The Saskatchewan Government Is Refusing to Declare a Public Health Emergency Over the AIDS Epidemic

The Saskatchewan government will not declare a public health emergency over the HIV/AIDS epidemic in the province, despite urging from doctors there.

At a press conference in Regina Monday, Denise Werker, Saskatchewan's deputy chief medical health officer, said the government has no mechanism under the province's health act to make such a declaration.

Werker was responding to an open letter released Monday morning in which 31 of the province's HIV/AIDS physicians demanded a call to action.

The HIV rate in Saskatchewan is more than twice the national average (13.8 cases per 100,000 people versus 5.8 cases per 100,000 people).

According to the open letter, the problem is disproportionately affecting Indigenous Saskatchewans.

Of the 1,515 people diagnosed with HIV in Saskatchewan in the last decade, 1075 were Indigenous. On the Ahtahkakoop First Nation, 60 of 1,700 reserve members, or about 3.5 percent of the population, is HIV positive; those rates are higher than rates in the African nations of Nigeria, the Congo, and Rwanda.

While HIV rates in the province had been decreasing over the last few years, the number of new cases spiked from 112 in 2014 to 158 in 2015. Saskatoon physician Ryan Meili told VICE the 2016 numbers are on track to match those of last year.

The doctors want the government to adopt the 90-90-90 target set out by the United Nations. It calls for 90 percent of people who are HIV positive to be diagnosed, 90 percent of those who are diagnosed to be receiving antiretroviral treatment, and 90 percent of those in treatment to have viral levels that are low enough to prevent transmission to others.

"Despite the urging of experts from within the province and across Canada, the Government of Saskatchewan has refused to adopt the 90-90-90 goals," reads the letter, which also states that reaching the 90-90-90 target "would bring an end to AIDS in our province."

But Werker claimed that through the province's HIV strategy, which was implemented in 2010, the government has been providing $4 million a year to assist in the prevention and treatment of HIV.

Since 2006, the rate of HIV testing has jumped by 46 percent, she said, and the number of testing sites has increased from 0 to 59 in the last 10 years. Werker also said despite last year's increase in the number of HIV cases, there was a decrease in the number of cases of AIDS, which implies that people are getting tested and treated earlier.

"We are well aware that we have the highest rates in Canada everyone agrees this is not acceptable but this cannot be fixed overnight," she said.

Meili told VICE the government could be doing a lot more.

"If they were doing all they could, we wouldn't see the problem getting worse. Increased testing does not account for a 50 percent spike in one year."

According to the province's own numbers, each new HIV case costs $1.4 million including $450,000 in medication plus indirect costs, he added.

"An uncoordinated expenditure of a tenth of that is not going to solve the problem."

Meili told VICE the disease was previously transmitted primarily through intravenous drug use, but more and more sexual transmissions are now taking place. The doctors have created a 10-point plan needed to achieve 90-90-90 in Saskatchewan and say they need resources from the province to put it into action. One of the key elements is creating a centralized organization to ensure that the plan is on track.

He said there also needs to be better access to medical treatment.

"This isn't a terribly hard disease to treat. There's lots of examples that could work, we can draw on what's been done in BC and even what's been done in Saskatchewan already," Meili said. "But right now the resources aren't there."

Werker said an HIV mobilization event taking place next month will bring together 150 stakeholders in the province, who will be given the chance to collaborate on how to address the epidemic. She said the onus of on-reserve care is on Health Canada.

Follow Manisha Krishnan on Twitter.