What would Anderson Cooper say about the promised ADAP funding?

“Keeping them honest” – where is the money?

The ongoing saga over the number of Americans living with HIV/AIDS being denied access to care under the AIDS Drug Assistance Program (ADAP) belongs on CNN's Anderson Cooper 360. The crisis has been escalating for over two years, full of its share of empty promises, demands for fact-checking, and people -- especially patients -- wondering what to believe. "Keeping them honest" couldn't sum it up any better.


Almost two months ago on World AIDS Day, December 1st 2011, President Obama thankfully promised an additional $35 million dollars that would go to state ADAPs. This money should have already been rolled out. However no state has yet to see any of these additional funds, and the frustration level in the HIV/AIDS community is building.

Also building are the ADAP waitlists in America; which on January 19th, 2012 totaled 4,611 individuals across 12 states waiting to receive the anti-retroviral medication they need to stay alive, remain healthy, and productive. While this number is down from a high of nearly 10,000 last year, once again, the number has steadily been on the uptick.

So what is the hold up? Where is this money? Where is it coming from, and when will it be allocated to the states?

The $35 million dollars is reallocated HHS (Health and Human Services) funds, but before the funds can be reallocated the OMB (Office of Management and Budget) needs to approve. Apparently, saving lives is not at the top of the OMB list. As PLWHA continue to wait for these funds more people will become infected, more people will be put onto wait-lists, states will try to change criteria making it difficult for people to get medicine, and sadly people will likely die.

Once approved by the OMB then states will begin the competitive process of requesting this additional money. The most competitiveness will be among states with waiting list and already implemented cost containment measures. This all takes time. A current guestimate on when this money may start to roll out is not until July 2012!! That would be 7 months from the date of the announcement made on December 1st, 2012!

Did you know on the first day of American intervention in Lybia it cost US tax payers $100 million dollars, and over the three month period from April – July a total of nearly $1 billion was spent on the war with Lybia? Why will it take 7 months to distribute $35 million in reallocated HHS funds to states with people who continue to wait for the medicine they need?

Since Obama took office a robust national dialogue on HIV/AIDS has taken place, the National HIV/AIDS strategy was developed, his administration has increased overall funding to record levels, he re-authorized the Ryan White care act, and eliminated the travel ban on HIV positive individuals entering the United States. He has done a lot of good when it comes to HIV/AIDS, but more must be done here at home. With the 2012 International AIDS Conference coming to Washington, DC, isn't it embarrassing for the United States of America to deny access to care to thousands of patients who desperately need it?

“We are at the beginning of the end of this epidemic” the President said on World AIDS Day 2011, and said on this day that his vision was that “…..every American can get access to life extending care” but that vision, neither is hope in insight for the thousands of Americans that continue to be on ADAP wait-lists.

Ohio ADAP Crisis Shapes Up as Firewall for ADAP Stakeholders Nationwide

As goes Ohio, so could the Nation. The Ohio Health Department is putting up a strong fight to lower the federal poverty limit from its height of 500% in July 2010, lowered to 300% at that time, to now have the ability to implement a potential income eligibility change to as low as 100 % FPL at any time with no notice to anyone with a stroke of pen. If that rule had gone into effect, it would mean in order to qualify for the AIDS Drug Assistance Program a single individual cannot make more than $10,890 a year in order to be eligible. Further, ODH could implement medical criteria one must also meet. Those given the highest priority will be PLWHA who’s CD4 counts are lower than 201. The medical criterion makes no mention of an important aspect of HIV care which is the Viral Load.

Back on December 14th, three Ohio HIV-Positive advocates with the assistance of The AIDS HealthCare Foundation won an injunction to these proposed rule changes in the Franklin County, Ohio Court of Common Pleas, resetting the FPL to 300%. ODH had proposed one set of rules, had a hearing, and then changed the rules to the above without telling anyone. The judge had ordered ODH to go back to the drawing board…and they did. The end result is the terrible rules listed above.

