Tuesday, June 1, 2010

A Matter of Life & Death

I just had an op-ed posted on NC Policy Watch and the Carroboro Citizen and wanted to share it with you.

Here's the post:

For years, North Carolina's AIDS Drug Assistance Program (ADAP) had the most restrictive eligibility level in the nation. This critical program is designed to make sure that low-income people living with HIV get the medicine they need to stay healthy and significantly reduce the risk of transmission.

A few years ago, the state was actually telling people who made $14,000 a year that they should buy their own AIDS medicines, which cost $12,000 or more every year. People were literally choosing between rent, food, and medicine.

Fortunately the legislature took action in 2006 and 2008 to increase the eligibility level to the national standard of 300 percent of the Federal Poverty Level. Since that time, the program has served hundreds of people and has been something our state can be proud of.

This program isn't something that folks stay on forever. When people are on today's AIDS drugs, they can live healthy and productive lives. They often get jobs with insurance that allow them to get off the program.

When people aren't able to get these medicines, the outcomes are very different. Their viral loads are much higher, making the risk of transmission much greater. Often, they're too sick to work, driving them deeper into poverty. And people die unnecessarily.

ADAP has been working and preventing those deaths, but in February the program closed to new enrollment due to increased enrollment and lack of funding.

In just three months since the program closed, 481 eligible people have been put on a waiting list and turned away from the program. That's by far the largest waiting list of any state in the country, and there are more people added every week.

What does that mean? It means a young person who just tested positive can't access the program. Testing programs lose their impact if clinics can't connect their low-income patients with care.

It means that a worker who lost her job-and her health insurance-due to the economic downturn may have to go off of the medicines that have been keeping her healthy. That doesn't just put her health at risk, it can create drug-resistant strains of the virus that add to the public health crisis in our state.

It means that a kid who was born with HIV loses access to the drugs that have kept him alive his entire life the day he become an adult and ages out of Medicaid.

The state cannot continue to risk the lives and health of its citizens by turning people away from this critical program.

Fortunately, Governor Perdue took an important step by seeking an additional $14 million in state funds to re-open ADAP to the lowest-income patients. That's movement in the right direction, but it's not enough to keep the program open throughout the upcoming fiscal year.

The legislature must take the Governor's proposal and increase it to at least $17.7 million to allow the program to reopen and remain open to serve low-income North Carolinians who need access to these drugs. Even with such a boost, ADAP's eligibility level would fall back to the shockingly low level it was a few years ago: 125 percent of Federal Poverty Level.

Budget writers face tough decisions this year, and many valuable programs that make our state a better place will be on the chopping block. None of us want to take away from other important efforts to fund this or that. But when legislators are weighing how to allocate health and human services funding, fully funding programs like ADAP that are literally a matter of life and death should be their first priority.

Ian Palmquist is Co-Chair of the North Carolina AIDS Action Network and Executive Director ofEquality North Carolina.


  1. What I find so hard to believe here is the lack of common sense on this issue. Senator Brunstetter quoted, "the lack of funding for ADAP is not something we should expect to change because we are experiencing overall budget deficits. " However, this is an issue of life or death as Ian has already mentioned. We cant find a place to fit individual's lives into the budgetary equation? What does that say about our morals and ethics?

    This isnt an issue that is negotiable. Individuals cannot be expected to pay for medication that equals the amount of their yearly income. That is another common sense piece of knowledge. The issue regarding the budget really is: How do we better appropriate monies we already have in order to provide for more serious issues (such as human lives) and less for other things (say General Assembly travel expenses and salaries).

    This isnt an issue I expect to be easily resolved any time soon. However, we do need to reapply common sense back into the General Assembly and into the discussion of the issues.