Across-the-board federal spending cuts – the sequester – may leave people living with HIV/AIDS without drugs and emergency housing and threaten the quest for a vaccine and cure, caution activists across the country.
In Wisconsin, efforts are being made to cover potential gaps in care and assistance, said Mike Gifford, president and CEO of the AIDS Resource Center of Wisconsin. “There is such great hope today in the fight against HIV,” he said. “We are working hard to make sure that none of that changes in light of the sequestration.”
On March 1, spending cuts under the sequestration law took effect for defense and discretionary spending programs. The cuts are projected to impact a range of federal services and programs and lead to the furlough of federal workers.
The damage to HIV/AIDS programs will be acute, agree health care and social service experts. Foremost among their concerns is the impact the cuts will have on the AIDS Drug Assistance Programs that are operated by each state using a combination of federal and state dollars. Carl Schmid, deputy executive director of D.C.-based The AIDS Institute, warned that the continuing resolution passed by the House and sequestration cuts could “force states to be in a dangerous situation of stopping payments for medications to over 7,400 people currently in treatment.”
Patients who go off their medication run the risk of a rebounding infection that not only imperils their lives but also increases their level of contagion to others. Patients who miss even a single dose of their anti-viral medication can develop resistance to the entire class of drugs to which it belongs, meaning no drug of the same class will ever control their virus again. That’s a particularly grim scenario at this point in the epidemic, with many patients now on the last remaining drug capable of holding their virus in check.
Gifford said Wisconsin’s HIV/AIDS leaders will do everything possible to protect the state’s ADAP.
“In Wisconsin, we have a proud history of never having a waiting list for the AIDS Drug Assistance Program,” Gifford said. “We’ve made it our top priority to make sure the program is fully funded. And we are hopeful that the political support we have received will be maintained even in light of sequestration.”
Gov. Scott Walker’s budget proposal would fully fund ADAP. So community leaders and health care officials, along with activists such as Madison resident Sean Burke, are working to make sure legislators are aware of the sequester’s impact and the need to protect ADAP at the state level.
Burke, expressing concern for a lack of attention and awareness on the issue, said eliminating patients from ADAP would threaten lives. In such a situation, wondered the activist who is living with HIV, “Who would decide who would live and who might die? How do you do that?”
Yet another state concern is addressing a $100,000 reduction in federal funding for HIV prevention. “That cut in funding by the federal government is foolhardy,” Gifford said, noting that caring for a person living with HIV costs hundreds of thousands of dollars. “We would hope that the state would find a way to absorb that cut.”
The CDC and Milwaukee health officials have been struggling in recent years to rein in the skyrocketing rate of new infections among African-American gay and bisexual males in the city.
AmFar/The Foundation for AIDS Research and the National Minority AIDS Council recently released national estimates on the impact of across-the-board funding cuts to domestic HIV/AIDS programs:
The groups, in a statement released with their estimates, cautioned that the sequester will “have a devastating impact on people living with HIV/AIDS in America” and limit “the United States’ ability to reduce the rate of new HIV infections, improve access to care and reduce the disproportionate impact of HIV/AIDS on communities of color.”
Longtime activist Phil Wilson, who founded the Black AIDS Institute, said the most severe effects will be “felt in black America” and come at a “deciding moment in the trajectory of the AIDS epidemic.”
The Obama administration has said that creating an AIDS-free generation is a realistic goal, but sequestration threatens success. “We are either going to decide to do what’s necessary to end the epidemic in this country or we’re going to decide to continue to see American citizens get infected, get sick and die from AIDS,” Wilson wrote in an op-ed for the Florida Courier.
He and others made the case that to continue advances against HIV/AIDS, funding must be increased, not decreased.
“With the advent of antiretroviral medicines, HIV has turned from a near-certain death sentence to a treatable chronic disease if people have access to consistent and affordable health care and medications,” said Schmid. However, he added, only 37 percent of the people with HIV in the United States are prescribed antiviral treatment and only 25 percent are virally suppressed.
On the Web…
Activist Sean Burke's White House petition on funding.