Since the full sanction of syringe exchange programs (SEP) by then Mayor Frank Jordan in 1993, the San Francisco Department of Public Health has been responsible for the management of syringe access and the proposal disposal of these devices in the city. This sanction, which was originally executed as a state of emergency to address the HIV epidemic, allowed SEPs to provide sterile syringes, take back used devices and operate as a service for health education to support individuals struggling with drug abuse. Since then, it was approximated that from July 1, 2017 to December 31, 2017, only 1,672,000 out of the 3,030,000 distributed needles (60%) were returned to the designated sites. In April 2018, acting Mayor Mark Farrell allocated $750,000 towards the removal of abandoned needles littering the streets of San Francisco.