The Centers for Disease Control (CDC) recently warned that the cost of providing free HIV therapy is putting increasing pressure on the government agency’s limited budget, but found little support for a suggestion that patients share some of the financial burden.
CDC division director Chen Chang-hsun (陳昶勳) said at a public hearing on Friday on the agency’s HIV therapy program that its spending on HIV treatment rose from NT$1.37 billion (US$46.7 million), or 23 percent of its overall budget in 2007, to NT$2.69 billion, or 45 percent of its budget, last year.
This year, HIV therapy spending is expected to reach NT$2.9 billion, a 53 percent share of the budget, Chen said, highlighting the increasing pressure the CDC faces in setting aside funds for HIV care.
The increased spending on HIV care has squeezed CDC funding for other programs, such as tuberculosis therapy and flu vaccinations, CDC Deputy Director-General Chou Jih-haw (周志浩) said.
Taiwan has provided the antiretroviral drug azidothymidine (AZT) for free to HIV patients since 1988 and began offering highly active antiretroviral therapy (HAART), the most effective method of attacking the virus, free of charge in 1997.
As a result, the HIV death rate in Taiwan has fallen from 40 percent in 1995 to under 4 percent this year, Chen said, but the therapy has also added to the financial burden of the country’s healthcare system.
Prior to 2007, all expenses for the treatment were covered under the national health insurance program — Taiwan’s universal healthcare system.
However, in 2007 the health insurance program stopped covering HIV therapy and medication because of the rapid growth in costs and the responsibility for the HIV program was shifted to the CDC.
Unable to stem rising costs, the CDC last year proposed that HIV patients pay part of the cost of their treatment to share the financial burden. The proposed move, which is still under consideration, drew strong opposition from HIV patients and activists who worry that charging fees could lead to patients giving up on their therapy.
At Friday’s hearing, they said many HIV patients already face difficulties finding work because of what they described as discrimination and prejudices against them, and would have trouble paying for even a part of their treatment.
One AIDS patient, who wished to remain anonymous because of the sensitivity of the issue, said she was one of the few lucky ones to have a job that enabled her to cover her daily expenses. Many of her friends who are HIV-positive are not so lucky, she said, with some of them being drug addicts who have just been released from prison and cannot find jobs.
If the government does not offer free treatment for these patients, many of them are likely to stop taking medicine, which puts the public at increasing risk of exposure to the virus, she said.
Persons with HIV/AIDS Rights Advocacy Association secretary-general Ivory Lin (林宜慧) said at the hearing that AIDS prevention and education was also critical to containing the spread of the disease.
The government should invest in prevention instead of focusing on cutting back on treatment, she said, saying that a national campaign to raise awareness of HIV and AIDS and to increase high-risk groups’ willingness to be screened for HIV is just as important as treating the disease itself.
Her push for prevention was based in part on the continuing rise in HIV cases since the CDC took over the HIV therapy program in 2007. From 2007 to last year, a total of 9,079 new HIV cases were reported — more than 40 percent of the total number of HIV/AIDS cases identified in Taiwan since 1984, when the disease was first tracked in the country — with 1,967 of those reported last year alone, according to CDC data.
Lin also urged coverage for HIV therapy to revert back to the national health insurance program. The last recorded vertical transmission of HIV, or mother-to-child transmission, in Taiwan was in 2008, according to data compiled by the agency.
There are 22,020 people known as HIV-positive in Taiwan, 8,413 of whom have experienced symptoms of HIV. A total of 3,360 patients have died of the disease, according to the CDC.