Several HIV care providers are warning of a looming crisis for some of their poorest patients if more money cannot be found for the AIDS Drug Assistance Program this year.

Georgia’s wait list for the program now includes more than 1,000 people and represents a public health crisis, supporters of ADAP said at a press conference March 1 at the Grady Infection Disease Program office in Atlanta.

ADAP provides access to up to 60 different medications used to treat HIV, AIDS and related infections for 4,300 people in Georgia. Funded through a mix of federal and state money, the program’s $44.8 million budget is approximately $15 million short of what it needs to deal with increasing demand.

Dr. Larry Lehman, executive director of AID Gwinnett, said that none of his patients on the waiting list are going without medications, but he fears the situation could change.

“What’s happening right now is that due to the compassion of the pharmaceutical companies, no one is actually going without meds. The concern is that we had a waiting list many years ago, and as demand grew the pharmaceutical companies began to change the eligibility requirements, so we could actually see people going without meds,” Lehman said.

The fear spreads across the medical community. Jacqueline Muther, HIV policy, contracts and resource manager for the Grady IDP, said there is worry about how long the good will of companies like Bristol Myers Squibb and GlaxoSmithKline will last.

“I thank God for the pharmaceutical companies stepping up in a crisis, but they didn’t say they were going to do it forever, for ever increasing numbers, and they can’t,” she said. “They might cap the program or even decrease enrollment, but when it happens it’s going to be scary.”

Call for more money

To find the additional $15 million to meet the needs of those on the waiting list, the coalition of medical providers and AIDS advocacy groups hopes to find $10 million in federal funds and $5 million state funds from the Georgia Legislature.

Georgia Equality is one of the organizations lobbying for the increase in state funds. Simply protecting the current funding is no longer enough, GE Executive Director Jeff Graham said.

“I do feel that there is still strong enough support at the Capitol for ADAP that there won’t be any cuts. … However it is a completely different situation that we have now because we have this waiting list of 1,009 people as of the end of last week, growing by 30 people each week,” Graham said.

Protecting a program’s funding is one thing and trying to boost a budget during a funding shortfall is another. Graham said there are ways to shift the burden around to find the funding for ADAP without having to cut other programs or raise taxes.

“Certainly the easiest solution is to increase funding,” he said. “However there are actually some provisions through the new federal healthcare reform legislation that I think Georgia can take advantage of to ease the burden on ADAP and perhaps roll some of those people off of the waiting list.

“That again is going to take leadership and a commitment to solving this crisis,” he said.

The Georgia General Assembly held its 21st day of the 40 legislative days on March 1 and is on pace to finish the session in early April. Funding for ADAP has been a focus for HIV care providers for over a decade, said Dázon Dixon Diallo of Sisterlove, an HIV education and advocacy group.

“At the national level and then those of us involved in the CARE Coalition, there’s always been a push to make sure ADAP is protected and/or increased,” Diallo said. “It’s only been because of the economic crisis that it has come back up...

“This is the first time in a very long time that we have had a national crisis of people getting access to care and Georgia has been rising to the top in a hurry,” she said. “That’s scary.”