Politico - Life-and-Death Power of AIDS Funding

Op-Ed

By Sir Elton John and Senator Bill Nelson

Last year, Steven Dimmick, 31, sold his car and home in Jacksonville, Fla., then filed for bankruptcy protection. He needed cash to purchase the drugs that keep him from dying of AIDS.

Dimmick was one of the 9,039 low-income Americans living with HIV/AIDS who are on waiting lists to receive medication through public AIDS Drug Assistance Programs. These are people with families and jobs -- productive citizens. But they lack health insurance. And they don't make enough to afford lifesaving drugs.

Some have died waiting.

All 50 states now have assistance programs for people with low income, living with the disease. But, in an increasing number, the need for these medications is greater than federal and state funding. As a result, 13 states have already reduced the amount of drugs offered -- and increased the number of people on waiting lists.

Things now look as if they are about to get much worse. Many states facing severe budget shortfalls are considering plans to drastically cut eligibility. Florida -- with the nation's longest waiting list at more than 3,900 people -- is proposing changes in eligibility that would not only leave more people like Dimmick on the waiting list but cut off more than 1,600 from the program.

Federal, state and local governments must understandably tighten their belts. But focusing on such short-term savings is horribly shortsighted.

For several reasons, these cuts will only lead to higher costs to taxpayers in the long run.

First, patients who lose their assistance and are forced off HIV medications could develop drug-resistant strains of HIV -- which may well be more difficult to manage.

Second, denying treatment to low-income, HIV-positive people will most likely result in increased transmission of the disease. A recent, groundbreaking study by the National Institutes of Health demonstrated that people living with HIV who receive effective drug treatment are 96 percent less likely to pass the virus on to their uninfected partners.

Third, while HIV/AIDS medications are expensive, the emergency room and hospital care required by people who do not receive them is far more costly.

Right now, more than 1 million Americans are infected with HIV/AIDS and 56,000 new cases occur every year. AIDS is the leading cause of death for young African-American women in the United States.

The epidemic has hit hard in New York, California, Florida and Texas. In Florida, for example, one in every 205 white men, one in every 113 Latino men and one in every 42 African-American men is HIV-positive.

In the 30 years since the Centers for Disease Control and Prevention made its first report on AIDS, there has been enormous scientific progress in treatment and prevention, but there's still a long way to go.

In these difficult times, we must not lose sight of the fact that prevention and care remain a critical weapon against this epidemic -- which is why we must have affordable and accessible treatment for those living with HIV/AIDS.

Until this week, Dimmick had relied on a drug company's assistance program. But now his future -- whether he continues to live with AIDS medication, or dies without it -- is uncertain. He had temporarily joined the state's assistance program but learned Wednesday of his removal again.

This spring, President Barack Obama asked Congress for an increase in AIDS medication funding. The president requested $940 million for the next fiscal year. A key Senate appropriations subcommittee recently approved $900 million. In the days ahead, Congress will have to decide.

On this issue, we see no reason to argue -- and there's precious little time to wait. This isn't a partisan issue. As President George W. Bush noted in 2008, it's a question of our moral interest. As Bush said of America's AIDS programs, "We believe in the timeless truth: To whom much is given, much is required. And we believe that the power to save lives comes with the obligation to use it."

We believe Congress has the power -- and with it the obligation -- to save the lives of 9,039 Americans.

Sir Elton John, the musician and songwriter, is the founder of the Elton John AIDS Foundation, which has raised more than $225 million for HIV/AIDS treatment and prevention since 1992. Sen. Bill Nelson is the senior U.S. senator from Florida, one of the states hardest hit by AIDS.

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