(Florida International University) –Arvil Lewis took her 2-year-old daughter to Jackson Memorial Hospital in 2002 because she was too weak to walk.
The toddler had pneumonia and a blood sample determined she had AIDS. Lewis learned the same day that she also had HIV. (Because of the stigma often attached to HIV/AIDS, Lewis asked that her real first name and her daughter's name not be used.)
Jackson doctors told Lewis about the state's AIDS Drug Assistance Program – known as ADAP — which pays for medication used by HIV/AIDS patients who otherwise could not afford them. The program may have saved the lives of both mother and child.
“My daughter is 11 years old but she looks 14,” Lewis said. “She can bake a cake and does very well in school.”
About 26 of every 100,000 Floridians are infected with HIV or about double the national rate and third highest in the nation. The rate among blacks, however, is 117 per 100,000; among Hispanics it’s about 28 per 100,000 and among whites about 13 percent.
But Florida’s ADAP program ran out of money Feb. 1 and won’t receive the federal and state funds that support it until April.
That leaves the 10,000 or so patients the program supports potentially without life-saving medicines for two months, raising the risk their illnesses will worsen. There are about 3,100 patients on the program’s waiting list with nowhere to turn.
“The immediate problem is for patients that haven't been taking their medications. Now, if they get sick they can’t even get the medications," said Dianah Hill, a case manager for the South Florida AIDS Network, the Jackson Health System program that administers ADAP.
On average, it costs $2,000 to $3,000 a month to pay for ADAP patients’ medications.
For the year starting April 1, 2010, the state received $85 million in ADAP funding from the federal government and contributed $90.5 million from general revenue. Of that amount, nearly $53 million ended up in South Florida, where the HIV/AIDS epidemic is the worst in the state: $24.9 million to Miami-Dade County, $20 million to Broward and $8.3 million to Palm Beach.
But that wasn’t enough to make it through April 1, 2011.
For the moment, a non-profit pharmacy and a consortium of drug companies are filling part of the gap.
Welvista, a South Carolina-based non-profit that works with pharmaceutical companies, has agreed to provide 6,500 Florida ADAP patients with the anti-retroviral drugs that fight the HIV virus through April 1.
But that leaves no source for the medication patients need to fight off the opportunistic infections that attack weakened immune systems.
And 3,500 other patients have no source of any medication.
To Arvil Lewis, that sounds like a death sentence.
"Before my daughter was released from the hospital, she was put on oxygen for three and a half weeks,” Lewis said. “Since we started taking our medications, we haven't been back. Without our medicine, we die."
Dr. Cheryl Holder, a professor at Florida International University’s medical school, who has 20 years’ experience treating HIV/AIDS, warns that when patients stop taking medication they risk the possibility that the virus will become immune to their current drug regimens.
That would make the patients need more expensive medications and potentially cost the government a fortune.
But Holder explains that the cost of these patients getting sick and ending up in the emergency room would cost the government much more in healthcare costs, in addition to non-medical costs that could crop up.
“The ADAP patients are usually in their 20s, 30s and 40s. They are productive members of society and still have a lot to offer,” Holder said.
Alec Scott may be contacted at firstname.lastname@example.org.