AIDS drug funding program cuts could have deep impact to South Carolina
By R. Darren Price
Edited by Henry W. DeHart
Posted April 22, 2010
Every morning at 7 a.m., Ali Shabazz takes four pills. Twelve hours later – "Like clockwork," he says – he takes three more.
Shabazz, 58, got HIV from doing drugs in 1984. Now, he works with the South Carolina HIV/AIDS Council, helping others with the virus navigate their lives.
His medications would cost him around $236 a week, but the state pays for them through the AIDS Drug Assistance Program for low‑income South Carolinians. Shabazz says he hasn't missed a dose since starting his current regimen in 2007.
But budget cuts mean he and most of the more than 2,000 other South Carolinians on the program could lose those vital drugs.
Next year's budget that begins July 1 has $2.2 million in subsidies, less than half the $5.9 million state health officials and the council say is needed just to cover those already enrolled.
"I'm a resourceful person," Shabazz said. But talk about the possibility of losing some or all of the subsidy, and "that's frightening," he said.
Right now, it's all about the numbers:
- About 14,000 people in South Carolina live with AIDS or HIV, according to the federal Centers for Disease Control and Prevention.
- South Carolina has the tenth highest HIV infection rate in the country, 16.1 per 100,000 residents, according to the Kaiser Foundation.
- The state also has a more than $560 million budget gap the House is trying to close in next year's $5.1 billion spending plan, and almost every state program has been under the knife.
House budget writers initially eliminated the drug subsidy. That alarmed Dr. Wayne Duffus, medical director for the sexually transmitted disease and HIV division of the state Department of Health and Environmental Control.
"Without medication, people will die," he said. "People that could work and pay taxes will die."
About 500 people rallied at the State House on March 17 to protest the funding elimination. The House then restored $2.2 million at the urging of Rep. Joe Neal, D-Richland. Numerous messages seeking more information from Neal and several other state legislators were unanswered.
However, with AIDS medications costing $10,000 to $15,000 yearly, that still would support just 220 people, Duffus said.
Even with additional federal money – the state received $13.1 million last year– patients will be dropped and put on a waiting list expanding by 100 South Carolinians a month, said Elizabeth McLendon, the council's volunteer coordinator. Federal funding information for the upcoming fiscal year have not been released.
Duffus said this has happened before—four years ago the state had the largest waiting list in the country, 600 people.
To be eligible for the subsidy, a South Carolina resident can't make more than three times the federal poverty level of $10,830 for a single person. The person also generally cannot have health insurance.
Shabazz, who came here from New York in 2007 for warmer weather, considers himself lucky because the state pays for his medications, the same ones he still takes.
His count of white blood cells, the ones that fight diseases, had dropped as low as six. But he said it is now more than 600, just inside what the federal Health and Human Services Department considers normal for a healthy adult without HIV.
The danger is that if Shabazz or others can't afford their medications and stop taking them, the virus they carry could develop a resistance, said Bambi Gaddist, director of the HIV/AIDS Council where Shabazz works.
At one point, Shabazz said, he was taking up to 30 pills a day, but the virus was resisting the treatments until he began his current treatment in 2007.
It could ultimately be cheaper to fund the subsidies, said Elizabeth McLendon, a volunteer coordinator at the council.
"When they get sick and end up in emergency rooms, where a 10-day visit costs $30,000, the taxpayers pay the bill," McLendon said.
She wants people to press legislators to restore full funding. "I don't think some of the legislators realize its not a ‘bad person's disease,' " she said.
Shabazz, meanwhile, spends most of his days making sure people with the virus take their medicines. He takes them to food banks and even helps some learn to read – things he says he probably would not have done had he not contracted HIV.
"HIV, for me, has been more of a blessing than a curse," he said.