US Politics

BooksMisfire review: a bullseye from Tim Mak – but the NRA isn’t beaten yet The NPR reporter has written an important book about the moral bankruptcy which put the powerful and merciless gun group on the back footCharles KaiserSat 6 Nov 2021 02.00 EDTLast modified on Sat 6 Nov 2021 02.02 EDTTim Mak has written a sprawling tale of the greed, incompetence and narcissism which has dominated the National Rifle Association throughout Wayne LaPierre’s 30 years as its leader. Abetted by his wife, Susan, LaPierre has allegedly used his members’ dues to fund a billionaire’s lifestyle.‘We have to break through that wall’: inside America’s battle for gun controlRead moreThe LaPierres’ wedding in 1998 was a near miss: he almost ran from the altar, until she and the priest changed his mind. Mak calls this “emblematic” of “a man driven by fear and anxiety over all other forces … his reaction to these emotions is usually to flee and hide”.These qualities, Mak writes, have made LaPierre “prey” to an endless series of conmen, throughout his leadership of America’s most-feared lobbying group.“Pushed and prodded” by his wife to discover “money’s alluring glow”, Mak writes, LaPierre saw his salary balloon from $200,000 in the mid-1990s to $2.2m in 2018. According to the investigation of the New York attorney general, which has done the most to expose serial excesses at the NRA, between 2013 and 2017 the black cars, private jets and hundreds of thousands of dollars of expensive clothing led to $1.2m in reimbursed expenses.Between 2013 and 2018, companies used to book the LaPierres’ private planes received an astonishing $13.5m. There were trips to Lake Como, Budapest and the Bahamas. Just the hired cars for trips to Italy and Hungary cost $18,000. LaPierre spent $275,000 on suits at a single Beverly Hills emporium, including $39,000 on one day in 2015. To disguise such excesses, the bills were sent to an outside vendor which the NRA reimbursed.Mak also does a good job of describing how every mass shooting has pushed the NRA ever further right, transforming it from advocacy group for gun rights into a fully fledged player in the culture war, especially after the massacre of 20 young children and six adults at Sandy Hook Elementary School in Connecticut in December 2012.Mak offers a particularly depressing account of how the NRA chief lobbyist, Chris Cox, was personally involved in negotiations over the Manchin-Toomey bill, a Senate measure which would have modestly increased background checks if, as Mak points out, not enough to have prevented the Sandy Hook massacre, since that gunman used guns legally obtained by his mother.In any case, after months of negotiation the NRA double-crossed both sponsors, made sure the bill failed to get the 60 votes it needed to pass the Senate, then dropped its A-ratings for Manchin and Toomey to D and C respectively.The NRA’s role in the Trump-Russia scandal was substantial. Maria Butina, eventually convicted as a Russian spy, used “relationships within the NRA to build an informal channel of diplomatic relations with Russia”. Her efforts included a famous public exchange with Donald Trump during his first campaign, in which he expressed his affection for Vladimir Putin and promised to improve relations as president.The NRA spent $30m to help to elect Trump, more than his own fundraising super pac. Ironically, NRA membership dues fell after Trump entered the White House. The organization lost its most lucrative fundraiser when Barack Obama left office.Power struggles and a ‘personal piggy bank’: what the NRA lawsuit allegesRead moreThe great unravelling began on 6 August 2020, when the New York attorney general, Letitia James, filed a lawsuit to dissolve the NRA entirely. She accused LaPierre of using the organization for 30 years “for his financial benefit, and the benefit of a close circle of NRA staff, board members, and vendors”.Six months later, the NRA filed for bankruptcy. But despite endless infighting, Wayne LaPierre remains in charge. And because Trump was elected, with the NRA’s help, the supreme court now includes three justices appointed by him – at least two of whom seemed eager in arguments this week to demolish most of the remaining state restrictions on carrying concealed weapons, in New York and six other states.The passions of gun owners – and the fear they have instilled in a majority of public officials – remain dominant forces in American politics despite the greed and incompetence of their leaders chronicled so thoroughly in this important book.
