Baltimore Alternative, June 1991

June 1991 ▼ Volume 6, Number 6 ▼ Serving The Baltimore /Washington Community Since 1986 AZT Works/Health Care System Doesn’t Hopkins Study Makes the Case for National Health Care BY GAREY LAMBERT THE ALTERNATIVE One of the first major epidemiological studies ever undertaken on populations affected by AIDS has revealed startling evidence that the United States’ health care delivery system is failing for large number of sick, poor and minority Americans. The study was authored by researchers at Johns Hopkins Hospital and the Maryland AIDS Administration and was pub¬ lished as a “Special Article” in the May 16, 1991 issue of the New England Journal of Medicine. It used information gath¬ ered from public hospital and clinic records throughout the state of Maryland and collected in the Maryland Human Immunodeficiency Virus Information System. The study was designed primarily to discover the long-term effects of AZT (Zidovudine) therapy on survival for People With AIDS (PWAs). The study found that for those PWAs who received AZT therapy, median survival time increased 140 days — from 310 days to 450. It found that men survived longer than women, younger people survived longer than did those over the age of 45, and “non-Hispanic whites survived] longer than minori¬ ties.” Gay men survived longer than did “those who acquired HTV infection through heterosexual contact, transfusion, or less common modes.” But, while the researchers studied the effect of AZT therapy The ‘Bill and Dick Show’ on CBS CBS News and CNN came to Baltimore on Wednesday, May 15 to cover the release of an important study of AZT use that reveals major flaws in the American health care delivery system. To speak for Hopkins. CBS and CNN chose Drs. Richard Moore and Richard Chaisson. co-authors of the report. To speak for the community of people affected by AIDS, both CBS and CNN spoke with The Alternative's Editor and Publisher Bill Urban. On the CBS Morning News. Dr. Chaisson and Mr. Urban were asked to draw conclu¬ sions about the study. Dr. Chaisson reported that the study revealed a significant failure by the health care delivery system to provide care for Maryland's most needy and vulnera¬ ble populations. Bill Urban was more specific, and placed direct blame for the problems on the Baltimore City Health Department, and the Maryland Department of Health and Mental Hygiene. Both made the point that Maryland's health care problems are reflective of those faced by People With AIDS everywhere in the United States . PHOTO BY STEVE BROWN/ALTERNATIVE they also revealed irrefutable evidence that the health care delivery system in the U.S. is failing for large numbers of peo¬ ple. For people with HTV infection, over half (51%) failed to get AZT after receiving a diagnosis of AIDS. A whopping 57% of minority people, and over two-thirds of women with a diagno¬ sis of AIDS (67%) were not provided with AZT. Those least likely to receive AZT were IV drug users — a full 62% did not receive the drug. Those most likely to receive AZT were gay men (59%), men in general (53%), and people 30 years old or younger (56%). Even with those figures, over 40% of gay men were not offered AZT, and 47% of men overall did not receive it. Both Dr. Richard Moore and Dr. Richard Chaisson, who with Dr. Julia Hidalgo and Barbara Sugland, MPH, authored the report, concluded that the statistics revealed widespread discrimination in the delivery of health care in Maryland. Despite any number of publicly funded pro¬ grams. minorities and poor people are least like¬ ly to receive adequate medical care. Since the study could only follow those people who had received a specific diagnosis of AIDS, and were therefore being seen by a physician, one of the most disturbing conclusions in this study is that physicians are not offering AZT to a majority of their patients. There are specific programs in the state to provide AZT for low income or indigent popu¬ lations. yet physicians are apparently not pre¬ scribing the drug. The study was able to track only those people who were reportable under Centers for Disease Control (CDC) guidelines. They were 17 years old or older, had CDC-defined AIDS; were enrolled in Maryland Medicaid. Maryland Pharmacy Assistance, Maryland Blue Cross & Blue Shield, or the Maryland AIDS Drug Assistance Program (MADAP); or, who had received AZT through a John Hopkins clinical study. It could not trace those people who had been denied entry into these programs. BALTIMORE ALTERNATIVE YEARS OF SERVICE TO THE GAY COMMUNITY |une 1986 T June 1991 ACT UP/BALTO Asks GLCCB 'Where’s the AIDS Money?’ Jackson resigns as Center’s Executive Director BY MARKTRAUTMAN _ THE ALTERNATIVE he Gay and Lesbian Community Center of Baltimore's annual Spring Brunch was "zapped” by ACT UP/BALTO. The 400 shocked and surprised diners, who paid S40 each to attend the brunch, were show¬ ered by artificial dollar bills. On each was printed “Ask Mardie Walker: Where does your money go? State and Local grants and money from AIDSWalk and bequests from PWAs. earmarked for AIDS related services are deposited in operating accounts and disappear, never to be seen again. When you make a donation. ..think about where you want [it] to go. Then try to find out where it went!” Mardie Walker is the GLCCB ’s president. ACT UP/BALTO spokesperson Mark Shaw, said the “zap” occurred after a March 5, 1991 letter from ACT UP to the GLCCB which raised questions about the use of AIDS-specific funding went unanswered. Walker says that the GLCCB voted to undertake a reporting of its accountability jointly with ACT UP. “While information has been compiled.” said Walker, “the report is not yet finished. The delay [on the report] was mutually See GLCCB, page 5