Puerto Rico's HIV/AIDS Treatment Program To Be Overhauled To Ensure Access

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Puerto Rico's HIV/AIDS treatment program will be overhauled to ensure that people living with the disease have access to drugs without delays, Gov. Anibal Acevedo Vila (D) announced on Tuesday, the AP/Fox News reports. According to Vila, about $78 million in federal and local territorial funds will be allocated to streamline the treatment program. Some of the funds also will be used to hire 23 additional employees -- including Jorge Delgado, an HIV-positive physician from California who will serve as the program's new director -- Vila said (Coto, AP/Fox News, 7/17).

According to some local doctors and advocacy groups, hundreds of people living with HIV/AIDS in Puerto Rico are not receiving needed medical care. The situation reflects a number of problems on the island, including an overstretched health care budget and contention between the commonwealth and San Juan city governments, which run separate HIV/AIDS programs. Federal officials and some local doctors say that the primary cause is the island's mismanagement of funding from the Ryan White Program.

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Puerto Rico receives about $58 million annually under Ryan White. Some clinics in San Juan in March began rationing drugs for hundreds of HIV-positive people after they stopped receiving reimbursements from the program. Ryan White invoices from Puerto Rican health agencies have received extra scrutiny since 2005 because of previous management issues. In addition, FBI agents in December 2006 raided four San Juan government health offices that manage Puerto Rico's Ryan White funds as part of a broader fraud investigation.

The Health Resources and Services Administration, which administers Ryan White funding, repeatedly has called for streamlining Puerto Rico's health care system and sent advisers to the island, Laura Cheever, HRSA deputy associate administrator, has said. Local physicians say that it takes months to obtain approval from the island's central government to switch a patient to a new antiretroviral regimen, adding that the new drugs often are not available. The commonwealth health department also often makes errors in antiretroviral distribution, some doctors say (Kaiser Daily HIV/AIDS Report, 6/5).

Health officials are reviewing existing HIV/AIDS cases so they can improve services, Vila said, adding that a system to oversee the management of federal and state funds also will be created. The New York-based Latino Commission on AIDS praised the planned overhaul of the program (AP/Fox News, 7/17).

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