Since January 2003, President Bush has pledged $15 billion to fight HIV and AIDS in Africa, Vietnam, and the Caribbean. In the United States, on the other hand, funding for HIV medications is suffering. AIDS Drug Assistance Programs (ADAPs), which provide medications to some 136,000 Americans who cannot otherwise afford treatment, are either capping enrollment or limiting the numbers of medications they offer. According to the eighth annual ADAP Monitoring Project Report, more than 1,200 people in nine of the 11 states that have closed enrollment in ADAPs are on waiting lists.
The report says that several factors, such as rising rates of HIV infection and the rising prices of antiretroviral medications, are limiting the programs' abilities to treat patients. (In December 2003, for example, Abbott Laboratories increased the price of its antiretroviral, ritonavir [Norvir], by 400%, a decision that prompted senators on both sides of the political fence to call for a Federal Trade Commission investigation into Abbott's motives.)
While ADAPs receive some funding from the federal government, their primary source of funding is the individual state governments, and patients fare better or worse depending on the state they live in. For example, patients with HIV in Colorado have access to only 18 different medications through the state's ADAP; New York's ADAP offers 474. Eligibility criteria also differ greatly from state to state: while in North Carolina patients must be at or under 125% of the federal poverty level (or earning about $11,000 per year) to qualify, in New York, New Jersey, Delaware, and Massachusetts they must be at 500% or under.
President Bush announced that the federal government will allocate an additional $20 million in 2005, but this increase isn't likely to fill the deep crevasses in states' budgets or to make medications available to all who need them, especially if companies like Abbott are permitted to increase their prices so drastically .-Dalia Sofer