AIDS 2022 in Montreal: Will Canada’s HIV response hold up against scrutiny?

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In a few weeks, the world is invited to Montreal for AIDS 2022, the 24th International AIDS Conference.  At this time of writing, no public announcement has been made as to which of Canada’s dignitaries will be present.

The last time this conference was held in Canada was 2006, in Toronto. The absence of our then prime minister, as well as the previous federal government’s abysmal record on HIV policy issues such as harm reduction, became an embarrassment for Canada on an international stage.

Since then, we have seen some indications of progress. In 2016, Health Minister Jane Philpott signed Canada on to global targets to achieve 90% HIV diagnosis, 90% HIV treatment initiation and 90% HIV suppression by 2020. At the CATIE Forum In 2017, Canada’s Chief Public Health Officer Dr. Theresa Tam publicly announced for the first time that a person with HIV on effective treatment doesn’t transmit the virus sexually – “undetectable equals untransmittable”, or U=U. Then, on World AIDS Day in 2018, Health Minister Ginette Petitpas-Taylor signed on to the Prevention Access Campaign’s U=U consensus statement, making Canada the first country to declare its government’s support. At AIDS 2018 in Amsterdam, she donned a U=U t-shirt at the podium, further demonstrating her and her government’s support for U=U.

While we have applauded these important words and statements, unfortunately Canada has not demonstrated as much success through its actions or accomplishments. Canada has not yet reached the 90-90-90 goals it set for 2020, and as of this writing, has no concrete plan to reach its second commitment to 95-95-95 by 2025.

New leadership at Canada’s health ministry

In the fall of 2021, new leadership arrived at Canada’s health ministry, with the appointment of Jean-Yves Duclos as minister of health and Dr. Harpreet Kochhar as president of the Public Health Agency of Canada.

After several requests from HIV organizations to meet with Minister Duclos and Dr. Kochhar, I attended an online meeting on June 1 with about 30 members of civil society organizations working in Canada’s HIV response. In this meeting, we expressed several concerns, including: the flat-lining of federal HIV funding for more than a decade, in the face of increasing HIV prevalence and skyrocketing inflation; the addition of hepatitis C and other sexually transmitted and bloodborne infections (STBBIs) to our mandates with no additional funding; the increasing racialization of the HIV epidemic in Canada and its disproportionate impact on marginalized communities; the commitment to global elimination targets with no additional funding or concrete action plan.

Additionally, we expressed concern that we are beginning to see the results from restricted healthcare access during the COVID-19 pandemic, including fewer HIV, hepatitis C and STI tests, and increasing numbers of overdoses. Similar to other health issues, we expect to see an increase in HIV, hepatitis C and other STBBIs as infections that went undiagnosed and untreated during the pandemic start to be uncovered.

The funding envelope for STBBIs hasn’t increased since 2007. The $100 million in annual HIV funding recommended by the House of Commons Standing Committee on Health – in 2004 and again in 2020 – has never been realized. In the meantime, in the spirit of integration, the funding originally earmarked for just HIV has been expanded to include hepatitis C and all STBBIs.

Canada’s track record on an international stage

And the world is now coming to Montreal. With no further commitments for funding and no acknowledgment of frontline service providers’ contributions and ongoing needs, it is difficult to stand proud of our track record here in Canada.

We remain grateful to previous Ministers Philpott and Petitpas-Taylor for their public commitments to global HIV targets and to the science of U=U. But the question remains for Minister Duclos and President Kochhar: what will be your legacies?

 

Laurie Edmiston is executive director of CATIE, Canada’s source for HIV and hepatitis C information.

Want to stop the HIV funding freeze? Take action by joining other people and organizations advocating for stronger, well-funded HIV/AIDS programs and services.

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1 Response

  1. Hi Laurie, Thanks for your column above. In addition to the mystery of who has our money and the unfunded expansion of services from what were ASO’s to include HCV and other STBBI’s, I have experienced ” Mission ” collapse and abandonment at 2 BC former AIDS Service Organizations of safe access and/or interest for HIV+ and the often co=infected HCV+ individuals.
    AVI was an early embracer of services for HCV+ people as many of our HIV+ clients were also HCV+. Of course good news that there are now cures that completely eradicate the HC virus. Sadly, il n’existe pas for HIV. There is just long term HIV suppression via HAART. In my case 26 years 8 months and counting. Since the Crixivan trial that saved my life on November 1, 1995 was held only in the USA and available to a small fraction (1400) who might have benefitted, by immigrating to Canada where Crixivan did not become available at least 6 months after my first dose.
    Becoming a front reception volunteer at what was then AVI and our public face of HIV + t at a time when HIV stigma was alive and well on Vancouver Island and quickly a member of and then Chair of our BOD seemed an obvious choice for my first volunteer work after my immigration.
    Katrina Jensen, the now rather long in the tooth AVI ED quickly raised my hand for the Vancouver Island HIV+ seat on the then Pacific AIDS Network BOD.
    Sadly and inappropriately AVI applied for and received the bulk of Island health’s harm reduction $ in the first years of the opiod OD Public Health Emergency here in BC.
    The offices we had recently occupied before that funding shift , did not anticipate the day long presence of substance users who were self medicating the trauma of childhood abuse.
    Unfortunately many of my fellow HIV+ members had history with that self medication and had worked very hard to walk away from self medication. The non stop presence of current self medicators , often actively and noticeably “under the influence” were triggers for many of my HIV+ peers. Katrina and the rest of her HIV- staff had little interest in addressing this conflict.
    As an architect , i can say that there was no physical change possible to separate 2 conflicting clients who needed assistance. The only potential solution was to separate times of access and sitting around for those who needed harm reduction supplies and HIV+ people who wished to keep their distance.
    Katrina and her staff refused to effect this necessity. You may have noticed that the aso that was AIDS Vancouver Island is now AVI Health Services to more accurately reflect the current reality.
    You may have noticed my ability to whine continuously in 4 languages until the rest of the world presents itself publicly in a way that mirrors its actual reality.
    The loss of ASO’s is an additional challenge to the well being of those of us who are or may become HIV+. This is imho as important as the lack of actual promised funding et al from our Federal government.
    Laurie, I do want to give you a big “THANK YOU” for your long career at CATIE. Your commitment of both time, energy and inspiration is equivalent to my now retired friend Richard Elliott. And as beneficial to HIV+ Canadians like me and other around the World

    am fortunate to receive one of Canada’s 75 full scholarship to come and participate in AIDS 2022 very soon in Montreal. This will be my first opportunity to attend the International event. I was fortunate to receive PHAC scholarships that brought me to 3 of the 4 CAHR conferences I have attended. I look forward to seeing friends like you and Richard who (although in Richard’s case almost monthly hour long telephone visits) i have not seen in almost 3 years!
    Cheers
    Andrew Beckerman

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