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Message to Congress: Save ADAP!

December 2002

Dear Senator/Representative:

The undersigned organizations serving the needs of people living with HIV write to ask that Congress provide a minimum of $162 million in additional federal funding for AIDS Drug Assistance Programs for FY 2003.

This year, 13 state AIDS Drug Assistance Programs (ADAPs) have been forced to take steps to limit access to life-saving HIV medications for uninsured and underinsured Americans due to inadequate funding. Texas, for example, has recently announced that in order to close its deficit, it will retroactively lower its income limits from 200 percent of the federal poverty level (300 percent with spend downs) to 140 percent. That action will require the removal of 2500 presently enrolled ADAP clients from the program by June 1, 2003.

New York must also address a $16 million structural deficit in 2003 and a projected $50 million deficit in 2004 if either state/and or federal funding is not increased by that amount.

According to the most recent National Alliance of State and Territorial AIDS Director's (NASTAD) Report, the following states have also initiated waiting lists as of 12/5/2002: Alabama (175), Indiana (34), Kentucky (62), Montana (2), North Carolina (60), Oregon (18) and South Dakota (43). Idaho, Nebraska and Wyoming have closed to new enrollees. In addition to New York and Texas, Colorado, Florida, Georgia, Nevada and South Carolina have projected the need to impose access restrictions in early 2003.

One major factor driving increased ADAP need is enrollment growth, which is due to the success of the new drugs in decreasing deaths and slowing progression to AIDS. Since the introduction of effective combination HIV therapies in 1996, America's death rate from AIDS has fallen by over 50 percent. Because people are staying alive longer, they need ADAP longer and so enrollment continues to climb. While this should be taken as a sign of the program's success, resources flowing to ADAPs are not being increased to take care of the swelling numbers of people that are being kept alive.

Ironically, attempting to save money in the short term may cost taxpayers more money in the long term. Recent data presented by the University of Alabama at Birmingham at the International AIDS Conference in Barcelona demonstrates that the average cost of care for a person with early HIV disease is approximately $14,000 a year while waiting to treat that person until they are disabled costs about $34,000 a year.

Fears of particularly serious problems for FY 2003 are exacerbated by the expected arrival of new drugs that few programs in crisis are likely to be able to afford. Fuzeon (T-20), the first fusion inhibitor to reach the market, could provide urgently needed support for patients whose anti-retroviral options have run out when it is approved in early 2003, but the drug is expected to be expensive, which could force ADAPs to ignore the need for the drug.

The second class of drugs that most ADAPs are unlikely to be able to afford are those to treat HCV. While HCV has become the number one cause of death among people with HIV, most states are resistant to adding new classes of treatment when resources are scarce.

Finally, in order to make best use of ADAP funding we ask that you fund required services provided under the Ryan White CARE Act at the highest possible levels. Without the support services provided by the CARE act, many ADAP clients would have no realistic access to the medical care and auxiliary services they require to maximize the usefulness of anti-HIV medical regimens.

We believe that it is imperative to provide life-extending AIDS drugs to all Americans in need. We hope that you will agree.


Partial listing: ADAP Working Group • African Services Committee, New York, NY • AIDS Action • AIDS Action Baltimore • AIDS Coalition of Texas Now! (ACT Now!) • AIDS Council of Northeastern, NY • AIDS Foundation of Chicago • AIDS Rochester • AIDS Services of Dallas • AIDS Treatment Data Network • AIDS Vaccine Advocacy Coalition • Alianza of New Mexico • AMASSI, Inc. • Bailey House, New York, NY • Betances Health Center, New York, NY • Boulder County AIDS Project • CARE Resource, Miami, FL • Catholic Social Services of Mobile, Alabama • Center for Community Alternatives • Families Connecting for Kids, The Adoption Exchange • Florida AIDS Action • GMHC • Hepatitis C Action & Advocacy Coalition, San Francisco • Hepatitis C Advocate Network, Inc (HepCAN) • • IDC Research Initiative, Orlando, FL • International AIDS Empowerment, El Paso, Texas • International Foundation for Alternative Research in AIDS • Long Island Association for AIDS Care (LIAAC) • Los Angeles County Office of AIDS Programs and Policy • Los Angeles Family AIDS Network (LAFAN) • Los Angeles Gay and Lesbian Center • Miami Beach Community Health Center, Inc. • Milwaukee Lesbian, Gay, Bisexual, Trangender Community Center • Montrose Clinic, Houston, TX • National AIDS Treatment Advocacy Project • New York AIDS Coalition • New York City AIDS Housing Network • North Carolina Council for Positive Living • Nova Southeastern University, College of Dental Medicine • Physicians' Research Network • POZSeattle • Project AZUKA, Inc. • Project Inform •Provincetown AIDS Support Group • San Mateo County AIDS Program • Search for a Cure • Sierra Foothills AIDS Foundation • Staten Island HIV C.A.R.E. Network • Tarzana Treatment Centers • Tennessee AIDS Support Services, Inc. • The Center for AIDS: Hope & Remembrance Project • Title II Community AIDS National Network • Treatment Action Group • Tucson Interfaith HIV/AIDS Network (TIHAN) • United Foundation for AIDS • Vermont People With AIDS Coalition • Williamsburg/Greenpoint/Bushwick HIV CARE Network

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This article was provided by Gay Men's Health Crisis. It is a part of the publication GMHC Treatment Issues. Visit GMHC's website to find out more about their activities, publications and services.