September 2010 ADAP Update: The Sprinklers Are on, but the Water Pressure's Low

At this point last year, there were only 157 people in the U.S. on waiting lists for AIDS Drug Assistance Programs (ADAPs) -- if you can say "only" about any number of people at all being on a waiting list. There are now 3,337 people waitlisted in 13 states, with additional states creating or considering ways to cut ADAP costs.

Secretary Sebelius at USCA 2010

The ADAP crisis was a major topic of conversation at the recent United States Conference on AIDS (USCA 2010). Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services (DHHS), spoke at a plenary session. She mentioned the emergency funding that the Obama administration has allocated to help ease the crisis -- $25 million, announced in July -- and a recent request for an additional $30 million. She also highlighted ways the U.S. National HIV/AIDS Strategy and the Affordable Care Act will help, and emphasized President Obama's commitment to people living with HIV/AIDS:

Three decades after this epidemic began, we face a turning point. Either we can choose to get used to HIV/AIDS, to accept that it's a permanent feature of our society, to be satisfied with lengthening lives instead of saving them, to go back to the days when insurance companies were free to discriminate against Americans with HIV/AIDS.

Or we can choose to redouble and refocus our efforts, to put a new emphasis on prevention, to expand access to care, to target HIV/AIDS in the communities that bear the brunt of this disease, to move forward with reforms that will give every American access to affordable care.

This Administration has chosen the second path.

Sebelius' speech was held up as it began, while protesters voiced frustration with the ADAP situation:

Sebelius responded, "Thank you for reminding us all that we are here to save lives," according to AIDS.gov's official Twitter feed.

Update on July's Emergency Federal Funds

In mid-July, the DHHS allocated $25 million to assist states with their ADAP programs. The money was distributed according to need, and was ultimately given to 27 states plus Washington, D.C., Puerto Rico and the Virgin Islands, according to a state-by-state breakdown from the U.S. Health Resources and Services Administration's HIV/AIDS Bureau.

The largest allotment of federal funds went to Florida, which has 1,361 people on its ADAP waiting list, the largest in the nation. Florida received $6.9 million -- which will only pay for three weeks' worth of medication, said the state's AIDS director at USCA 2010. For now, Florida ADAP clients still have the longest waits for assistance in the U.S., and minorities in particular are feeling the effects.

Though the funds have had a positive impact in other states, they aren't a miracle cure-all. According to Bobby Edelen, president of the Kentucky HIV/AIDS Advocacy Action Group, the $1.78 million Kentucky received is enough to cover everyone on the state's waiting list. But Edelen also tempered the good news with a reminder to be cautious:

This is good news and we are grateful for the opportunity that is afforded the individual on the wait list to receive the life saving medication, but when we continue to look at the short term accomplishments and have no real plan to take care of the needs of the citizens that will need these services in the future, have we really anything to celebrate.

What is needed is a sustainable way to deliver medications to those individuals who will need them after the funds have run out and the wait list is once again a reality.

Iowa, meanwhile, received about $665,000 in federal funds. Even put together with a supplemental Ryan White Part B award, it isn't enough to end the state's waiting list, though it will allow "many clients" to access medications, according to Randy Mayer, the Iowa Department of Public Health's HIV, STD, and Hepatitis Bureau chief.

Over in Ohio, Governor Ted Strickland stated that the influx of federal funds -- about $1.2 million -- will "sustain the program at its current levels through the remainder of the fiscal year." As positive as that sounds, it's also worth noting that Ohio's "current level" has dropped sharply from previous levels, after it reduced its drug formulary and lowered financial eligibility earlier this summer. Those moves led to 257 clients being disenrolled from the program altogether, according to the August 27 ADAP Watch.

The ADAP Advocacy Association put a fine point on the issue in a community letter to President Obama, Senator Reid and Speaker Pelosi. The letter was cosigned by 125 HIV/AIDS organizations from around the U.S. It stated, "Unfortunately the $25 million solution proposed by President Obama in July 2010 is not sufficient, nor will it end the wait for the ADAP waiting list patients. ... The crisis cannot be solved using a band-aid remedy, which is what we've seen, suggested in various government quarters, we need your leadership on this issue and we need it now!"

Becky Allen is the site manager for TheBody.com and TheBodyPRO.com.

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