If the Ohio Health Department lowers the income limit to 100% FPL, nearly 2,600 of Ohio’s PLWHA will be forced off of ADAP (half of the program) , and countless others who will become newly infected will have no access to the medicine they need to remain healthy and alive.

Ohio is trying to implement these rules on the backs of the poor and vulnerable, especially those living with a potentially life threatening disease such as HIV/AIDS.

With today’s medicine PLWHA can lead long productive lives; they are at less risk of developing an opportunistic Infection, and in 2011 a ground breaking study stated those on Anti-Retro viral Therapy (ARV) are 96 percent less likely to pass the virus to their partner.

The Ohio Department of Health is soliciting comments from the public:

The Public notice process is as follows:

1) Public Comment Period- Once the rules have been reintroduced, the Department will solicit public written comments regarding the new proposed rules. This period runs until January 23, 2012

2) ODH Public Hearing- Once the Public Comment period has been completed, there will be a public hearing held in which all interested parties will be able to submit written or provide in-person testimony in support or in opposition of the new proposed rules. This hearing is mandated by the legislature to be within 31-45 days after a rule change is proposed.

3) JCARR hearing- Once an agency has completed the public comment period and has held the public hearing; the rules then go to a legislative committee to ensure that the agency has complied with the law in proposing the new rules. After this hearing, the agency final files to enact the new rules to bring them into effect.

How can ADAP stakeholders help:

Anyone from the United States can send an e mail to HCS@odh.ohio.gov emphasizing concerns over these proposed changes. In the subject line use: Rule 3701-44-03

Click to see ODH proposed Medical Rule Criteria proposed

Click to see ODH proposed changes to financial eligibility

Hershey hate; demand the Hershey's Company intervene to reverse decision on HIV+ student and dismiss school officials

***Reprinted with permission from RiseUpToHIV***

How sad that this story continues and the school has not reversed course.  Each night for the past three nights CNN’s Anderson Cooper AC360 news show has made this a top story and has been giving it a lot of attention. Thank you Anderson. To view a clip of the story that appeared on AC360, click here.

However, this story has fallen out of news media and the public spotlight, we need to press on with story. We must not allow this school and the Hershey's Company to remain silent on this issue. We deserve a dignified and actionable response.  Below is my take on this incident and the various information that has been in the news.


The communications director of the school has made numerous on air appearances continuing to support statements coming from the school. Does Connie McNamara, Vice President of Communications at Milton Hershey School really stand behind these statements each night, does she really believe in the words in these statements, and is she THAT uneducated about HIV/AIDS?!? Or, is she trying to keep a job? If I were her I would do the right thing and resign my position immediately.  I feel this fear goes deeper into the administration at Milton Hershey and those NOT in support of this decision have a moral duty to walk away,  bring down the veil and reveal who the real fear mongers are at this school.  It is time for Milton Hershey Trust Company to intervene in this matter!

I cannot believe the ignorance surrounding this story, and why the parents of these children of the school are not in support of this boy?!? Have we really fallen back 20 + years on AIDS education and awareness? I am mad and saddened. If I had the organizing power I would organize busloads of protestors to descend on the school and we would hold out for days, or weeks. If not to force the school to accept this student, but to stand in solidarity with this student as reminder that HIV/AIDS is still around 30 years later, and that this kind of discrimination today, especially in America cannot be tolerated.

I am further outraged that a school founded by the Hershey Co.  in 1909 and financed by the Milton Hershey School Trust, which also holds the controlling interest in The Hershey Co. has yet to issue a statement or intervene in this matter. Below is part of the mission statement for the Hershey Co…..

"At The Hershey Company, we make the chocolate brands that people love. Hershey’s Mission Statement, Bringing sweet moments of Hershey happiness to the world every day, summarizes our company, our people, our past and our future. Our history of producing the world’s best treats goes back more than 100 years. We take great pride in our brands and in the fun and enjoyment our products add to the lives of our consumers.

Hershey has a distinguished record of supporting the well-being of children through our relationship with Milton Hershey School. The School was established by the company’s founder in 1909 and provides a nurturing environment, quality education, housing, and medical care at no cost to children in social and financial need. The School is administered by the Hershey Trust Company, Hershey’s largest shareholder, making the students of Milton Hershey School direct beneficiaries of Hershey’s success."