Misfire is published in the US by Dutton
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US politicsSetback for Biden as Democrats delay vote on sweeping investment planModerates want more details before reconciliation bill advancesPelosi signals she has votes to pass bipartisan infrastructure bill Lauren Gambino in Washington and Adam Gabbatt in New YorkFri 5 Nov 2021 16.43 EDTFirst published on Fri 5 Nov 2021 09.27 EDTDemocrats on Friday once again postponed a vote on the centerpiece of Joe Biden’s economic vision, after lobbying by the president and House leaders failed to persuade a small group of moderates to support the spending package without delay.Despite the setback, the House Speaker, Nancy Pelosi, said she planned to plow ahead on the bipartisan infrastructure bill, another key pillar of the president’s legislative agenda, indicating she had the votes to overcome resistance from progressives who want to pass it in tandem with the social policy and climate mitigation spending package.“We had hoped to be able to bring both bills to the floor today,” Pelosi said at an impromptu news conference on Friday, after a day of frenzied negotiations appeared unlikely to break an impasse over Biden’s agenda.But Pelosi insisted the House was on the cusp of breakthrough that would not only send the infrastructure bill to Biden’s desk, notching a much-needed victory, but would move the party a “major step” closer to approving the social policy package.“We’re in the best place ever, today, to be able to go forward,” she said.A plan to advance both Biden’s social and environmental spending package and a smaller bipartisan public works measure was upended amid pushback from moderates demanding an official accounting of the spending bill.As tensions escalated, Pelosi proposed a new strategy, announcing in a letter to Democrats that the House would hold two votes on Friday: one on the infrastructure measure and a procedural vote related to the spending package.But that plan was thrown into jeopardy by progressives, who had for months said they would not vote for the infrastructure bill without a simultaneous vote on the spending package. That position derailed two previous attempts to advance the infrastructure bill first.The scrambled timeline deflated hopes of giving Biden a much-needed legislative accomplishment after months of false starts and electoral setbacks this week.Biden and party leaders have worked furiously to reach a consensus on the spending bill, which seeks to combat the climate crisis while reforming healthcare, education and immigration, all paid for by raising taxes on the wealthiest Americans and on corporations. With razor-thin majorities, they need the support of every Democratic senator and nearly every House Democrat.Centrist lawmakers want to see an independent cost analysis from the non-partisan Congressional Budget Office before voting on the $1.85tn package – which could take several days or even weeks.In a statement, Washington congresswoman Pramila Jayapal, chair of the Congressional Progressive Caucus, signaled that her members had not softened their position on advancing the bills together.“If our six colleagues still want to wait for a CBO score, we would agree to give them that time – after which point we can vote on both bills together,” she said.Biden urges ‘every House member’ to support agenda ‘right now’ as crucial vote nears – liveRead moreNegotiations have seen the initial Biden spending proposal nearly halved from $3.5tn, with many provisions pared back or dropped entirely.Touting a strong monthly jobs report on Friday, Biden implored House Democrats to “vote yes on both these bills right now”, arguing both pieces of legislation were critical to economic recovery.“Passing these bills will say clearly to the American people, ‘We hear your voices, we’re going to invest in your hopes,” Biden said.After his remarks, the president said he was returning to the Oval Office to “make some calls” to lawmakers.Pelosi worked furiously on Thursday to pave the way for a vote before lawmakers leave Washington for a week-long recess, whipping members on the House floor and keeping them late into the night in an effort to shore up support for legislation which runs to more than 2,000 pages.Democrats suffered a series of stinging electoral setbacks this week, including losing the governorship of Virginia and being run to the wire in New Jersey.Major legislative victories will, leaders hope, help regain momentum and improve electoral prospects ahead of next year’s midterm elections.With unified Republican opposition, House Democrats can lose no more than three votes. If passed, the spending bill will go to the 50-50 Senate, where it will face new challenges. Two centrist Democrats, Joe Manchin and Kyrsten Sinema, have already thwarted many proposals and are expected to have further objections.House passage of the $1.2tn infrastructure bill to upgrade roads, bridges, waterways and broadband, which has already passed the Senate with the support of 19 Republicans, would send the measure to the president’s desk.The $1.85tn spending package would provide large numbers of Americans with assistance to pay for healthcare, raising children and caring for elderly people at home. There would be lower prescription drug costs and a new hearing aid benefit for older Americans, and the package would provide some $555bn in tax breaks encouraging cleaner energy and electric vehicles, the largest US commitment to tackling climate change.House Democrats have added other key provisions, including a new paid family leave program and work permits for immigrants.Much of the cost would be covered with higher taxes on those earning more than $400,000 a year and a 5% surtax on those making more than $10m. Large corporations would face a new 15% minimum tax.
