AEGiS-ATDN: ADAP In Crisis

Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.

ADAP In Crisis

Information Bulletin #15 - May 2002

September 11th brought the end of a very long period of prosperity in the United States. The economy is faltering and the ongoing war has brought changes of all kinds. Even small changes can have major consequences for people who have very little to begin with. Loss of employment or health insurance has had devastating effects, especially for individuals and families living with HIV.

The AIDS Drug Assistance Program (ADAP) is especially important to low income and financially challenged individuals and families, preventing them from succumbing to constant illness and financial ruin. ADAP has always had to very carefully manage its' resources by balancing federal, state and other contributions, but there have still been times when people have not been able to get the treatment they needed because enough funds were just not available. Now, however, ADAP faces a serious crisis. Several factors are coming together at the same time, drastically increasing next year's ADAP funding needs:

More People Need Help: Currently, ADAP serves roughly 75,000 people each month in the United States. The sharp rise in unemployment will cause some people to lose their health insurance. This means that more people will depend on ADAP for HIV treatment than ever before. New HIV infection rates are also climbing again ,reversing previous trends. As people are benefiting from effective anti-HIV drugs, they are living longer and are not leaving ADAP. Unless emergency funds are found, ADAP will need to start changing program guidelines and restricting access to certain medications, or enrollment by specific groups of people.

More Crises, More Restrictions: Currently, there are over 700 people on waiting lists for ADAPs in 6 states across the country. By March of 2002, 4 more states will have joined their ranks. These states are: Alabama, Georgia, Idaho, Kentucky, Maine, Nebraska, North Carolina, South Dakota, West Virginia and Wyoming. As we move into next year, more restrictions could be imposed on ADAPs just to be able to serve the people already enrolled. The establishment of stricter financial and medical eligibility criteria, restrictions on necessary medications, and reduction of drug coverage will become more wide spread. Drug Prices are Increasing: Long term side effects from anti-HIV drugs continue to emerge, requiring additional drugs to manage these side effects. New treatments for AIDS and HIV-related conditions - including Hepatitis C - have been approved by the FDA. T-20, a new type of anti-HIV drug called a fusion inhibitor, is also likely to be approved by the FDA later this year. New drugs, and more drugs, always mean greater expense.

Shifting political priorities: Post September 11th spending by the federal government and states is causing budget shifts, and crises across the country. Even when there were budget surpluses, adequate AIDS funding was hard to come by. When times are bad, the level of political will and commitment in the fight against AIDS is severely tested. But spending money now on early treatment of HIV avoids very expensive emergency HIV care. The final budget passed by congress is at least $82 million short of the ADAP's needs.

2002 National ADAP Monitoring Project Report Contact The Access Project for detailed information on your state's ADAP. Call Lei Chou at The Network or e-mail him at or TheAccessProject@aol.com. The 2002 National ADAP Monitoring Project, a joint project of NASTAD, The Network, and The Henry J. Kaiser Family Foundation of Menlo Park, CA, is available online. Check out the new database on all 54 ADAPs at www.atdn.org. Webcast by kaisernetwork.org at http://www.kaisernetwork.org/healthcast/adap/09may02
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