Sunday, April 11, 2010

Obama's 'Cost-Effective' Health Care Dooms Overseas Aids Victims; A Harbinger of things to come under Obamacare?

From the Boston Globe:
US officials have asked some AIDS clinics overseas to stop enrolling new patients in a US-sponsored program that provides lifesaving antiretroviral drugs, in a bid to stem the rising costs of one of the most ambitious US assistance programs, according to interviews with doctors and official correspondence.

The move, which was prompted by tighter budgets as well as a debate over how limited global health care dollars can be spent most effectively, has sparked fears among AIDS advocates that the Obama administration is curtailing its commitment to a program that provides lifesaving drugs for 2.4 million people and that many view as President Bush’s most successful foreign policy legacy...

The effects of the cost-cutting measures are beginning to be felt in parts of Africa. For patients arriving at some front-line AIDS clinics in Africa, the limits have the same effect as a cap, critics say.

“Virtually every day, we have to turn away patients who need treatment, including breast-feeding women,’’ said Dr. Peter Mugyenyi, a prominent AIDS specialist in Uganda. “We have to tell them ‘There is a freeze.’ ’’

Mugyenyi is in many ways a symbol of how much has changed since the program began in 2003...

The night that Bush announced the massive new program during the 2003 State of the Union address, Mugyenyi was seated next to Laura Bush. In the years that followed, his research facility, the Joint Clinical Research Center in Kampala, Uganda, received millions of dollars to test and treat patients...

In the early years, as US officials struggled to meet the president’s aggressive targets, they celebrated when clinics exceeded their enrollment goals. But last July, Mugyenyi’s facility received a sharp e-mail warning: “USAID have clearly communicated . . . to stop enrolling new patients.’’

In October, other facilities in Uganda received a similar memo from the program, which is commonly known by its acronym, PEPFAR...

The warnings about taking on too many new patients can be traced to a debate within the administration over the expense of the program. Although viewed as a major success at helping slow the spread of the disease, enrolling millions of new patients who require drugs for the rest of their lives — at a cost of $300 to $2,000 a year each — the program is seen in some quarters as prohibitively expensive...

In Obama’s first year, the growth of funding for the AIDS program slowed. Obama campaigned on a pledge to add $1 billion a year, but asked Congress for an increase of only $366 million for 2010 because of the recession. That has pushed thousands of people onto waiting lists for the drugs, including children, according to interviews with more than two dozen health care providers across Africa.

At some clinics in Uganda, opportunities to receive the drugs are so limited that some enrolled patients are sharing their drugs with relatives, which could increase the spread of drug-resistant HIV strains, according to health specialists.

“Basically, they are telling families, including kids who want to test for HIV, that if you test positive, you are going to have to sit on a waiting list for months and we can’t give you any assurance that you will ever get the drugs you need,’’ said Asia Russell of Health GAP, an AIDS advocacy organization.
In December of 2009, All Africa.com reported as follows:
Activists are expressing disappointment with President Barack Obama's plans for the Aids treatment programme in Africa, charging that he has fallen short of the achievements of his predecessor, George W. Bush.

"President Obama has all but failed to fulfil his commitments to wage an aggressive battle against global Aids," a coalition of Aids-focused groups declared last week, assigning him a grade of D+ for his performance to date.

Gregg Gonsalves, a leading US anti-Aids campaigner, warned an audience in New York last week, "I am about to say something shocking: I miss George W Bush...[President Bush's] Emergency Programme for Aids Relief (Pepfar), despite its flaws, saved millions of lives around the world."

Obama, by contrast, is not providing the resources needed to sustain the rate of growth in the number of HIV-positive Africans who receive ant-viral treatments through Pepfar.

That trend prompted Dr Peter Mugyenyi, director of a Uganda Aids clinic, to express fear that "the carnage of Aids will once again surge and the obvious success we have seen of Pepfar may begin to be reversed."...

Under Obama's recently announced five-year Pepfar strategy, the average annual rate of growth would slow [from 5000,000] to 320,000.

By 2014, according to this new plan, about 4 million people worldwide will be receiving anti-viral drugs through Pepfar.

That's roughly 1 million fewer than would have gained access to the life-extending treatments had the Bush-era growth rate been sustained...
Ah yes, the virtues of cost-effective & quality health care - compliments of the Obama administration!

Related Post: Obama: 'End-of-Life' Care Too Costly

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