The Cost of Doing Nothing

The Ryan White CARE Act is the backbone of not only care, but of access to life-saving medications that have made such a dramatic change in the AIDS epidemic by changing mortality rates.  The access to these medications is through the AIDS Drug Assistance Program, known as ADAP and which is part of the Ryan White CARE Act.  ADAP funds come primarily from the federal government, with states also kicking in some of the money. 

So on this eve of the election, it is important to take into account the consequences of that inaction.

In South Carolina, there are more than 200 people on the waiting list for the benefits that ADAP brings to the life of a patient.  A year ago, the state did not have a waiting list.  The National Alliance for State and Territorial AIDS Directors stated in September, 2006, that the $2 million dollar increase in funding from the federal government was the smallest increase in the program ever and that six states had developed wait lists. 

Look at the consequences for those on wait lists.  According to the Title II Community AIDS National Network (T2CANN), three people in South Carolina have died while on the waiting list and it is expected that by the end of the year, the waiting list in that state will reach 350.  Federal funding has essentially, according to T2CANN’s press release, been basically flat for the past four years.  It bears noting that a majority of the people on the ADAP program in that state, are African American.  T2CANN states that many states are in the position of having to devise waiting list for the life saving medications. 

Other consequences are a shrinkage of formularies in states and new eligibility requirements, both with a cost to public health. 

Quoting Congressman Maurice Hinchey, the release states "The saddest part of this is that everyone in Congress is well aware that these drugs save lives.  It isn’t ignorance; instead it’s a dangerous incapacity in Congress to be able to prioritize saving human lives… Congress knows the ADAP need, they just haven’t acted on the obvious."

The cost of doing nothing, was very high to the three people on the South Carolina wait list, and their families, and the hundreds more perhaps yet to come.  It is uncanny that the talent of industry to come up with these life-saving drugs could be hampered by the inaction of legislative bodies to protect the public health.

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