The Associated Press contributed reporting
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OpinionUS politicsThe real lesson of the election results? Democrats must go big and boldAndrew GawthorpeCentrist Democrats may use electoral setbacks to try to water down the party’s legislative plans. That would be a big mistake Fri 5 Nov 2021 06.23 EDTLast modified on Fri 5 Nov 2021 15.56 EDTDemocrats this week suffered a stinging rebuke in elections up and down the country. The damage was most notable in Virginia, where Republican Glenn Youngkin won a state that Joe Biden carried by 10 points just a year ago. But there were warning signs elsewhere, too – from the party’s eroding support in the southern suburbs of New Jersey to its still-declining fortunes in Hispanic areas of south Texas, where Republican John Lujan flipped a heavily Hispanic state legislative district which Biden won by 14 points last year.Although depressing, these results are not entirely surprising. Even as Biden triumphed in the 2020 presidential election, there were ample signs that the suburban voters who propelled him to victory were keeping their options open. Democrats won the presidency, but declining suburban support nearly cost them the House of Representatives. In the Senate, they fought Republicans heroically but unsatisfyingly to a standstill, splitting the chamber 50/50. Voters rejected Trump, but they seemed not to want to pass complete control of government to his opponents, either.These latest results confirm that not much has changed since, and Democrats have only themselves to blame. They have enjoyed unified control of the federal government for a year, but have spent their time trapped in negotiations with one another over a pair of legislative packages covering infrastructure, climate and social welfare. Even seasoned pundits find the process confusing and opaque and, for the busy ordinary voter, the problem is multiplied tenfold. At a time when the coronavirus and its associated scourges – inflation, joblessness and parental panic over their children’s education – are still stalking the land, the party is struggling to break through because it’s too busy talking to itself.There’s a risk that Democrats – or, more precisely, one faction of them – react to this week’s results in a way that makes the problem even worse. Already, “moderate” senators Joe Manchin and Kyrsten Sinema have been the main roadblock to Democrats passing large, popular social welfare bills. They are backed, though more quietly, by other senators and House members who fear that the party will be punished if its agenda becomes too bold and too progressive. If moderates decide that this week’s results represent the beginning of just such a backlash, they may force the party to abandon its plans and retreat into a defensive crouch.This would be an enormous mistake. If Democrats are to reverse their fortunes, they have to be bold and rack up big accomplishments. Rather than backing off expansive legislation, they should double down on it. If Democrats pass an ambitious package to fight poverty, expand healthcare, assist families with childcare expenses, and introduce paid family and medical leave, there will be no mistaking what they stand for. Republicans, meanwhile, will be left arguing against programs that are standard throughout the developed world and – more importantly – popular in the United States as well.Nor is there much reason to believe that Democrats’ recent electoral setbacks resulted from being too progressive. Although a socialist candidate for Buffalo mayor lost out to her moderate rival and a police reform measure failed in Minneapolis, these results reveal nothing about the popularity of the party’s mainstream economic agenda. Democrats struggled not because they appear too progressive, but because, after months of infighting, they don’t appear to stand for anything.The need to move quickly and boldly is underlined by looking at the other factors that are draining the party’s support. The first is inflation, where the party’s plans to expand the social safety net in the future don’t do much to help voters struggling with rising prices right now. Although economic policymakers expect this period to pass relatively quickly, there is little the White House can do to address the fastest price increases in a generation. Even worse, the policymakers might be wrong, leaving Americans still struggling as the midterms approach. Their inability to do much about inflation increases the party’s need to act elsewhere if it is to demonstrate that it can deliver concrete improvements in people’s economic situation.Finally, the outsized role played in the Virginia election by concerns about the teaching of so-called critical race theory in schools is another reason Democrats badly need to change the conversation. As the party has retreated into bickering among itself, the political debate has become increasingly dominated by hyped-up culture war issues to which Democrats struggle to respond.It may be true that concerns about critical race theory are mainly a form of manufactured outrage designed to activate white grievance, but describing them as such doesn’t seem to be a winning political strategy. Even as the party crafts a new message about school curricula which disassociates it from the warped image put forward by the right, it also needs a more concrete response – one that emphasizes how the party is investing in the nation’s schools and families, including through improved access to childcare and paid family leave.But to do that, they need to actually pass the legislation that will create these programs. The painful truth Democrats have to face is that, to many voters, even imaginary claims about critical race theory feel more real right now than the social welfare programs being debated in Congress. To flip that calculus and show that Democratic governance can benefit the country while the culture war is designed to hold it back, Democrats have to be big and bold. Otherwise, they – and, given the Republican party’s extremist turn, the country – are in serious trouble.
