Frontdesk
by David Waggoner
At Disney World, the waiting lines to get onto rides are deceiving. They look short at first but, once you shuffle forward enough spaces and round a corner or two, you then see the rest of the line, which up till then had been hidden from view. It’s kind of a nasty trick, but easily forgiven in the end when you finally scramble into the ride car and get back into the swing of excitement.
Not so easily forgiven are the federal- and state-funded AIDS Drug Assistance Programs (ADAPs), whose lines for admittance suddenly and shockingly came into view last month. ADAPs offer HIV medications to low-income, uninsured, and underinsured people living with the disease, so the longest those in need should wait should be the amount of time it takes to process the paperwork.
According to the National ADAP Monitoring Project 2005 Annual Report released last month by the Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors, eleven U.S. states have started waiting lists in response to shortfalls in ADAP funding. Waiting in Alabama, Alaska, Arkansas, Idaho, Iowa, Kentucky, Montana, Nebraska, North Carolina, West Virginia and Wyoming are 627 HIV-positive people and counting. In addition, ten other states have had to limit access or enact other cost-cutting measures, including three states which have capped enrollment and four that have reduced or restricted ADAP drug formularies.
According to CQ HealthBeat, seventeen ADAPs do not offer all FDA-approved antiretroiviral drugs. Fifteen ADAPs offer fewer than ten of the sixteen drugs highly recommended for the prevention of OIs. In fact, the discrepency from one state to another makes one wonder if mass migration of HIV-positive individuals is not in store: Louisiana offers twenty-five drugs in its formulary compared to New York’s 500.
If the CDC and other public-health agencies recommend that HIV-positive individuals start treatment as early as possible, doesn’t the government really need to start putting its money where its mouth is?
True, about thirty percent of people estimated to be living with HIV nationwide do receive ADAP services. And most states with the greatest number of HIV-positive residents currently do not have waiting lists. And ADAP budgets did rise eleven percent from 2003 to 2004, though one-third of that bump was due to rebates from drug manufacturers.
The bright spots of ADAP, however, provide only cold comfort because waiting is never easy. It’s hard enough to wait for the next available slot in your doctor’s schedule, let alone for drugs that might very well extend your life. Lines help to create anxiety; they incubate a “Why bother?” sense of defeatism. A first step to counter this is to show America how long the line truly is for those in need of funding and services.
And to line up in support of all people living with HIV/AIDS. Craig Miller, the founder of the AIDS Walk movement, has been doing that for over twenty years. As A&U’s Chael Needle found out in one of this month’s feature interviews, AIDS funding is on a downward trend but we do not have to let our confidence and own sense of empowerment plummet as well. Miller reminds us that the public has always been ahead of the government in leading the way. We have a deep fund of compassion and power ready to be tapped.
As actress and writer Jenifer Lewis, this month’s cover story interview subject, says, “Being an activist just means being alive and being aware. It doesn’t take much. It’s very simple.” Now that’s a line to live by!
May 2005
