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Abstract: This case describes the policy disagreement and resulting political in-fighting which accompanied the Clinton Administration's consideration of whether to allow federal funds to be used to support "needle-exchange" programs meant to reduce the spread of HIV infection among drug addicts. The case invites discussion of why "drug czar" Barry McCaffrey was able to thwart an apparently imminent announcement by the President that would have signaled an end to the funding prohibition, a goal sought by Health and Human Services Secretary Donna Shalala.
Learning Objective: More broadly, this case allows for discussion of the reasons for the relative strength and effectiveness of competing senior officials in a policy-making dispute.