March 27, 2013
The spending bill (called a Continuing Resolution or CR) which was passed by Congress on March 21 does not include funding needed to continue providing HIV medications to almost 8,000 people with HIV/AIDS, despite the efforts of The AIDS Institute, AIDS United, and other HIV/AIDS organizations. The bill now goes to the president for his signature.
The CR will fund the federal government through the end of September, but both the House and the Senate failed to continue the $50 million in emergency funding that President Obama announced on World AIDS Day in December 2011 -- $35 million for the AIDS Drug Assistance Program (ADAP) and $15 million for clinical medical care provided through Part C of the Ryan White CARE Act.
In testimony before Congress, Carl Schmid, Deputy Director of The AIDS Institute, warned that under the Continuing Resolution, together with sequestration, states will likely have to remove patients from the ADAP program.
Donna Crews, Director of Government Affairs at AIDS United, noted that this is one of the things that make this different from past funding crises. "Before, we had waiting lists for new applicants, but these would be people who have already been getting their medications through ADAP," she explained.
|This map shows how ADAP will be affected by the sequestration cuts. The cut from the CR will be in addition to the sequestration.|
Antiretroviral drugs must be taken every day without interruption or an HIV-positive person's viral load and the risk of opportunistic infections can increase, CD4 T-cell count can decrease, and the possibility of developing resistance to medications can occur, even with a single missed dose, potentially leading to serious health complications and higher health costs. Without the $35 million continuation in ADAP funding, states such as Alabama, Florida, Georgia, Illinois, Nebraska, Tennessee, and several others will likely have to stop providing medications to many ADAP clients.
Schmid also advocated for the entire Ryan White Program, including the Part C programs that would be affected, saying, "With this increased demand for medications comes a corresponding increase in medical care and support services provided by all other parts of the program."
Iowa's Tom Harkin, Senate Labor, HHS, Education and Selected Agencies Appropriations Subcommittee Chairman, attempted to address the ADAP funding cut with an amendment that would have resolved the issue, but it was defeated in a 55-44 party-line vote in the Senate, failing to get the required 60 votes.
There is still a small chance the funding could be restored before the bill is finalized and sent to the President. But even if it is restored, Crews pointed out that the previous cuts from the debt deal and the sequestration would occur on top of the loss of the $50 million to the Ryan White Program. Without the money, ADAP would be funded at the 2012 level before the $35 million was added, a level that demand had far outreached back in 2012.
Schmid commented, "We hope that before the bill is finalized and sent to the President, Congress will see fit to find a way to continue this funding to avoid any interruptions in lifesaving care and treatment. With sequestration and discussion of further budget cuts, continuation of this funding is an absolute necessity."