The Texas legislature cut $19.2 million in funding for AIDS drug assistance programs, which could deny 1,800 new patients access to life-saving medication. This comes 30 years after the start of the AIDS epidemic, when little could be done to treat patients. While drug treatments have allowed many to live long lives, some fear Texas is stepping back from its commitment to care for those with HIV/AIDS. The funding cut may lead to increased drug resistance and visits to public hospitals as patients lose access to treatment.

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After 30 years of AIDS, funding could become
Texas
By SHERRY JACOBSON
Staff Writer
sjacobson@dallasnews.com
Published 04 June 2011 11:31 PM
As if Helen Goldenberg didn’t have enough on her mind already.
Diagnosed with AIDS in 1987, the 64-year-old grandmother is clinging to a lifeline of 27 pills she takes daily
“I never miss a pill,” she said.
About 1,800 new, needy patients across Texas may not be as lucky. They could lose access to lifesaving H
years.
The Legislature, facing a $23 billion shortfall, decided to save money by holding back $19.2 million requeste
Assistance Program. About 70,000 Texans have the disease.
“Why are they picking on the sickest people in the state?” said Goldenberg, who relies on the program.
Sunday is the 30th anniversary of the start of the AIDS epidemic in the United States — when doctors first p
were gravely ill.
After years of medical advances, some people fear Texas is now going backward in its commitment to treat
decision.
It was not uncommon in the 1980s for state lawmakers to question any amount of funding for AIDS, even th
by 1989.
That year, a member of the Senate Finance Committee compared state spending on AIDS programs to “po
recommended focusing on diseases that could be cured.
The comment sparked outrage among groups that were advocating for more help for the neediest AIDS pat
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Now, doctors and other professionals who have spent their careers taking care of AIDS patients say they do
legislators debated whether AIDS patients will get what they need.
“We can’t go back to the 1980s when AIDS was a death sentence,” said Dr. James Luby, a professor of inte
Center , who began treating AIDS patients at Parkland Memorial Hospital in 1984.
Now 76, he still sees patients at the AIDS clinic on Tuesday afternoons.
“The people that I see are really doing quite well as long as they’re complying with their medications,” he sa
Yet, the apparent effectiveness of AIDS treatments has not kept the disease off the state’s cutting board.
While the $96.7 million spending level was maintained in Austin, the additional money for new patients was
AIDS patient advocates questioned the effect that might have on low-income sick people.
Dr. Steven Harris, medical director of Dallas County Health and Human Services, predicted that it could lea
render HIV resistant to certain drugs.
“Doctors do not want these drugs withheld,” he said. “This will make treatment of HIV disease more difficult.
Zachary Thompson, director of the county health department, said the funding gap likely would result in dru
AIDS patients seek treatment.
“We’re going to see an increase in visits at our public hospital,” he said. “We should not be balancing the sta
the funds most.”
15,000 in D-FW area
More than 15,000 people with HIV or AIDS are living in a seven-county area that includes Dallas and Fort W
Each of them probably can tell a story of being saved by AIDS medication.
Bob Helm, 58, was diagnosed in 1992 and takes about 40 pills daily to keep going. His meds are covered b
of many HIV/AIDS patients.
“I feel well,” he said, despite being blind and diabetic as a result of AIDS complications. “Fifteen years ago,
because of the medication, HIV has become almost a chronic disease.”
From the beginning of the AIDS epidemic, the primary focus has been on developing medicine or treatment
person’s immune system.
The first indication of the epidemic came on June 5, 1981, when a small notice appeared in the weekly dise
Centers for Disease Control and Prevention. It described how five healthy young men in Los Angeles had d
The men did not know each other but all were described as “practicing homosexuals.”
The CDC did not realize it had discovered the leading edge of an epidemic that the World Health Organizat
around the world in the last three decades. An additional 33 million people have acquired the disease, WHO
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In the beginning, it was futile for the diagnosed.
“There was nothing we could do for the patients in the early days,” recalled Sylvia Moreno, nursing director
The first sign of hope was zidovudine, or AZT, an anti-cancer drug that could block the spread of HIV inside
effects and fell far short of being a cure, it was embraced by desperately ill patients in the late 1980s.
“We were doing open-label testing, and there wasn’t enough experience with AZT to know that the doses w
Emanuele, a medical case manager at AIDS Services of Dallas, who previously was a nurse in the Parkland
‘Sense of hopelessness’
In those early years, the cost of caring for AIDS patients in Texas was passed to the county hospital districts
taxpayers.
In 1989, the Dallas County health department spent $1.4 million on HIV testing and education programs. An
related treatment.
“There was a big sense of hopelessness and helplessness,” recalled Emanuele.
By the end of the 1980s, almost 2,000 Dallas County residents had been stricken with AIDS and 1,200 had
“It was so difficult because the only drug was AZT,” recalled Salvator Garcia, 63, who tested positive for HIV
Almost 30 drugs have been developed since the mid-1990s that slow the effects of HIV, and 14 others that
claimed the lives of early AIDS patients.
By the end of the second decade, the death toll in Dallas County alone had risen to 6,500. But near the end
longer talking about a cumulative death toll.
A 2009 HIV surveillance report by the state Health Department estimated that Dallas County had 14,309 res
diagnosed.
Statewide, the 2009 report listed 109,288 cumulative HIV cases, with about 60 percent still alive.
Clearly, the key to longevity for anyone with HIV involves medication, the experts say.
Today, a 20-year-old person newly found to have HIV could expect to live at least an additional 50 years, or
to a study published last week in the Annals of Internal Medicine.
Indeed, AIDS patients are living to old age, including three who are in their 80s and being treated at Parklan
“Our older patients can go to the hospital’s geriatric clinic for extra attention,” she noted. “We are giving peo
backwards.”
New patients at risk
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Parkland Memorial Hospital, which provides medical care for more than 4,500 HIV/AIDS patients annually,
on medication for them. It also will receive about $15 million for the 1,500 patients enrolled in the state AIDS
“The state Health Department has promised that it will not dis-enroll anyone on the program now,” Moreno s
“New people who are diagnosed with HIV will probably end up on a waiting list,” Moreno said. “Parkland has
pay for these patients’ medications.”
Sen. Jane Nelson, R-Flower Mound, who chairs the state Senate’s Health and Human Services Committee
AIDS drugs if the money runs out in the next two years.
“The budget includes provisions to cover growth in the HIV medication program if the stockpile of drugs runs
were purchased with federal money and could extend the program until 2013.
A rider was attached to the health budget that would allow the Human Services Commission to access fede
Meanwhile, new guidelines are being drafted by the state for how future HIV/AIDS patients will access free
example, a certain degree of illness before a needy patient can get a certain drug.
“We’d like to make the changes in eligibility apply to new applicants only,” said Christine Mann, spokeswom
Services. “But we are anticipating the shortfall.”
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