By denying access to this child to the Milton Hershey School, Hershey Co. has gone a 100 year back on its strong values, and distinguished record of supporting the well-being of children. Milton Hershey School and Hershey Co. have put the well-being of this child at risk, and the school and Hershey Co. should be held liable to the highest extent of the law. No longer will I think of Hershey as bringing sweet moments and happiness to the world every day. When I see a Hershey product it will bring me disgust and sadness. I will forever connect the Hershey Co Brand with this horrific display of ignorance.

I have started a petition on change.org asking people to sign and leave a comment, regarding boycotting the Hershey brand and supporting a statement directly from the Hershey Trust Company.  Again, if I had the organizing power I would position protestors outside grocery stores throughout the country, asking shoppers to boycott Hershey products; especially during this holiday season.

I can only hope the community of Hershey, PA, surrounding communities, the students and the parents of the school take a stand, by rising up to HIV, dismantle the ignorance that lies deep within this schools administration. As a PLWH and in solidarity with those around the World; we must and will continue to educate the public on the very minimal risks of contracting HIV/AIDS. I would immediately call on and ask the Hershey Trust Company to intervene and issue a statement on this matter.

In the interim I have compiled a list below of all Hershey products you may consider boycotting, and remember to sign the petition!

With sadness in my heart and with hope for a positive outcome,  

Kevin Maloney
Founder: Rise Up To HIV
“Voices in Unity Strengthening Community”
Twitter: http://www.twitter.com/riseuptohiv

SIGN THE PETITION

If you would like to write a letter, send an e mail, and/or call the school and the Hershey Company a list of contact information is below:

Milton Hershey School
PH: (717) 520-2000
E-mail: mhs-communications@mhs-pa.org
Admissions 1-800-322-3248
Fax: (717) 520-2117
E-mail: mhs-admissions@mhs-pa.org
Hershey Company
http://sites.hersheys.com/contactus/canada/
(A phone number is listed, and you can fill out an online form choosing which state in the US or where in Canada you are located)



Dagoba
5TH AVENUE
Almond Joy Bars
Breathsavers Pucks
Breathsavers Rolls
BUBBLE YUM
CADBURY
GOOD & PLENTY
Hershey's Chocolate for Baking Bars
Hershey's Cocoa
Sweet & Salty granola bars
HEATH
Hershey's Bars
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Hershey's KISSES
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JOLLY RANCHER
Kit Kat Wafer Bars
Mauna Loa Boxed Chocolates
Mauna Loa Mix
Mauna Loa Chocolate Covered Macadamia Nuts
Mauna Loa Cookies
Mauna Loa Macadamia Nuts
MILK DUDS
Mounds Bars
Mounds Sweetened Coconut Flakes
MR. GOODBAR
Shell Toppings
Scharffen Berger
SNACKSTERS
SNACK BARZ
Sprinkles
SUGAR FREE
Syrup
PIECES
Hershey's SYMPHONY
PAYDAY
Reese's Crispy Crunchy
Reese's FAST BREAK
Reese's NUTRAGEOUS
Reese's Peanut Butter
Reese's Peanut Butter Toppings
Reese's Select
Reese's WHIPPS
Reese's Peanut Butter Cups
REESESTICKS
ROLO
SKOR
TAKE 5
Twizzlers Bites
Twizzlers NIBS
Twizzlers PULL N PEEL Candy
Twizzlers Twists
WHATCHAMACALLIT
WHOPPERS
YORK
YOUNG & SMYLIE
ZAGNUT
ZERO

Solutions, not Proclamations, are needed to ‘End The Wait’

Since 1987, December 1st has been dedicated to raising awareness about HIV/AIDS with World AIDS Day. In 2011, people living with HIV/AIDS in the United States have much be thankful about with respect to the progress achieved over the years. HIV/AIDS is no longer a death sentence with the advent of highly active anti-retroviral therapy (HAART); HIV/AIDS is protected under the Americans with Disabilities Act (ADA); and President Barack Obama was the first president to unveil a National AIDS Strategy to combat HIV/AIDS in America. But not all the news is promising, and there remains much work to be done. Reflecting upon the millions of lives lost in the struggle against HIV/AIDS, it is important to remember that there remains negative stigma associated with the disease; thirty-six states have HIV criminalization laws on the books; and in the wealthiest nation there are 6,595 people living with HIV/AIDS in twelve states on waiting lists under the AIDS Drug Assistance Programs (ADAPs).


