Veil’s programme is a plan to make clean needles more widely
available. Kits containing two needles, alcohol-soaked cotton swabs, sterile
water for injection – and a condom – will be sold in pharmacies from September
at 5 francs a kit.

Many pharmacies refuse to sell needles or make it difficult for drug
users to buy them by selling only in bulk. The programme includes training
for pharmacists in how to deal with drug addicts. The government also intends
to change the law to break the monopoly pharmacies have on sales of syringes.
This means that groups such as Medicins du Monde, which run needle exchange
programmes, will no longer be breaking the law.

But this still leaves the problem of how to make clean needles available
late at night and at weekends when pharmacies and needle-exchange centres
are closed. Veil says dispensers are a ‘simple’ solution to the problem.
Mayors who oppose the idea ‘can be convinced’, she adds.

A spokeswoman for Chirac stresses that the city remains opposed to the
machines. They ‘dehumanise’ the problem, and drug users miss out on badly
needed contact with medical staff, she says. She also says the health risks
would be ‘colossal’ if used needles were thrown onto the street rather than
being exchanged for new ones.

Alain Tyrode, medical director of health services in the Paris suburb
of Gennevilliers, rejects this argument. ‘It’s hypocritical to think it
is more humane to sell needles in pharmacies. Drug users rush in, make their
purchase and leave,’ he says.

Gennevilliers, home to a large number of heroin addicts, installed its
first automatic needle dispenser five weeks ago. It will fit four more by
October. The first dispenser is next to a pharmacy where needle kits are
available during working hours. A token is given with every kit. When the
shop closes, the dispenser is switched on. It accepts one token in exchange
for a clean needle.