Here’s something you don’t expect Republican leadership to support: needle exchange programs. But Alex Azar, the secretary of the Department of Health and Human Services, did just that earlier this week. As The Hill reports, the nation’s health leader expressed public support for needle exchange programs as a way to prevent the spread of HIV among people who inject drugs. Such programs also reduce the risk of hepatitis C.

“Syringe services programs aren’t necessarily the first thing that comes to mind when you think about a Republican Health secretary, but we’re in a battle between sickness and health, between life and death,” Azar said. “The public health evidence for targeted interventions here is strong, and supporting communities when they need to use these tools means fewer infections and healthier lives for our fellow Americans.”

He was speaking during a national HIV prevention conference in Washington, DC. Government health leaders and recently appointed members of the Presidential Advisory Council on HIV/AIDS (PACHA) met March 11 and 15 to discuss Trump’s proposed plan to end the HIV epidemic in the United States by 2030.

Azar said that although he supports needle exchanges, the Trump administration opposed safe injection sites. These are safe spaces where people can use drugs; the spaces provide clean needles as well as staff trained to respond to overdoses. Last fall, California’s governor vetoed a bill that would have authorized the nation’s first safe injection site, in San Francisco. For more on that, click here.

One wonders whether Azar and other Republican health leaders support needle exchanges because they have learned from the HIV and hep C outbreaks that occurred among injection drug users in rural Indiana in 2015 under then-Governor Mike Pence, who initially opposed needle exchanges. His delayed response had grave consequences, with about 215 people contracting HIV.

Injection drug use, fueled by the opioid crisis, is an increasingly common route of HIV transmission. In recent months, health officials have reported HIV clusters among injection drug users in Seattle and West Virginia. 

To read more in POZ about the PACHA meeting click here. To learn about Trump’s plan to end HIV, click here and to see how HIV/AIDS groups responded to the plan, click here.