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This article discusses access to antiretroviral drugs by individuals living with AIDS. AIDS deaths, which increased ferociously in the United States throughout the 1980s and early 1990s to a peak of 51,000 a year, suddenly abated in 1996 with the advent of antiretroviral combination therapy, a pricey and toxic brew that pulled people from their hospital beds like Lazarus. Throughout the late 1990s, Congressional support for the AIDS Drug Assistance Program (ADAP) was so strong on both sides of the aisle that appropriations exceeded presidential requests every year. As the growing epidemic slams up against state austerity measures, ADAP has descended into crisis, and Republicans in Washington have refused to intervene. To save additional dollars, Alabama just blocked coverage of the latest HIV drug, Fuzeon, a treatment used almost exclusively by those who have run dry of options. In Oregon, when the cash-strapped state temporarily eliminated some Medicaid prescription coverage, the ADAP waiting list ballooned. In North Carolina, HIV doctor Aimee Wilkin says some of her waiting-list patients, forced to seek medicines through drug company charity programs, have faced multiple treatment interruptions, the result of bureaucratic delays, exposing them to the risk of HIV drug resistance. Even after aggressively negotiating with drug companies to save ADAP $65 million with price breaks for next year, advocates with NASTAD, an association of state AIDS directors, calculate that it will take an ADAP increase of $214 million to cover the growing need next year -- the amount requested by Senator Charles Schumer in a budget amendment rejected on a largely party-line vote (with one brave exception, Republican Mike DeWine). Other Republicans, even from states with bursting waiting lists, like Alabama, Colorado, Nebraska and North Carolina, voted no, apparently under intense pressure from U.S. President George W. Bush and Bill Frist to stick to their domestic budget cap.
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