Andrew Gawthorpe is a historian of the United States at Leiden University, and host of the podcast America Explained
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OpinionUS politicsIf Americans can’t have basic things like childcare, our democracy is a shamDavid Sirota and Andrew PerezCorporate influence and corruption defines American politics. No wonder most think the country is headed in the wrong direction Fri 5 Nov 2021 06.22 EDTLast modified on Fri 5 Nov 2021 13.28 EDTIn 2014, Northwestern and Princeton researchers published a report statistically documenting how lawmakers do not listen or care about what most voters want, and instead mostly care about serving their big donors. Coupled with additional research documenting the discrepancy between donor and voter preferences, they bluntly concluded that the “preferences of the average American appear to have only a minuscule, near-zero, statistically nonsignificant impact upon public policy”.Seven years later, America is witnessing a very public and explicit illustration of this situation in real time – and the country seems pretty ticked off about it, in the lead-up to Tuesday’s off-year elections and in advance of the upcoming midterms next year.Over the last few weeks, Joe Biden and Democratic lawmakers have been making headlines agreeing to whittle down their social spending reconciliation bill at the demand of corporate donors and their congressional puppets.The specific initiatives being cut or watered down in the Biden agenda bill share two traits: 1) They would require the wealthy and powerful to sacrifice a bit of their wealth and power and 2) They are quite literally the most popular proposals among rank-and-file voters.New polling demonstrates the silencing effect that systemic corruption is having on voter preferences:
82% of registered voters support adding dental and vision benefits to Medicare – and this is voters’ “top priority” for Democrats’ social spending bill, according to survey data from Morning Consult. Conservative Democratic senators Joe Manchin of West Virginia and Kyrsten Sinema of Arizona have pushed to keep these benefits out of the bill, following an aggressive lobbying campaign by health insurers who enjoy massive profits from the privatized Medicare Advantage program.
Another top priority for voters is allowing Medicare to negotiate prescription drug prices, with 72% saying they support the idea, according to Morning Consult. Sinema and a few House Democrats backed by the pharmaceutical industry managed to block the party’s original drug pricing measure from being put into the reconciliation bill. On Tuesday, Democrats announced they had reached a deal on a drug pricing plan, which Politico described as “far weaker” than Democrats’ promised legislation. One industry analyst said the deal “seems designed to let legislators claim an achievement while granting pharma protection”.
The poll also found that 70% of voters support including paid family and medical leave for new parents in Democrats’ spending bill. Manchin has demanded this item be cut.
After railing against the Republicans’ 2017 tax law for years, Democrats have largely refused to raise taxes on corporations and the wealthy, and their final bill may even end up being a net tax cut for the rich. This, even though Biden’s own pollsters found that raising taxing on the wealthy was “the most popular of more than 30 economic proposals” they tested during the 2020 presidential campaign.
