Funding gap threatens AIDS drug help In Florida and Other States


Patients who need HIV/AIDS drugs but can't afford them could be in danger of
going without if the Florida program that supplies the drugs runs out of
money as threatened by mid-February, state officials said Wednesday.
The AIDS Drug Assistance Program has a $14.5 million funding gap that could
last until the new funding year begins April 1.

``We're running out of money, and we're trying to help the patients through
this six-week gap,'' said Tom Liberti, chief of the HIV/AIDS Bureau of the
Florida Department of Health. ``We're exploring all our options.''
But Liberti said he's ``99 percent of the way'' toward working out an
agreement in which major drug manufacturers will supply drugs to tide over
the program.

Locally, the Miami-Dade HIV/AIDS Partnership, which advises the county on
AIDS matters, will hold an emergency meeting Friday to discuss whether to
reduce the number of nonessential drugs available to AIDS patients while
keeping them supplied with life-saving antiretroviral medicine.

Doctors say it's important for newly diagnosed HIV patients to get
antiretroviral drugs quickly to keep them from progressing toward AIDS and
to reduce the chance of infecting others.


In Florida, ADAP has been providing drugs to 10,600 patients, with 3,000 of
them in Miami-Dade and Broward. Short of money last year, the state on June
1, 2010, started putting new patients on a waiting list that now has an
additional 2,800 people, including 685 in Miami-Dade and 475 in Broward,
Liberti said.

Patients on the waiting list have been receiving antiretroviral drugs from
major pharmaceutical companies' charity ``Patient Assistance Programs,'' but
in some cases have been unable to get ``nonessential'' drugs that treat side

``At present, no patients are doing without AIDS drugs,'' said Dan Wall,
director of the Miami-Dade Office of Grants Coordination. But he said
funding could run out by mid-February unless a solution is found. On April
1, another $100 million in federal AIDS drugs funding arrives in Florida,
Liberti said.

Help may be on the way through Wellvista, a South Carolina nonprofit
organization. The group, acting on behalf of medical manufacturers, helps
provide drugs to patients who can't afford them. ``We have nearly every
major manufacturer -- Merck, GlaxoSmithKline, Bristol-Myers Squibb and
others,'' said Jeffrey Lewis, president of Heinz Family Philanthropies,
which is working with the drug companies.

Also, state Sen. Joe Negron, a Stuart Republican, and others are working to
persuade the Florida Legislature to provide money to help support the ADAP
program, Liberti said.

Liberti blamed the poor economy and a list of applicants that has grown by
25 percent since 2008 to reach 13,000 people statewide. In 2009, the
Legislature cut ADAP support by $1 million to $10.5 million. No additional
funding was appropriated in 2010.

President Barack Obama has proposed an increase of $20 million for 2011,
while the AIDS Institute and others are calling for an increase of $126
million. The federal government provides 49 percent of ADAP funding, down
from 69 percent in 2000.


While funding is being worked out, the Miami-Dade HIV/AIDS Partnership may
have to recommend temporary restrictions on certain nonessential medications
like vitamins and aspirin, a spokeswoman said.

On Friday, the Partnership will hold an emergency meeting at the Behavioral
Science Research building, 2121 Ponce de Leon Blvd., Coral Gables, to
discuss such restrictions and how to deal with the financial crisis. The meeting is open to the public.

Call 305-443-2000 for information.

How do African Americans view the epidemic themselves?

A 2009 survey by the Kaiser Family Foundation discovered over a fifth of black Americans cite HIV/AIDS as the most urgent health problem facing the US, significantly higher than the 6% average. (It should be noted that both figures have declined dramatically since as recently as 2004.)46 In another survey, four-fifths of African Americans believed that government spending on the disease domestically was insufficient. They also reported experiencing the highest levels of HIV-related stigma, were the most aware about transmission routes, were the most likely to have been tested, and were the ethnic group that was the most likely to say that they knew someone who was living with HIV or had died of AIDS.47

The level of concern and awareness about HIV is perhaps unsurprising given the severity of the AIDS epidemic within the black population. Though such surveys reveal higher levels of awareness among African Americans about HIV and AIDS, there are troubling signs that this is decreasing. Between 2004 and 2009, the proportion of black Americans who said they had seen, heard or read a lot about AIDS in the past year declined by almost half from 62% to 33%.48

A significant proportion of African Americans do not blame the spread of HIV on risky sexual behaviour, but instead hold the government responsible. 48% of African-Americans surveyed by Oregon State University researchers between 2002 and 2003 believed that HIV was a man-made virus. Over half (53%) believed that there was a cure for AIDS that was being withheld from the poor, and 27% thought AIDS was produced in a government laboratory. 12% thought that HIV was created and spread by the CIA and 15% thought it was a form of genocide against blacks.49
Such beliefs are perhaps understandable given the context of prejudice and exploitation that many black Americans have grown up with. Indeed, those that were found to have the most extreme conspiracy theory views in the study were unsurprisingly those that had encountered the most racism in their lives. Some cited the infamous ‘Tuskegee’ experiment as the basis for their beliefs. Conducted by the US government between 1932 and 1972, the study aimed to investigate the natural course of the sexually transmitted disease syphilis in the black population. Over 600 black men were enrolled, many of whom were infected with syphilis, but none were ever offered treatment. Many died as a consequence, fuelling outrage throughout the black community, and beyond.50

Such unethical practices have left a scar on the African American population that may never fully disappear. The conspiracy theories that they have given rise to also pose a serious risk to HIV prevention strategies, as they place the blame for infection elsewhere, and can stop individuals from taking responsibility for their own actions.51

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