Officials with AIDS Drug Assistance Programs across the country have reacted with alarm to proposed ADAP spending increases being considered by Congress that the program administrators consider too inadequate to meet the needs of low-income and uninsured people with HIV. The House is considering boosting ADAP spending by $38.9 million in fiscal 2004, while the Senate's spending proposal includes just a $25 million increase. ADAP officials say the increases are less than 15% of what the programs will need for the year to maintain current drug formularies, eliminate waiting lists, and prevent tightening of eligibility requirements.
"This will lead to a disastrous shortfall in the majority of states for the remainder of 2003 and 2004," said Laura Hanen of the National Alliance of State and Territorial AIDS Directors in a press release. "Over 90,000 patients per month are accessing ADAP services today, and, according to our reports, that number is sure to increase significantly over the next 18 months. What Congress has provided will provide almost no new money to take care of any new applicants for the program."
NASTAD reports that there are already as many as 1,200 people on ADAP waiting lists around the country and that 10 states have capped program enrollment to deal with budget shortfalls. An additional 20 states are either soon implementing ADAP restrictions or are considering them. ADAP officials say that as many as 20,000 people newly diagnosed with HIV disease may be denied access to antiretroviral medications due to the program restrictions unless federal funding is boosted to a total of at least $283 million for fiscal 2004.
"By definition, American patients on ADAP are in desperate need," said Bill Arnold, director of the ADAP Working Group. "To essentially ignore that need sets a very unhappy precedent. This could be the darkest 18 months in the history of ADAP and the Ryan White CARE Act. The Bush administration and Congress have taken laudable steps toward addressing the HIV/AIDS epidemic in developing nations. We must also address the critical needs of Americans living with HIV/AIDS here in the homeland."