People living with HIV/AIDS have come to expect proclamations on World AIDS Day from the President, Congress, Governors, State Legislators, Mayors, City Councils, AIDS Service Organizations, State Health Departments, and so on. Whereas proclamations make us all feel good, they do little to solve the ongoing ADAP crisis that has allowed thousands of people living with HIV/AIDS to fall through the cracks of our public health system. So, it begs the question: What do these proclamations do to help the 75 people in Alabama, 3,213 people in Florida, 1,525 people in Georgia, 5 people in Idaho, 475 people in Louisiana, 9 people in Montana, 9 people in Nebraska, 95 people in North Carolina, 0 people in Ohio, 65 people in South Carolina, 13 people in Utah, and 1,111 people in Virginia presently being denied access to appropriate, timely care and treatment?

While there remain a few ideological "Talibangelicals" who view HIV/AIDS as God's "punishment" for behavior or lifestyle, Americans have mostly opened their hearts and their minds to accepting and helping people living with the disease. By in large, politicians of both political parties have recognized the importance of stable, robust HIV/AIDS programs - including ADAPs. That is why what marks the 24th celebration of World AIDS Day, how can thousands of people living with a potentially life-threatening disease be asked to WAIT for their life-saving medications?

Read related CNN Story, "The long wait"

Yesterday, Senators Richard Burr (R-NC), Tom Coburn (R-OK), Michael Enzi (R-WY) and Johnny Isakson (R-GA) sent a letter to State Department Secretary Hillary Rodham Clinton and Health & Human Services Secretary Kathleen Sebelius seeking to find a solution to the lingering ADAP crisis facing thousands of people living with HIV/AIDS languishing on waiting lists. Their letter comes on the heels of similar requests made by Senator Marco Rubio (R-FL), as well as Representatives Alcee Hastings (D-FL-23), Debbie Wasserman Schultz (D-FL-20), Ted Deutch (D-FL-19), and Frederica Wilson (D-FL-17) to HHS. Each of these lawmakers have been fighting to secure additional federal funding since the crisis started over two years ago.


[Photo: Burr-Coburn-Enzi-Isakson ADAP Letter]

And today, President Obama announced he has directed HHS to increase funding for domestic HIV/AIDS treatment by $50 million, including $35 million to ADAPs. This represents the second time in as many years whereby the President has reprogrammed funding to the cash-strapped program. While the additional funding is welcomed news, it remains short of the level necessary to eliminate the ADAP waiting lists entirely.

World AIDS Day is important because it highlights a disease that continues to impact millions of people in this country, and abroad. The proclamations are important because they symbol the national commitment to eradicate the disease. But more important are the solutions designed to help people (and help people help themselves) RIGHT NOW! After all, it are those solutions that are a true testament to nation's commitment to fight HIV/AIDS!

Deficits vs. Austerity: Where do either leave ADAPs

Once again, Congress demonstrated that its effectiveness as a governing institution is in serious peril. Congress was unable to complete its Constitutional and Statutory duty to approve a federal budget and send it to the President for his signature. Annually, thirteen appropriation bills must be passed by Congress prior to the end of the fiscal year, which ends on September 30th. They fund those programs, projects and activities that operate within the discretionary sector of the Federal budget - including the AIDS Drug Assistance Programs (ADAPs) under the Ryan White Program. The federal government is now operating under a short-term spending authorization - otherwise known as Continuing Resolution - but it certainly leaves the fate of funding for the cash-strapped ADAPs up in the air.

