Critics Denounce Bush's Proposed Budget for HIV Prevention and Care
March 20, 2002
President Bush's proposed 2003 budget provides no additional funding for the Ryan White Care Act or HIV prevention. National Institutes of Health AIDS research received an additional $300 million in the proposal.
The proposed budget could be devastating for many HIV-infected people who do not qualify for Medicaid and have no private insurance to cover their medications, advocates say. The AIDS Drug Assistance Program (ADAP), which typically helps those in this situation, now needs $162 million to cover shortfalls for FY 2002 and FY 2003, said Bill Arnold, chairperson of the ADAP Working Group in Washington, D.C. ADAPs pick up nearly 600 new clients monthly, and "six or seven" states now have waiting lists while others have "unofficial" waiting lists, he said. By late winter, about 700 HIV/AIDS patients were on waiting lists to receive antiretroviral drugs in the Southeast.
Southeastern states -- including Georgia, Alabama and North Carolina -- appear to be having the most difficulty with ADAP funding. In New York, California and many Northeast states, liberal Medicaid programs help ease the burden on ADAP. But many Southern states put so many restrictions on who is eligible for antiretrovirals through Medicaid that ADAPs are the chief safety net, Arnold said. The allocation for prevention funding is also a disappointment because it goes counter to the CDC's focus last summer on improving HIV prevention efforts, said Tanya Ehrmann, public policy director of AIDS Action.
Cash-strapped states cannot be expected to make up the shortfall in federal spending, said Laura Hanen, director of governmental relations for the National Alliance of State and Territorial AIDS Directors in Washington, D.C.. In Florida, AIDS groups are asking the legislature for an additional $5 million in ADAP funding, and they say a drug waiting list will be inevitable unless the state receives another $5 million from the federal government.
Activists note that while antiretroviral therapy continues to be the biggest expense in the program, there is considerable cost to society when patients develop opportunistic infections. ADAP pays an average of $893 a month per covered person for antiretroviral drugs, but the average annual treatment cost for a cytomegalovirus retinitis infection is $65,734.
AIDS advocates hope Congress will improve on the president's budget, as it has in the past. But they note that even during the budget surpluses of the Clinton years, the final figure typically fell short of what AIDS groups said was needed. And now, "there's a small pool of money left after defense spending and new homeland security, so I think it's going to be a tough fight," Ehrmann said.
This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update. Visit the CDC's website to find out more about their activities, publications and services.