WASHINGTON, D.C. Fifteen years into the AIDS epidemic, the fragile health care
system created to assist people with HIV may well be in imminent danger of
collapse under the weight of new and expensive therapies designed to extend and
enhance the lives of those living with HIV and AIDS. The magnitude of this
change in standard of care has forced the 50-state network of AIDS Drug
Assistance Programs (ADAP) to cap enrollments, severely restrict access to the
latest life-enhancing and extending drugs, or drastically cut the number of
drugs available to patients.
From Washington state to Washington, D.C., virtually every state is bearing the
burden of explosive increases in ADAP enrollment and the demand for expensive
combination drug therapies. While some states have been forced to restrict
access to AIDS therapies, others (such as Washington, D.C.,) face a total
cessation of drug distribution because of inadequate funding.
"In the short term, the ADAP system must be infused with enough cash to
effectively operate. Otherwise, drug assistance programs nationwide will
continue to operate in a state of perpetual crisis," said Gary Rose, AIDS
Action's treatment and research legislative representative. "Every state ADAP
program in crisis means tens of thousands of uninsured or underinsured people
with HIV and AIDS will be denied access to drugs that could help them live
longer and healthier lives."
Budget projections issued by the ADAP Working Group - an historic collaboration
of national and regional AIDS organizations and the pharmaceutical industry
dedicated to working with Congress and the federal government to find solutions
to the crisis in access to new AIDS therapies - suggest that ADAP programs will
require at least $200 million federal dollars and $60 million state dollars to
provide the drugs needed to treat HIV disease for uninsured and underinsured
"We have about four weeks to work with the Clinton Administration and Congress
to make this funding available before Washington shuts down for election '96."
Rose said. "Before President Clinton and members of Congress hit the campaign
trail, they should ensure that Americans living with HIV and AIDS are
effectively cared for. It's difficult to cast a vote when you're too sick to
get out of bed."
While emergency fiscal year 1997 funding will save lives, Rose said, it remains
a short-term solution. Without a stable funding base, states will continue to
slash their drug formularies, place caps on drug enrollment programs and, quite
possibly, shut down their programs temporarily when their resources have been
Rose said, the AIDS community is grateful to the Clinton Administration for
their speedy response to the ADAP crisis - $52 million in fiscal year 1996
funding and a request of $65 million for fiscal year 1997. Unfortunately, he
added, the magnitude of this revolution in care will require much more. AIDS
Action calls on Congress and the administration to appropriate desperately
needed funds for state ADAP programs (short term) and to exhibit continued
leadership in ensuring real access to health care for the uninsured and
underinsured (long term). Additionally, President Clinton must maintain his
commitment to the Medicaid program by ensuring that any attempts at reforms
consider the needs of people living with HIV.
Finally, Rose explained, we cannot let the drama of the ADAP crisis collapse the
fragile structures created over the last 15 years to cope with this expanding
epidemic. AIDS Action calls upon the federal government to unwaveringly
- The underlying titles of the Ryan White CARE Act: Without these vital
services provided by the CARE Act, people living with HIV and AIDS will lack
access to a continuum of care necessary to take full advantage of new therapies
or to be cared for if the therapies fail. In addition, Title V of the CARE Act
funds the AIDS Education Training Centers (AETCs) , the best method available
for getting information on how to use these therapies to physicians.
- Housing Opportunities for People With AIDS (HOPWA): People who are homeless
or at risk of becoming homeless will find it difficult, if not impossible, to
comply with the difficult regimens required by new therapies. AIDS Action
enthusiastically supports the administration's request for $15 million in new
- Prevention: The least expensive way to treat this disease still lies in its
prevention of new infections. The federal government must continue its support
for prevention programs that are designed and implemented by local communities.
- Research: Protease inhibitors are not a cure. In order to find the next
generation of treatments for HIV disease, the federal government must maintain
its support for AIDS research at the National Institutes of Health (NIH) and for
the consolidated budget authority of the Office of AIDS Research (OAR).
For more information, contact:
AIDS Action Council
1875 Connecticut Avenue NW #700
Washington DC 20009
202-986-1300, extension 3053