August 17, 2004
As the GOP prepares to highlight President Bush's compassionate side at its upcoming convention, the White House will likely trumpet the president's global AIDS plan as a prime example of his care for the less fortunate. But the fact is, not only has the U.S. global AIDS initiative failed, so has the domestic fight against the virus.
Bush promised a little more than a year and a half ago to put $15 billion into global AIDS treatment and prevention programs over the next five years. So far the United States has given out only about $850 million of the money, and with all sorts strings attached. The program won't pay for generic drugs, and it pushes abstinence-only prevention campaigns.
Here at home, about 1 million Americans are known to be currently living with HIV, more than half of whom are not receiving care, some researchers believe.
In the poor neighborhoods of the richest country in the world, we are failing our own people.
Soon after aggressive drugs called anti-retrovirals were introduced in the mid-1990s, drug companies immediately began charging astronomical sums, making the price of treatment between $10,000 and $12,000 a year. When associated costs are added in, it's closer to $20,000 a year.
Studies estimate that only about a third of Americans living with HIV have private insurance (compared to three-quarters of Americans overall). How do the rest pay for treatment? Half are enrolled in Medicaid or Medicare, and a fifth are uninsured altogether.
In just about every state, Medicaid is on the brink of financial collapse, in large part because of the programs' disproportionate load of disabled and chronically ill subscribers. Rather than boost the federal share of this burden, the Bush administration has spent the last four years pushing a plan that would cut federal funding to states. In return, the White House would relieve states of the cumbersome rules that accompany federal cash -- like, say, the one that prevents them from "cherry picking" the most desirable (in other words, the least expensive) applicants.
The AIDS Drug Assistance Program, which is the federally funded, state-run safety net for uninsured HIV-positive folks, is in even worse shape than Medicaid.
As of the beginning of August, more than 1,500 people in nine states had been forced onto waiting lists due to lack of funds. Another 10 states have set up other cost-containment measures, such as limiting what drugs are available, and six more are expected to do the same soon.
In fact, only 17 states offer the full range of HIV meds recommended by the U.S. Public Health Service.
In June, Bush announced $20 million in emergency funding to get rid of the existing waiting lists. But that money also has not yet gone out, and the waiting lists have since grown.
What's more, the White House's budget for next year gives the AIDS Drug Assistance Program only an extra $35 million. That's about $280 million less than what state AIDS program directors told Bush they would need to avoid having the same waiting lists this time next year.
Sadly, the White House appears to have chosen to conserve its compassion.
Kai Wright is editor of BlackAIDS.org, and lives in New York City. He can be reached at pmproj@progressive.org.