An article in the NJ Spotlight about little or no funds for needle exchange programs in New Jersey leads me to ponder the challenge to the "three-legged stool" paradigm as well as nonprofit board advocacy. The story is simple: the (state) government doesn't want to fund needle exchanges and the private sector (which includes mega drug companies) AND the philanthropic sector, the funders (also have some large players as well) not the providers, don't appear that interested either. The paradigm suggests that the nonprofit sector fills the void where the government sector and the for-profit sectors have neither the public interest or consumer demand to invest. In the case of needle exchange, what I believe to be a public health issue, what is superimposed and couched in resistance are core values or beliefs about the "beneficiaries" of the needle exchange programs. Values inform a lot of decisions within all three sectors and when the values differ, so too does support.
This said, the role of the nonprofit boards of the needle exchange program, folks who have values in common, have in my mind, attitudes and environment of tight monies not withstanding, failed to make their case that needle exchange programs are just about the program beneficiaries. Public health is never just about those directly affected. But that the case has not been made, for whatever the reason, I believe it's incumbent upon the boards of these providers to reconsider their approach and message and perhaps recruit folks who do not look or think like them, to the cause. Changing hearts and minds is not easy and those at the helm, the nonprofit owners are responsible. And actually, I think I would be starting with the faith institutions - places where messages about caring for your brother and sister is not so exclusively defined (depending of course on which faith we are discussing).