Examining the methods of AIDS treatment and prevention in the U.S. in comparison with the U.K. and Germany where fewer people die of the disease:
No one knew how severe the epidemic was among drug users until 1984, when the still-under-development antibody test found that 50 percent of drug users in New York City and Edinburgh and 30 percent in Amsterdam were already infected. (Des Jarlais says genetic tests have since shown that the epidemic in Amsterdam originated in New York.)
Here’s where the differences come in. Almost immediately after those first tests, Western European countries installed needle-exchange programs, gave out free syringes, and established opiate-substitution treatment. Germany even got needle vending machines. By 1997, England and Wales were giving out 25 million free syringes per year. Anything to keep the virus from spreading, even if it meant making it a little easier to be a heroin addict that day.
The United States, on the other hand, refused to provide federal funds for needle exchanges or even fund research into whether they were effective.