As my predecessor indicated in replies to previous questions on this subject, it has not been possible to isolate the costs of caring for and managing persons with AIDS or HIV from general health expenditure due to the range and level of services which have to be provided to each individual patient. During the course of his or her illness an infected person passes through a spectrum of illness, each with varying degrees of severity and each requiring different types and varying levels of care and management. For example, services would be required by persons with HIV and AIDS in the following areas: primary care level; outpatient clinics; hospital services; community care services, such as public health nurses and home helps; tertiary and hospice care; voluntary agencies such as CAIRDE, the AIDS Alliances, Body Positive and the Irish Haemophilia Society; literature and documentation produced by the voluntary and statutory sectors and financial assistance from a variety of sources, both public and private.
The difficulty in estimating costs is complicated further by the evolving epidemiology of the disease where early-intervention therapies have been introduced recently for the care and management of persons with HIV and this has added a dimension to the situation which was not present before. In addition, the cost of managing categories of patients would differ, depending on the category in question. The public and private sources of funding which enable services to be delivered by both the statutory and voluntary sectors also render the estimated costs extremely difficult. Despite these difficulties, however, my Department are endeavouring to draw up approximate cost indicators for AIDS-HIV patients. This will have to be done in the context of work of the National AIDS Strategy Committee.
I am chairperson of this committee, reflecting my intention that AIDS will be dealt with by me as a priority. Up to now, a total of 252 cases of AIDS have been reported to my Department. Of the patients concerned, a total of 101 have died. In addition nearly 1,200 tests for HIV have been confirmed as positive and it can be expected that there are more persons than this with the infection in Ireland. As there is no cure for AIDS at present, these people with HIV will regrettably develop full AIDS and will require ongoing care and management at primary, secondary and tertiary levels as they progress through their infection.
It is vital therefore that we develop a fully integrated framework to deal with AIDS and HIV and, towards this end, the national strategy committee will be bringing forward recommendations on the components of such a framework in the very near future. These measures will be funded and will enable us to respond efficiently and effectively to the evolving situation.