An editorial in this week's Lancet reminds us of the problems being experienced by HIV positive people in the USA who are on a low income or are without adequate health insurance. While AIDS Drug Assistance Programmes (ADAPs) exist as an important safety net to meet the shortfall, providing vital drugs and social support to more than 191000 Americans in need, a number of ADAPs themselves are facing financial difficulties and can no longer accommodate all those in need of assistance.
By mid-May 2011 a record total of 8100 people, in 13 states, were on waiting lists to join ADAP. In an indication of the situation's seriousness, several states have already tightened their criteria for ADAP eligibility while others have closed their programmes to new joiners. The economic downturn has been blamed for this. Not only are federal funds tight, rising unemployment has led to larger numbers of people living with HIV losing their jobs and, as a result, their health insurance cover.
So what is being done to avert this crisis? State and federal HIV budgets have increased in the current financial year in an attempt to address the need. HIV drug manufacturers have also played their part- donating drugs to several ADAPs and by engaging in negotiations to reduce or freeze HIV drug prices. Signed into law in March 2010, 2014 should see full implementation of President Obama's Patient Protection and Affordable Healthcare Act, with provisions ensuring those in greatest need will gain improved access to healthcare.
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