Yale Bulletin and Calendar

April 5-12, 1999

Volume 27, Number 27

The Surgeon General speaks out
on some tough issues

Before he delivered his speech "Toward a Balanced Community Health System: Opportunities and Challenges," (see related story) U.S. Surgeon General Dr. David Satcher answered questions from several members of the media at an informal reception in the School of Medicine's Beaumont Room. The following are some of those questions and Satcher's responses.

Just under a year ago, the Clinton Administration announced it wouldn't fund needle-exchange programs. Do you think they should be federally funded?

First, I will attempt to answer two major questions. Number one, are needle exchange programs effective in reducing the spread of HIV, and two, do needle exchange programs increase drug use? Needle exchange programs are indeed effective in reducing the spread of HIV if they are carried out in the context of other programs for prevention and education. And there's no evidence that they increase drug use. So we were disappointed at the decision not to provide federal funds, and obviously, both the [Clinton] Administration and Congress have agreed on that position for now. But there are a lot of programs in local communities that work well and we try to be supportive in terms of the science. We can't be supportive in terms of the money.

Is public consensus possible with regard to such controversial issues as genetic engineering and reproductive technologies?

I think it's possible. I think people bring a lot of different values to this debate in how they see human life, but I think we're coming closer to that kind of consensus. The National Institutes of Health just announced the funding of stem cell research, and even though there's controversy over the announcement, I think there's general agreement that the benefits of stem cell research will be tremendous in terms of advancing human health. So there is considered to be a very high good in all of that. But there will continue to be debates about it as people bring different values to the table.

Should there be nationally mandated sex education programs in the public schools or are they best undertaken at the local level?

It's hard for me to see how you can do it nationally because that would take a lot away from the local community. I still think there's a key role here for the local community in terms of the curriculum of the schools -- physical education, sex education, etc. But I do think that it would be appropriate for us to develop some guidelines about what works and what has not worked in terms of sex education. Obviously, there is a lot that young people need to learn about themselves as it relates to human development, and a lot that they are not learning today in terms of their experience in the schools. So I think there's a void there, and it's unfortunate. ... Sex education at its best, unlike some people think, does not increase sexual behavior. If anything it delays the initiation of sexual behavior and it certainly increases protected sex -- and I say "protected sex" with the understanding that there is no such thing as 100 percent protection -- but we do know that we can prevent a lot of things that happen unintentionally.

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