Article I, Section 9, Clause 7 of the Constitution provides that "no money shall be drawn from the Treasury but in Consequence of Appropriations[.]" More accurately however, it can be characterized like making sausage.

In recent history, Congress has been forced to lump a litany of federal programs together during a messy, non-transparent legislative process...ending with an "Omnibus" spending package. Omnibus spending bills provide both opportunities and challenges for important federally-funded programs. But in the current fiscal environment, many HIV/AIDS advocates are concerned that needed funding increases will fall by the wayside.

In fact, there is already some indication that programs like ADAP could be facing even harder times. The House Appropriations Committee earlier this year released its draft fiscal year 2012 Labor, Health and Human Services (LHHS) Appropriations. The spending bill includes federal funding for programs within the Departments of Labor, Health and Human Services, Education, and other related agencies.

Upon releasing its LHHS spending bill, House Appropriations Chairman Hal Rogers said, “Many of the programs and services funded in this bill protect the health and safety of the American people and provide assistance to the most vulnerable among us. However, excessive and wasteful spending over the years has put many of the programs and agencies funded in this bill on an irresponsible and unsustainable fiscal path. To protect critical programs and services that many Americans rely on – especially in this time of fiscal crisis – the bill takes decisive action to cut duplicative, inefficient, and wasteful spending to help get these agency budgets onto sustainable financial footing.”

While most observers agree that something needs to be done about the ballooning federal deficit, it begs the question whether deficit spending or austerity measures are more harmful to the public safety net. Are the current 6,489 people living with HIV/AIDS being denied access to appropriate, timely care and treatment "duplicative" as described by Rep. Rogers since the Committee proposed no new ADAP funding?

With respect to Ryan White the draft appropriations bill reads:

"For carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, $2,311,665,000, of which $1,980,670,000 shall remain available to the Secretary of Health and Human Services through September 30, 2014, for parts A and B of title XXVI of the PHS Act, of which not less than 25 $885,000,000 shall be for State AIDS Drug Assistance Programs under the authority of section 2616 or 311(c) of such Act: Provided, That in addition to amounts provided herein, $25,000,000 shall be available from amounts available under section 241 of the PHS Act to carry out parts A, B, C, and D of title XXVI of the PHS Act to fund Special Projects of National Significance under section 2691."

ADAPs under this scenario would be flat-funded, despite thousands of people living with HIV/AIDS languishing on waiting lists in twelve states. Carl Schmid, Deputy Executive Director of The AIDS Institute, summarized this Republican-backed approach accurately when he said, "If ever passed, this spending bill would set back the progress we are making in preventing HIV and providing basic care and treatment for those who have HIV/AIDS in our country."

According to the National Alliance of State & Territorial AIDS Directors (NASTAD) there were 6,489 individuals in 12 states on ADAP waiting lists, as of October 27, 2011 - including 44 individuals in Alabama, 3,260 individuals in Florida, 1,415 individuals in Georgia, 2 individuals in Idaho, 489 individuals in Louisiana, 11 individuals in Montana, 8 individuals in Nebraska, 78 individuals in North Carolina, 0 individuals in Ohio, 60 individuals in South Carolina, 31 individuals in Utah and 1,091 individuals in Virginia.

The House legislation would not only flat-fund ADAPs, but also cut certain prevention programs and ban federal funding of syringe exchange programs. Unfortunately, things don't look much better on the Senate side either. When the Senate Appropriations Committee passed its FY12 Labor, Health and Human Services, Education and Related Agencies Appropriations bill, it proposed only a $15 million increase for ADAPs despite the waiting list crisis. Fortunately, other HIV/AIDS-related programs were not cut in the Senate's pending version.

In the final analysis, thousands of people living with HIV/AIDS on ADAP waiting lists will be looking to the Congress...and President Obama...to address this ongoing crisis by making sound decisions on fiscal policy and public health, which aren't mutually exclusive. Whether it's deficit spending, or austerity measures steps need to be taken by the leaders in Washington, DC to enhance the AIDS Drug Assistance Programs. Period!

