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On July 19, 2012, the Secretary of Health & Human Services (HHS), Kathleen Sebelius, announced the availability of roughly $80 million dollars in grant money to increase access to HIV/AIDS care, including eliminating waiting lists,[1] which have been a challenge in operating the Aids Drug Assistance Program.

A Global Pandemic

HIV/AIDS remains a global pandemic that affects millions of Americans each year.  Strategies focus on eliminating new incidence of HIV infections and getting individuals with existing infections into early treatment. Medications can be costly, averaging about $25,000 per year.[2] The ADAP was developed to supplement the costs of HIV/AIDS related medication to uninsured and underinsured individuals living with HIV/AIDS, many of whom are now in their 50s and older.[3] Consequently, living with HIV/AIDS is fast becoming an important concern to older Americans.[4]

High mortality rates and the lack of reliable medical options to save or prolong life were an initial struggle in responding to HIV/AIDS even with online hiv odds tests all around the web. Fortunately, in the 1990s, medical research began to show that antiretroviral drugs could significantly alter the amount of HIV in the blood and thus stabilize the health of infected persons, and in many instances, allow them to thrive. 

The Centers for Disease Control (CDC) estimated that there were 1.2 million adults and children infected with HIV at the end of 2008.[5]  Significant progress has been made in HIV prevention and in the treatment of new and existing HIV/AIDS infections.  ADAP covered drugs such as Highly Active Antiretroviral Therapy (HAART) remain a critical component in extending the life expectancy of infected individuals and making HIV/AIDS more manageable.[6]

ADAP Funding

ADAP was incorporated in the Ryan White Comprehensive AIDS Resources Emergency Act (CARE) of 1990.[7]  This legislation quickly became a critical source of funding to make life-saving treatment available to low income, HIV positive persons and those living with AIDS.  Under the Ryan White Act, Congress has made funding available for ADAP since 1996. [8] Even so, the economic recession, coupled with state budget constraints, causes ADAP funding to fluctuate, leaving many prospective recipients on coverage waiting lists. 

The Waiting List Problem

According to a report by the National Alliance of State & Territorial AIDS Directors (NASTAD), as of July 12, 2012, there were approximately 2,030 individuals in 9 states on ADAP waiting lists. [9]  The states primarily affected by waiting lists are in the southeastern part of the country, the states with the largest waiting lists were Virginia, Georgia, Louisiana, and North Carolina.[10]

A core priority of the Obama Administration's "National HIV Strategy" is improving healthcare access and optimizing health outcomes.[11] The July 19, 2012, announcement of funding to eliminate waiting lists is part of the Administration's overall strategy for addressing HIV/AIDS.[12]  Of the announced funds, about $69 million dollars will be sent to twenty-five states and territories to fund ADAP and clear waiting lists.[13]  And, as part of the President's Emergency Plan for AIDS Relief (PEPFAR) strategy, ADAP funding is seen as moving the nation toward an AIDS free generation through the removal of financial barriers to necessary treatment. 


Having a national strategy to combat HIV/AIDS, including increased funding opportunities such as for ADAP, is essential to bringing HIV/AIDS into the realm of a manageable disease as we await a cure. And, for those who are HIV positive and on waiting lists, the recently announced increase in funding for ADAP is a key element in providing drug coverage to the thousands of people who have been on waiting lists since 2008.  It is hoped that this increased funding will further the goal of an AIDS free generation.

MSW candidate and Washington Intern, Irving Moore, Jr., (from the National Academy of Social Insurance) contributed to the development of this CMA Alert.


[2] David Brown, "For Americans with HIV, there are many obstacles to successful Treatment" The Washington Post (July 2012). Available online
[3] See
[4] Ibid.
[6] Anthony S.  Fauci, and Gregory K. Folkers, "The World Must Build On Three Decades of Scientific Advances To Enable A New Generation To Live Free of HIV/AIDS", Health Affairs 31, No. 7 (2012).
[7] See  the Henry J. Kaiser Family Foundation, "Fact Sheet: AIDS Drug Assistance Programs (ADAPs)" (April 2009).  Available online at:
[8]  See also
[10] Ibid.
[13] Ibid.





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