Needle exchanges, long credited with helping to slow the spread of infectious diseases by public health experts, have made inroads in recent years, even in states traditionally opposed to them.

A ban in federal funding for needle exchanges was lifted earlier this year. States including Ohio, Kentucky, and West Virginia have made it easier, or in some cases possible for the first time, for programs to operate. Even Vice President-elect Mike Pence, who resisted needle exchanges on moral grounds, repealed a ban on syringe exchanges as governor of Indiana when confronted with an HIV outbreak (albeit too slowly for many experts).

New data released by federal health officials Tuesday further demonstrated the value of needle exchanges, suggesting they had contributed to a major reduction in new HIV infections among people who inject drugs.

But the report also included some warnings. There aren’t enough needle exchanges or clean needles being supplied, and few drug users use only sterile syringes, researchers from the Centers for Disease Control and Prevention found. Plus, changes in the demography and geography of drug users suggest problems to come.

The health care industry is abuzz over Donald Trump's picks of Tom Price for HHS Secretary and Seema Verma for CMS administrator. But first: The vote on 21st Century Cures is finally here.

CURES HITS THE FLOOR TODAY, AND BIPARTISAN BACKERS WANT THE HOUSE TO PASS IT — That includes industry players like Intel, Republican leaders like Sen. Lamar Alexander — and the Obama administration, too.

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— Meanwhile, 11 city health leaders petition Price to invest in public health. "The Republican Party Platform proposes reducing costs by converting Medicaid into block grants," write the letter-signers, which include Baltimore health commissioner Leana Wen and New York City health commissioner Mary Bassett. "This concerns us, as it risks depriving our most vulnerable residents of access to healthcare and adversely affecting health outcomes." Read the letter.

Today, a conversation about Safe Streets, a program that uses the street wisdom of former felons and reformed gang members to fight the epidemic of gun violence in some of Baltimore’s most dangerous neighborhoods. The concept was inspired by a similar program in Chicago called Ceasefire. Community outreach workers known as "violence interrupters" patrol neighborhoods, interacting with residents and stepping in to mediate tense conflicts before they escalate to violence. Many of the violence interrupters have criminal records and gang ties, and all of them have credible reputations on the streets, an aspect that proves important when stepping into potentially violent situations. 

Advocates of Safe Streets say the program has dramatically reduced violent crime in the four community sites it’s operating in, McElderry Park, Cherry Hill, Mondawmin, and Park Heights. In 2015, Safe Streets outreach workers mediated nearly 700 conflicts, 80 percent of which were deemed “likely” or “very likely” to have resulted in gun violence.

Recently, I treated a patient in clinic, a woman in her early 40s. Just two years prior, she was experiencing homelessness and frequented emergency rooms every few weeks. Through the Affordable Care Act, she was able to get health insurance, which in turn helped her get her blood pressure managed and diabetes treated. It also enabled her to obtain treatment for depression and alcoholism.

As a result, she now had a job and a home. She regained custody of her children. Thanks to health insurance, which she called "her rock," she had her life back.

For my patient, like so many of our residents, the national uncertainty we face is deeply personal. In 2010, 81,000 adults in Baltimore City were without health insurance. That number has been cut in half — meaning that more than 40,000 now have access to life-saving care. Will their coverage now be at risk? Will our neighbors and family members be priced out of the basic right to health?