TITLE:
An Evaluation Synthesis of US AIDS Drug Assistance Program Policy
AUTHORS:
Michael A. Horneffer, Y. Tony Yang
KEYWORDS:
HIV; AIDS; Drug Policy; Program Evaluation; Health Reform
JOURNAL NAME:
World Journal of AIDS,
Vol.3 No.2,
May
31,
2013
ABSTRACT: US Congress passed the CARE Act in
1990 in response to a dramatically growing need for resources to combat the
AIDS epidemic. One of the programs contained in the Act was the AIDS Drug
Assistance Program (ADAP), a federally-funded but state-maintained and managed program primarily concerned
with providing medication for low-income HIV/AIDS patients. While ADAP programs
across the country reached one-third of all patients in 2007, these programs
are now in budgetary danger due to the economic recession, state budgetary
constraints, the rising cost of healthcare generally, and longer life
expectancies associated with current highly active antiretroviral therapy
(HAART). This paper first evaluates the current state of ADAP, its strengths
and weaknesses, and examines its sustainability in the short term if short-term
measures are taken. Concluding that such measures would not lead to long-term
sustainability, this paper then argues for a long-term solution to ADAP’s
current problems, namely a national, centralized ADAP standard for budgetary
and administrative matters. Such a program would increase the long-term
sustainability and effectiveness of current ADAP programs by employing more
efficient, standard policies and allowing larger, wholesale purchases of costly
HAART medications. Moreover, a national policy would address the disparity that
currently exists in ADAP programs today with regard to both minorities and
those on the waiting lists for treatment. The institution of a national ADAP
program would certainly face many political hurdles. Consequently, this paper
also looks to a recent political dispute, the enactment of the Affordable Care
Act (ACA), for guidance. Using the passage of the ACA as an example could light
the path for passage of a national ADAP standard. Ultimately, this would lead
to a more effective and sustainable program for HIV/AIDS patients in the United States.