In response to the funding crisis facing state programs that provide AIDS and HIV drugs to the public, the US Department of Health and Human Services late last week provided an additional $25 million to the states where patient waiting lists have ballooned and various belt tightening moves are under way (see statement). The only problem is that advocates say the long-sought reallocation isn’t nearly enough.

“It’ll help some people who are on waiting lists at a growing number of states, but it’s far from the amount that’s needed for the rest of the fiscal year. The situation continues to get worse,” Carl Schmid, deputy executive director of The AIDS Institute, an advocacy group, tells us. “It’s welcome news,” says Ann Lefert, associate director of government relations at the National Alliance of State & Territorial AIDS Directors. “But it adds real fiscal stress (to state programs) and we are very worried about their long-term stability. We will have to continue to push for more funds.”

The problem grew as federal funding failed to keep up with demand caused by more people losing health insurance and state budgets that have come under pressure, what Schmid calls “the perfect storm.” Consequently, the $25 million is far short of the $126 million sought. As Lefeft notes, the program received just $20 million in the current fiscal year and the same amount is budgted for fiscal year 2011. “It’s unclear at this point how far the $25 million) will go, but I can imagine in November and December, states receiving this will not be able to keep up with demand.”

As of last week, nearly 2,300 people were on waiting lists for medications from a dozen state ADAP programs, and a lack of funding has a dozen state programs - including some were waiting lists are growing, such as Iowa, Kentucky, North Carolina and Utah - to reduce formularies or raise eligibility (look here). Several other states are eyeing cost-cutting measures, too.

The ADAP program has a total budget of about $1.5 billion, says Schmid, who explains the federal government provides roughly $835 million, much of the rest coming from rebates issued by drugmakers. Recently, he says, several drugmakers increased their rebates and now provide around $500 million. “The situation would have been much worse if they didn’t do that,” he says. The amount of rebates “grew by about $150 million in one year.” You can read more background here.