AIDS Action Applauds President's $65 Million Request For AIDS Drug Assistance Programs
Amount Still Woefully Inadequate To Provide For Hundreds Of Thousands Of PWAs
July 24, 1996
President Clinton announced last night that he will seek an additional $65 million in emergency FY 97 funding for the beleaguered AIDS Drug Assistance Program (ADAP) funded under title II of the Ryan White CARE Act. This request would be in addition to $52 million in emergency FY 96 funding adopted by Congress with broad bipartisan support and which has been included by the House of Representatives in their FY 97 appropriations bill.
"We are pleased that the President has once again demonstrated his support for this important program," stated Gary Rose, treatment representative at AIDS Action. "This should be understood in the context of the President's original FY 97 budget request which included increases for all Titles of the CARE Act and his recently announced budget amendment requesting $25 million in additional FY 1997 funding for the Housing Opportunities for People With AIDS (HOPWA) program.
"These increases for underlying care services and housing are equally critical to ensure that PWAs have access to these new drugs," continued Rose. "However, we are gravely concerned that even this new funding will prove inadequate to meet exploding needs for drug assistance."
Late last week, Washington state announced that it was capping ADAP enrollment at present levels and that patients not already on triple combination therapy with protease inhibitors would be denied access to them. According to the Northwest AIDS Foundation, Washington state will need at least $5 million in FY 1996 funding to relieve these immediate pressures.
Even more frightening, Illinois has both capped its enrollment and, in order to pay for one protease inhibitor, has removed over 80 other drugs that fight opportunistic infections from its formulary. At least three other jurisdictions in the U.S. are expected to announce measures similar to Washington state and Illinois by summer's end.
"It seems patently clear," stated Rose, "that in light of the success of these new therapies - documented continuously over the last twelve months to extend the lives and improve the health of PWAs - there exists a moral responsibility to provide these drugs to all who need them, not just those who can afford them. "ADAP was designed to provide life-extending drugs to people who are either under-insured or uninsured. Without a sufficient influx of funding , estimated to be an increase of $250 million in new funding for FY 97, ADAP will fall tragically short in achieving its mission."
Rose also emphasized the stress that the demand for this new therapy would place on all underlying care structures. "If patients choose to undergo this new regimen, they must maintain strict compliance taking multiple drugs three times a day while adjusting meal schedules to compensate. They will also have to undergo frequent viral load testing to monitor therapeutic impact. Without adequate access to primary care, social support services and housing, we are likely to see dangerous levels of non-compliance that could lead to drug resistance and the ultimate failure of the regimen. This situation demands adequate resources for the services provided by the Ryan White CARE Act as a whole to assure that this does not occur."
"It is also difficult to imagine that anyone could adequately follow any complex regimen if they are homeless or in imminent danger of becoming homeless," stated Aimee Berenson, AIDS Action's legislative counsel. "It is tragic, then, that Housing Opportunities for People With AIDS has been flat funded since 1995. The President has requested an emergency $25 million supplemental request for FY 1997 and we must tie the urgency of our request for the new drug money with this essential increase in housing assistance for the most vulnerable Americans living with HIV.
"In addition, it is important to note that even if this regimen is wildly successful, it is not a cure. Therefore, we must continue to provide sufficient resources to prevention programs that will keep new infections with HIV to an absolute minimum. And yet, HIV prevention programs at the Centers for Disease Control were subjected to a $6 million cut in the last fiscal year. This makes no sense in the present context."
Compounding these problems are the choices that states are making in order to maintain their beleaguered programs. State Administrators are too often making program decisions based purely on financial concerns without considering the medical implications of their actions.
According to Rose, "In Illinois, the removal of over 80 drugs that treat opportunistic infections - infections that actually kill people with HIV disease - suggests that the state is willing to provide at least some people with HIV the therapies they need to stay healthy. However, should anyone progress to symptomatic disease," states Rose, "the state is willing to wash their hands of them."
In contrast with Illinois, states such as New York, California and Maryland have dug deep into their state coffers to provide stability for their hard-hit ADAP programs so that the continuum of needs of their HIV-affected citizens continue to be met. All states must follow this example if they are to cope with the crisis of access. In addition, the federal government, even in this year of extreme budget restraint, must be obligated to provide funds to prevent this crisis from worsening.
AIDS Action calls on President Clinton, on Congress, and on the presumptive Republican nominee, Robert Dole to assume a leadership role in assuring that these core needs of people with HIV are met.
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Founded in 1984, AIDS Action is the only national organization devoted solely to advocating on federal AIDS policy and legislation. AIDS Action represents more than 1,400 community-based AIDS service organizations throughout the United States.
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This article was provided by AIDS Action Council.