The flip side of all this also appears to be true – Democrats have protected initiatives to enrich powerful corporations, even though some of those measures aren’t very popular. One example: subsidies for health insurance plans purchased on the Affordable Care Act (ACA) marketplace that shower money on for-profit insurers. Morning Consult reports that extending new ACA premium tax credits passed by Democrats in March “is the lowest-ranking of all the health measures included in the poll”.The results of this latest middle finger to voter preferences? New polling data shows that almost three-quarters of Americans now think the country is headed in the wrong direction.Taken together, this is the democracy crisis thrumming underneath all the media noise – the day-to-day erosion of democracy by corporations that use a system of legalized bribery to buy public policy, which then erodes Americans’ faith in their government. And yet this erosion does not get discussed in a media-directed democracy discourse that focuses almost exclusively on the 6 January insurrection or Republican efforts to deny election results and limit voting.This is what my 2006 book called the “hostile takeover”: the conquest of democratic institutions by moneyed interests, to the point where “the world’s greatest democracy” routinely rejects the commonsense policies that the vast majority of voters want and that every other high-income country has already adopted.The hostile takeover is not just the rejection of the most popular policies – it is also the media discourse itself. The Washington press is constantly portraying industry-sponsored opponents of majoritarian policies as “moderates” or “centrists” and depicting supporters of those policies as fringe lunatics who refuse to be reasonable and compromise.Meanwhile, there is a pervasive omertà that silences most media discussion of the corporate influence and corruption that so obviously defines American politics – and there is scant mention that the “moderate” obstructionists are bankrolled by the industries lobbying to kill the popular policies that Americans want.There is some encouraging proof that more and more Americans innately understand the kleptocratic nature of their government, and want explicit accountability journalism to uncover it. Also mildly encouraging is the impact of that reporting in the reconciliation bill battle: Democrats tried to get rid of all the drug pricing provisions, but were successfully shamed into adding at least a few of the (pathetically weak) provisions back in after independent media aggressively exposed the pharma ties of key lawmakers.It’s not a huge victory and not worthy of some effusive celebration of Democrats because the provisions are watered down and a betrayal of the party’s promise to do something a lot better. But it’s a minimal proof-of-concept win.It may at least get the idea of Medicare negotiating drug prices into law for the first time. And as important, it shows that when there is a robust press willing to challenge power, the government can be forced – kicking and screaming – to respond, or at least pretend to respond.It’s going to take a whole lot more of that kind of reporting and a whole lot more movement pressure to secure real wins and beat back the hostile takeover.The silver lining here is that at least that takeover is now explicit. The polls showing what people want compared to what’s being excised from the reconciliation bill make this part of the democracy crisis impossible to deny – and ending that denial is a prerequisite for achieving something better.
David Sirota is a Guardian US columnist and an award-winning investigative journalist. He is an editor-at-large at Jacobin, and the founder of the Daily Poster. He served as Bernie Sanders’ presidential campaign speechwriter
Andrew Perez is a senior editor at the Daily Poster and a co-founder of the Democratic Policy Center
This article was originally published in the Daily Poster, a grassroots-funded investigative news outlet
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CaliforniaCalifornia town declares itself a ‘constitutional republic’ to buck Covid rulesOroville’s city council adopted a resolution stating it would oppose state and federal orders that it deems to be government overreach Dani Anguiano in Los Angeles@dani_anguianoFri 5 Nov 2021 06.00 EDTLast modified on Fri 5 Nov 2021 10.00 EDTA northern California town has declared itself a “constitutional republic” in response to Covid-19 health restrictions imposed by the governor, in the latest sign of strife between the state’s government and its rural and conservative regions.The city council in Oroville, located at the base of the Sierra Nevada foothills about 90 miles from the capital of Sacramento, adopted a resolution this week stating it would oppose state and federal orders it deems to be government overreach.Oroville leaders said the designation was a way of affirming the city’s values and pushing back against state rules it doesn’t agree with, although a legal expert said the designation was merely a gesture and did not grant the city any new authority.Religious exemptions threaten to undermine US Covid vaccine mandatesRead moreTensions have existed throughout the pandemic between the rural north and California’s leadership, which has been among the first to implement lockdowns, mask mandates and vaccination requirements.In Butte county, fierce opposition to Covid lockdowns and school closures drove support for recalling the state’s governor, Gavin Newsom, with 51% of voters in the county backing the ultimately failed effort. Newsom’s policies, however, appear to have worked and the state had the lowest Covid infection rate in the US last month.Last year, Oroville refused to enforce state requirements prohibiting indoor dining. Butte county, where Oroville is located, declined to recommend a mask mandate earlier this fall, even as cases surged and a a local medical center reported treating more patients than at any other point during the pandemic.Before passing the resolution, council members argued they were taking a stand and advocating for residents to make their own health choices.