Patient Assistance Programs: What Patients Need to Know

The AIDS Drug Assistance Programs (ADAPs) are in a state of emergency. According to the National Alliance for State and Territorial AIDS Directors (NASTAD), wait lists have tripled by state and increased by over 1,000% by count since the beginning of 2009. Furthermore, state budget cuts in AIDS programs to the tune of $167 million has truly shaken ADAPs nationwide – but especially in the ten (10) states that were forced to institute waiting lists. In 2000, Congress appropriated seventy-two percent (72%) of the federal ADAP earmark; a number which fell to fifty-four percent (54%) in 2009, and below fifty (50%) percent in 2010. This severe drop in the federal commitment to ADAP – in addition to state budget crises – has largely been the catalyst for the spike in HIV patients placed on wait lists since the start of the crisis. It is anticipated that additional states will have to implement some form of cost containment measure in the upcoming months, including wait lists. In light of the present predicament, educational programs designed to link stakeholders to available resources – including prescription assistance programs and co-payment assistance programs – are urgently needed. Only through a coordinated effort of public-private resources can the wait list crisis be averted.

The problem of growing ADAP waiting lists is exacerbated because the United States is facing an HIV/AIDS epidemic of devastating proportion. According to some estimates, the number of people living with HIV/AIDS in the United States exceeded two million people by of last year. These numbers are not due to decrease in the near future. In 2006 alone, the Centers for Disease Control & Prevention (CDC) estimated that there have been more than 56,000 new HIV infections per year for the last decade. If this was not severe enough, the disease is far from color blind. Currently, the incidence rate of new HIV infection among African American men and women is seven times that of the Caucasian population. Furthermore, racial disparities are echoed regionally as the epidemic has seen its most recent unfettered growth in Southern states, which often times have smaller state budgets and fewer access points to comprehensive care.

The good news is that with the advent of new medicines, people living with HIV/AIDS are able to live full and productive lives. The bad news is that it is increasingly difficult for people living with HIV/AIDS to afford their medications. Life saving medications can cost a single patient up to $20,000 per year. This is compounded by the fact that nearly three quarters of all people with HIV/AIDS are either uninsured or dependent on public insurance. This makes strengthening the public HIV/AIDS healthcare system of critical importance – but in the meantime efforts should concentrate on eliminating the wait lists.

With ADAP budgets stretched to the limit, other resources are needed to help plug the gap. Enter prescription assistance programs (PAPs) and co-payment assistance programs. Pharmaceutical company PAPs make available free or low-cost medications to eligible patients, while co-pay programs provide financial assistance for certain health care costs to patients who qualify financially and medically.

PAPs are designed to support low income U.S. residents with free or low cost prescriptions. The programs usually cover brand name drugs only and are administered individually by the pharmaceutical companies that manufacture the drugs. PAP programs are administered differently by manufacturer and sometimes by drugs within the same manufacturer. In most cases the programs are designed around income guidelines. Most often income has to be below or just above the poverty guideline set by the federal government. There are some companies that go as high as 2-3 times the poverty guidelines. The majority of the programs require the patients to be U.S. residents, be uninsured, and meet the income requirements. Income verification in the form of W-2, 1099, pay stub, etc. must be provided, as well as any benefit statement received. There are exceptions to these requirements. Some programs, for example, allow insurance but no drug coverage, Medicare D recipients are eligible in some cases. Each program has specific eligibility requirements with some are more stringent than others.

There exists an immediate need in ten states - plus numerous others - to link stakeholders with these two important resources. NASTAD is now reporting 7,299 individuals are currently on ADAP waiting lists, as of October 13, 2011 – including 3,389 people in Florida, 1,763 people in Georgia, 5 people in Idaho, 790 people in Louisiana, 11 people in Montana, 58 people in North Carolina, 0 people in Ohio, 18 people in South Carolina, 51 people in Utah and 1,044 people in Virginia.


