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Puerto
Rico's AIDS Care in Disarray over Funds |
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Across Puerto Rico,
hundreds of HIV/AIDS
patients are not regularly receiving medicine or care, say patients,
doctors, and advocates. A thin health budget and rivalry between the
commonwealth and San Juan, which run separate AIDS programs, exacerbate the
problem. Federal officials and many local physicians blame poor local
management of Ryan White AIDS funding, $53 million in 2006, for the
shortfall. Over the past five years, disorganization caused $6.5 million to
go unspent.
Clinics do not always receive HIV/AIDS drugs on time, and private
organizations are often reimbursed six or more months after providing
services, causing some to make cuts or close. Federal officials have placed
Puerto Rico's AIDS grants under stricter review, threatening to pull funds.
The Federal Bureau of Investigation raided four San Juan Health Department
offices in December, investigating potential misuse of Ryan White money.
Officials deny misallocating funds, though they admit concern over a
shortage in money. A waiting list for HIV/AIDS drugs had to be created in
the fall; its ranks have since fallen from 130 to 36 said officials, who
expect it to be eliminated soon.
Officials say any lapses in care have been brief. But Dr. José Varga Vidot,
director of the private San Juan care group Community Initiative, said he
knew at least 75 people who were unable to obtain all their medicine for up
to a month. Physicians say switching a patient to a new drug regimen can
take months for central health department approval, and newer drugs are
often unavailable.
National Ryan White funding has remained stagnant for four years, say
advocates, leaving states and territories competing for the funds. The main
San Juan clinic has stopped accepting new patients, saying it cannot afford
more. Federal administrators said they have offered to place San Juan's Ryan
White funds in a separate entity to manage them - an offer Mayor Jorge A.
Santini Padilla has refused.
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New York Times
(06.05.07):: Erik Eckholm |
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