“I assure you folks that great thought was put into every bit of this,” the city’s mayor, Chuck Reynolds, said. “Nobody willy-nilly threw something to grandstand.”But the city’s declaration does not shield it from following federal and state laws, said Lisa Pruitt, a rural law expert at the University of California, Davis, who said it was not clear what the designation meant.“A municipality cannot unilaterally declare itself not subject to the laws of the state of California,” Pruitt said. “Whatever they mean by constitutional republic you can’t say hocus pocus and make it happen.”Leaders in the city of 20,000 say the resolution is an effort to push back against state government and affirm the city’s values and commitment to the constitution. Oroville drafted its resolution from scratch after not finding any examples of other cities with similar resolutions, said Scott Thomson, the city’s vice-mayor.“I proposed it after 18 months of increasingly intrusive executive mandates and what I felt to be excessive overreach by our government,” said Thomson. “After the failed recall in California, our state governor seems to [be] on a rampage and the mandates are getting more intrusive. Now he’s going after our kids and schools.”The majority of speakers at the Oroville city council meeting expressed their support for their resolution – applauding its introduction and calling council members “heroes” – with several specifically citing the state’s vaccine requirement for schoolchildren.“We’re hoping that becoming a constitutional republic city is the best step in order to regain and maintain our inalienable rights protected by the constitution of the United States. What will be left if we don’t have that? if we don’t have bodily autonomy?” one speaker said in tears. “What else are they gonna want me to let them do to my kids? Where does it stop?”The resolution does not affect local schools, which fall under the purview of the school district, Thomson said, but is a way for the community to declare it will not use city resources to implement state rules it does not agree with. “We’re not ignorant that there are serious issues at hand, we just do not agree with the way it’s being handled.”One council member argued that mandates were “political theater” and that the immune system is the best defense against disease. The best protection against against Covid-19 is vaccination – Butte county has a vaccination rate of 48%, according to New York Times data.The council approved the resolution by a 6-1 vote on Tuesday, even as one member who voted in favor of it warned residents it had “no teeth” and was a “political statement”.The city’s efforts tap in to a common sentiment in rural northern California that the region is ignored, but also over-governed by the state, Pruitt said. Signs for the state of Jefferson, a movement to secede from California, are common here. But, Pruitt says, the city’s gesture does not grant it more power or the ability to ignore state law.“It seems to make the people of Oroville feel better that their city council has made this gesture but as a practical matter it doesn’t make any difference,” Pruitt said.TopicsCaliforniaCoronavirusUS politicsGavin NewsomnewsReuse this content More

Biden administrationCritics say Biden’s drug czar pick at odds with push for ‘harm reduction’ policiesConcern over role Rahul Gupta played in shutting down West Virginia’s largest syringe service program in the state’s capital Kyle Vass in West VirginiaFri 5 Nov 2021 05.00 EDTLast modified on Fri 5 Nov 2021 05.02 EDTJoe Biden is on record as the first US president to embrace a concept known as “harm reduction” – a public health approach that aims to mitigate harm done by drug use instead of the traditional just-say-no-ism of past administrations.Administration officials have said last week that the federal government will now support harm reduction concepts – like giving sterile syringes to people who inject drugs – in an effort to curb the transmission of infectious diseases.But the Biden administration has appointed Rahul Gupta as the nation’s new director of the Office of National Drug Control Policy despite the West Virginian having a controversial relationship to harm reduction policies in the past.The appointment of Gupta, a personal friend of Joe Manchin, the West Virginia senator, has sparked concern among some drug policy campaigners who see the move as at odds with the administration’s stated aims of a change in focus when it comes to harm reduction policies.The biggest criticism of the new “drug czar” comes from public health experts who recall the role he played in shutting down West Virginia’s largest syringe service program in the state’s capital of Charleston – now home to what the CDC has called “the most concerning HIV outbreak in the nation”.In the wake of the program’s shutdown, which Gupta supported, the state has formalized new legislation that is likely to shut down nearly all of its harm reduction programs despite facing multiple, new HIV clusters related to injection drug use.When Gupta began working as the director for the West Virginia bureau of public health in 2015, the state was entering a new phase of the opioid crisis. Prescription pill usage was trending down, but only because it was being replaced by people injecting heroin and fentanyl. The number of overdoses in West Virginia for that year more than doubled the number of people who had died in car accidents.Nationwide, the increase in injection drug use drove an uptick in new HIV cases, especially in small towns. In rural communities across the nation, where syringe possession without a prescription is often criminalized, people hooked on opioids still face two options: reuse (and perhaps share) already used needles or