On June 23, 2004, in a speech which centered on his administration's efforts to fight HIV/AIDS in the United States and around the world, President Bush announced a new $20 million program to end the AIDS Drug Assistance Program (ADAP) waiting lists which existed at that time. In his speech, the President said, "In 10 states, hundreds of AIDS patients are waiting for access to life-extending treatments. In other words, there's long lines. Some of these people have been waiting for months. That seems like a problem that we can deal with .... So we're going to provide $20 million, effective today, ... the purpose of which is to deliver lifesaving drugs to the men and women who are waiting. In other words, there shouldn't be lines here. And we're going to deal with the lines."

In recent weeks some of the details about this new program have become available. The $20 million direct purchase program is a one time source of funding outside of the normal appropriations process. Rather than give funds directly to the states, the federal government will purchase the drug therapies directly and distribute them to the states in order to achieve the lowest possible price. Furthermore, the drugs are being made available solely to those states which had a list of individuals waiting to enroll in drug assistance programs on June 21, 2004, 2 days before the announcement. Those states are: Alabama, Alaska, Colorado, Idaho, Iowa, Kentucky, Montana, North Carolina, South Dakota and West Virginia. With this decision the administration expects to be able to cover the individuals who were on waiting lists on June 21. No potential enrollees who were added to waiting lists in these states or any other state after this date are eligible.

It is not yet clear how drugs will be delivered from the federal government to the states and from the states to qualified individuals. At one time it had been reported that the Health Resources and Services Administration (HRSA), which will coordinate the programs with the states, was trying to use the Veterans Administration's drug purchasing program to purchase and distribute the drugs. More recent sources say that HRSA will not pursue that route and is now seeking a pharmacy benefits manager to fulfill this function. It should be noted however, due to the changing and challenging nature of the President's direct purchase initiative, it is possible that some of the details described above may change.

According to the National Alliance of State and Territorial AIDS Directors (NASTAD), the direct purchase program will only cover drugs on the client state's ADAP formulary as of June 21, 2004 and it will not cover Fuzeon or other injectable drugs. In a recent "ADAP Watch" released by NASTAD, 1,518 people were on waiting lists for HIV drugs as of August 4, 2004. Of these people, 127 individuals will not be covered by the President's plan. Additional information can be found at: www.nastad.org/documents/public/publicpolicy/NASTADADAPWatchAug2004.pdf.

Back to the AIDS Action Weekly Update August 27, 2004 contents page.