In response to this growing crisis, please participate in a training on the state of the epidemic and what can be done to help. The ADAP Advocacy Association (aaa+), in coordination with the Community Access National Network (CANN), HealthHIV, AIDS Alabama, Broward House and the Great Lakes ADA Center – which all work to ensure access to care and treatment for every person with HIV in need – is extending this invitation to all ADAP Stakeholders nationwide to gain a fuller perspective from the pharmaceutical companies about how their prescription assistance and co-payment assistance programs can address the many issues confronting people living with HIV disease on wait lists.

The “Accessing & Understanding HIV/AIDS Patient Assistance Programs” virtual trainings are being held to raise awareness about pharmaceutical patient assistance programs (PAPs), in an effort to alleviate the ongoing ADAP crisis. There will be an introductory training for ADAP stakeholders who have little or no knowledge about PAPs, and an advanced training for ADAP stakeholders who are well versed with PAPs, but seek additional information.

Registration is free!

To learn more, or register, please visit http://www.adapadvocacyassociation.org/events.html.

International AIDS funding vs. Domestic AIDS funding; POTUS must act NOW!

When the President's Emergency Plan for AIDS Relief, or PEPFAR, was enacted in 2003 under President George W. Bush, there was an international AIDS crisis facing the world. However, people living with HIV/AIDS (PLWHAs) in the United States were not immune from it because they were facing potential funding cuts to HIV/AIDS programs, as well as growing waiting lists under the AIDS Drug Assistance Program (ADAP). Today the story is unchanged; in fact, the AIDS crisis in America hasn’t been as dire since the epidemic began 30 years ago. How is it that America can spend BILLIONS in U.S. taxpayer dollars on overseas initiatives under PEPFAR, but cannot find approximately $100 million to alleviate the current ADAP crisis in the United States? Have American PLWHAs have fallen by the wayside under the Obama Administration’s handling of our domestic AIDS crisis, most notably with ADAP waiting lists reaching record high levels?

The outcries from numerous organizations, PLWHAs, their friends, family and loved ones have grown into one voice...one movement...with one goal. Their purpose is to bring awareness to the AIDS crisis in America with the achievable goal of ENDING the ADAP crisis now! When will POTUS and other leaders in Washington recognize the problem and finally ACT on it in a substantial and meaningful way?!? The crisis is not going away, and neither are HIV/AIDS advocates!

So, what is PEPFAR?

Launched in 2003 by President George W. Bush with strong bipartisan support, PEPFAR is America’s commitment to fighting the global HIV/AIDS pandemic. Through shared responsibility and smart investments, PEPFAR is saving lives, building more secure families and helping to stabilize fragile nations.

No one is questioning the need for PEPFAR!

How is PEPFAR funded?

With the generous support of the American people (through taxpayer dollars), the U.S. Government has committed nearly $46 billion to bilateral HIV/AIDS programs, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, and bilateral TB programs through fiscal year (FY) 2012.

PEPFAR’s success is measured in lives improved and saved.

➢ In fiscal year 2010, PEPFAR directly supported life-saving antiretroviral treatment for more than 3.2 million men, women and children worldwide, up from less than 2.5 million in 2009.
➢ PEPFAR directly supported antiretroviral prophylaxis to prevent mother-to-child HIV transmission for more than 600,000 HIV-positive pregnant women in fiscal year 2010, allowing more than 114,000 infants to be born HIV-free.
➢ Through its partnerships with more than 30 countries, PEPFAR directly supported 11 million people with care and support, including nearly 3.8 million orphans and vulnerable children, in fiscal year 2010 alone.

PEPFAR is making smart investments to improve lives, build more secure families and help stabilize fragile nations. With continued support from the U.S. Congress, PEPFAR will be able continuing working towards the goals of treating more than 4 million people, preventing more than 12 million new HIV infections, and caring for more than 12 million people, including 5 million orphans and vulnerable children.

➢ For FY 2011, President Obama has requested nearly $7.0 billion, including nearly $5.74 billion for bilateral HIV/AIDS programs, $1 billion for the Global Fund, and $251 million for bilateral TB programs.
➢ For FY 2012, the President is requesting nearly $7.2 billion, including nearly $5.6 billion for bilateral HIV/AIDS programs, $1.3 billion for the Global Fund, and $254 million for bilateral TB programs.