go into potentially fatal drug withdrawal.One community of 3,700 people in south-eastern Indiana went from having fewer than five HIV cases to 235 seemingly overnight in 2015. Surrounding local governments, desperate to find solutions, decided to buck small town conservatism and try an idea typically found in large cities, one grassroots outreach workers had been using for years: harm reduction.Although these governments couldn’t prevent people from using drugs, they could reduce the harm associated with their usage – especially the impact their usage had on public health. A syringe program was started in Scott county, Indiana, to provide people who inject drugs with sterile syringes. The results were staggering.In less than a year, there was an 88% drop in syringe sharing – a key victory in controlling the spread of HIV. Public health experts across the nation identified what was done in Indiana as the first step in preventing HIV transmission among people who inject drugs.Following the outbreak in Indiana, the CDC identified 220 counties across the US considered high-risk for HIV outbreaks associated with IV drug use. Of West Virginia’s 55 counties, 28 were on that list.Officials in West Virginia’s capital city, Charleston, started a syringe program through the local health department. The West Virginia bureau of public health, led at the time by Gupta, established statewide guidelines and the Kanawha Charleston health department sterile syringe program began operation.But in West Virginia, where Donald Trump’s brand of conservatism led to a state-record shattering 42.2% margin of victory in 2016, the rhetoric of giving people who use drugs syringes was a hard sell.The KCHD syringe program served nearly 25,000 people in the three years it operated. For a city of 49,000 residents, the program was meeting a massive demand for clean syringes. But, by 2018, conservative politicians and residents alike had successfully rallied against the program.An ugly public feud pitted former mayor Danny Jones and his supporters against the program and anyone who supported it. Jones, who in an interview had professed that people who use drugs should “be locked up until they’re clean”, enacted a series of changes on the program that include putting a police officer in charge of its design.The biggest criticism of Dr Gupta from his time as the state’s public health commissioner stems from an audit of the syringe program his office was asked to do by Jones. Flouting CDC recommendations that support lowering barriers to access and guidelines set up by his own office, Gupta’s audit called for a suspension of the syringe program because it didn’t require participants to first seek treatment for drug use before accessing clean syringes.Dr Robin Pollini, an epidemiologist at West Virginia University, and six other harm reduction experts nationwide wrote letters speaking out against Gupta’s findings saying his key criticism – that treatment options weren’t being prioritized above syringe access – showed he missed the point of harm reduction entirely.In an interview with the Guardian Pollini said: “The report was arbitrary in faulting the program for not adhering to practices that were not even required by the state certification guidelines” – guidelines written by Dr Gupta’s own office.When Gupta decided to leave West Virginia in 2018, Charleston and the surrounding county had fewer than five HIV cases related to IV drug use. Since then the number of new cases has gone up to 85, prompting the CDC to send in a team of disease intervention specialists.“They warned us there was going to be a massive HIV outbreak.” said April, who contracted HIV in Charleston last year from IV drug use and did not want her last name used. “I thought they were just trying to scare us into not using. But, they were right.”She added that she and people she had use drugs with didn’t have to share needles when the program was operational. “But as soon as it shut down, people started selling them just like they did dope.”But beyond the immediate public health crisis prompted by shutting down the state’s largest sterile syringe program, Gupta’s audit’s legacy lives on in the form of new legislation that has made it illegal for harm reduction programs in West Virginia to follow CDC guidelines.Proponents of the bill held up his report as an example of a public health official advocating for higher thresholds on syringe programs. As a result, three of the 28 counties in West Virginia originally identified as high-risk for HIV outbreaks have shut down their syringe programs, citing restrictions placed on their programs by the new law.Three years after the KCHD program was decertified by Gupta, people desperate for housing and access to medical supplies are not hard to find on the streets of Charleston. A man named Tommy said clean syringe access has completely dried up since the shutdown of the program.Desperate to reuse old needles, he described how people who are desperate to straighten out a used needle use the flint on matchbooks to reshape old needles which have been bent from use. He said the current market value for a clean syringe on the streets is around $5. Alternatively, people can get a used one for between $1 and $2.Seeing the devastation caused to her state’s public health by people who misunderstand or outright oppose harm reduction over the past few years, Dr Pollini is left with one question over the newly confirmed head of ONDCP. “Does he have a better understanding of these programs than he did three years ago?” Pollini asked.The White House was asked for comment but did not respond.TopicsBiden administrationUS politicsOpioids crisisnewsReuse this content More

Voters handed Joe Biden a devastating blow by electing a Republican governor, Glenn Youngkin, in Virginia. Jonathan Freedland talks to David Smith about how the president rallies his party ahead of next year’s midterms.

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