AIDS Drug Funds Drying Up for Uninsured Americans

As US activists struggle for ways to bring cheap AIDS drugs to Africa, a similar crisis is brewing in their own backyards: State programs that buy AIDS drugs for the uninsured are going broke. Across the country, an estimated 1,200 people with AIDS who should be taking antiviral medication have instead been placed on waiting lists. "We are very focused, appropriately, on global access to treatment, but we are also not taking care of our own," said Ryan Clary of the San Francisco AIDS advocacy group Project Inform.

Eight states have instituted waiting lists, and that number is expected to grow. California, however, bought its way out of the impending crisis by budgeting an extra $7 million for the program next year. The problem is most acute for North Carolina, where 671 patients have been unable to get into the state's AIDS Drug Assistance Program (ADAP) since a budget freeze last December. Stephen Sherman, director of AIDS policy for the N.C. Health Department, said the state's $1.8 billion deficit is hurting a range of social programs.

ADAP began in 1987, providing drugs to patients who quickly died of the disease. Since 1996, Congress has allocated money specifically for the programs as part of the Ryan White Care Act. Thirty-seven states -- including California -- supplement the federal money with state dollars. States have discretion as to what drugs they cover. California covers 145 different drugs. Utah, by contrast, covers 18. New drugs, like T-20, an especially promising but hard-to-manufacture drug awaiting FDA approval, brings huge financial headaches to the state programs.

This year, the federal government will channel $1 billion to state-run drug assistance programs, which buy the drugs for some 140,000 Americans with HIV but without health insurance. The number is growing by a rate of about 600 per month, and the cost of the program is outstripping the federal budget for it. A bill that would provide $100 million in relief has passed a Senate appropriations committee.

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