The Fate of AIDS Drug Assistance Programs

Last month, Sir Elton John penned a letter to Ryan White in honor of the 20th anniversary of the young Indiana boy's death. White, for those who have missed out on the last 25 years of life, was infected by HIV because he was a hemophiliac. As a result, he was subjected to harassment, and excluded from his school. He died at 18 from HIV-related illnesses.

In the letter, published by the Washington Post, Sir Elton writes, "Most important, Ryan, you inspired awareness, which helped lead to lifesaving treatments. In 1990, four months after you died, Congress passed the Ryan White Care Act, which now provides more than $2 billion each year for AIDS medicine and treatment for half a million Americans. Today, countless people with HIV live long, productive lives."

Elton does not gloss over the fact that the AIDS Drug Assistance Programs — funded by the Ryan White Care Act — are in trouble. Although he does soften the blow some. He notes that many people, mostly "poor people," are placed on waiting lists to garner access to the medications.

Well, actually it is happening in a lot of states.

A press release from Community Access National Network says that over 1,000 people in 10 states are on waiting lists for access to the life saving drugs. Those states, and the number of people on waiting lists are Hawaii: 2 individuals; North Carolina: 470 individuals; Utah: 96 individuals; Idaho: 26 individuals; South Carolina: 71 individuals; Kentucky: 200 individuals; Iowa: 71 individuals; South Dakota: 30 individuals; and Wyoming: 17 individuals.

The group also reports 11 other states have implemented cost containment strategies to reduce costs of the ADAP programs, and another nine states are considering restricting access to ADAP.

This while funding for ADAP from the Ryan White fund is currently funded at the same level it was in 2006, at $779.8 million. The budget for this actually saw decreases in 2007 and 2008, with a slight increase to the 2006 funding level in 2009. Not exactly a heart-warming notion, is it?

In my home state of Michigan, folks in the ADAP program tell me the state spends $15,000 a year on HIV anti-retroviral medications per person. It averages $11,000 per year per person in actual expenses. And this program only funds just under 2,800 people, out of an estimated 18,000 confirmed cases of HIV in the state.

Now, here's the rub. As the feds continue to pursue a test and treat strategy — that is test as many people as possible and immediately start anti-retroviral treatments — the cost and stress on an already underfunded and burdened ADAP is going to crush sky-rocket.

AIDS activists are asking for an ADAP Emergency Supplemental FY' 10 Appropriation of $126 million.

Photo credit: Wikimedia Commons