While international efforts are laudable, and the ROI is huge, domestic funding for HIV/AIDS services and supports are severely underfunded. If POTUS does not act, then many PLWHAs fear a flashback to the 80’s...people dying. This time not because there are no medicines to treat the disease, but because we have insufficient funding to put these medicines in the hands of the people who need them. This is unconscionable, and begs the question...is this American?

And no one is questioning the need for America to fund PEPFAR!

CLICK HERE to read "THE INTERNATIONAL vs. NATIONAL DEBATE: Is the President’s Emergency Plan for AIDS Relief (PEPFAR) international commitment to combating HIV/AIDS succeeding at the expense of those people living with the disease in the United States?"

Is PEPFAR is an unfit parent who feeds her neighbors as her own family goes hungry?

Through FY2012 under PEPFAR, U.S. taxpayers will have spent 46 billion to support this initiative. Is it wrong to think that the U.S. could have funneled some of that money over the past 9 years into domestic HIV/AIDS initiatives, such as treatment, prevention, research, and other services for PLWHA under the Ryan White Program? Increasingly, many PLWHAs are asking this very question!

Federal appropriations for the Ryan White Program FY2012 equate to $1.3 billion, and AIDS advocates are asking for an increase of $106 million just to maintain ADAP; though this would not be enough to end the ADAP wait-lists. An increase of $360 million is needed to maintain ADAP programs and fill the structural deficits that have built up over the last several years. Is 7.2 billion in taxpayer money appropriated under PEPFAR and $1.3 billion under the Ryan White program fair? Why would U.S. taxpayers, and especially American PLWHA not be outraged?

Further egregious, last week in an effort led by New York's junior Senator Kirsten Gillibrand, 18 U.S. Senators sought to immunize the Global AIDS funding from cuts threatened by the impending showdown over the national budget and deficit committee. The letter is signed by Kirsten Gillibrand, Richard Durbin (D-NY), Barbara Milkulski (D-MD), Daniel Akaka (D-HI), Dianne Feinstein (D-CA), Barbara Boxer (D-CA), Ron Wyden D-OR), Mary Landrieu (D-LA), Charles Schumer (D-NY), Frank Lautenberg (D-NJ), Bernard Sanders (I-VT), Sheldon Whitehouse (D-RI), Tom Udall (D-NM), Ben Cardin (D-MD), Jeff Bingaman (D-NM) and Christopher Coons (D-DE).

Do they know that this is the 30th year of the AIDS epidemic in America? Are they aware of the domestic AIDS crisis? Are they aware that the impending funding cuts could put the lives of PLWHAs in America at risk? Are they aware of the rich history of AIDS in America and the advocates who marched...who protested...who fought for future generations; all the while watching dozens upon dozens of friends die, and they themselves on the brink of death?

So again, is it wrong for Americans living with HIV/AIDS to look in their own ‘backyards’ before looking overseas?

Inaction and silence WILL = death of countless PLWHA in America. Mr. President, 1.2 million Americans living with HIV/AIDS, their friends, family, and countless advocates; with one resounding voice they ask you to intervene in this crisis, the time to ACT is NOW!

Please sign the petition on change.org requesting that the POTUS and Congress work together to divert 15-20 percent of PEPFAR funds to domestic HIV/AIDS programs: http://www.change.org/petitions/divert-15-of-international-aids-relief-money-to-help-american-plwha.

Blog by Kevin Maloney, ADAP Advocacy Association member from Clifton Park, NY

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Sources:

http://www.pepfar.gov/documents/organization/80161.pdf
http://www.adapadvocacyassociation.org/pdf/2009_Domestic_AIDS__04.06.pdf
http://www.nastad.org/Docs/100316_FY2012%20Ryan%20White%20Funding%20Needs%20B.pdf
http://www.dailykos.com/story/2011/09/22/1018932/-Senator-Gillibrand-Leads-18-Senators-To-Protect-Global-AIDS-Funding