In parts of Canada, HIV is more prevalent than it is in some countries in Africa.
Federal data shows that while the national average for new HIV infections is 5.9 per 100,000 people, in some First Nations communities, the numbers jump to 63.6 new infections per 100,000 people. On Saskatchewan's Ahtahkakoop First Nation, 60 of 1,700 reserve members, or about 3.5 percent of the population, are HIV positive. Those rates are higher than rates in the African nations of Nigeria, the Congo, and Rwanda.
While Indigenous people make up just 4 percent of the national population, they accounted for 16 percent of new HIV infections in 2013 and 21 percent of new AIDS cases, according to leading Vancouver researcher Dr. Julio Montaner.
Montaner, who heads up the University of British Columbia Medical School's Division of AIDS, told VICE the issue amounts to an "epidemic"—and he's astounded that the federal government won't recognize it as such.
"If HIV was represented in 'old stock Canadians' in the rates that its represented in First Nations communities, that would be declared an emergency tomorrow," he said.
Last weekend, Montaner attended 2015 UN General Assembly in New York City, where he discussed the 90-90-90 Target, a strategy to "end AIDS by 2030" based on work by BC Centre for Excellence in HIV/AIDS. The three-fold program aims to have 90 percent of all people living with HIV know their serostatus (antibodies detectable to HIV), have access to high-quality antiretroviral therapy, and have HIV suppression treatment by 2020. The plan has been backed by the UN, as well as a number of other countries including the US and China. But Montaner said Canada has largely remained silent about the developments, a result, he believes, of the ideology of the Conservative government.
"I've been told repeatedly by people based at the [Public Health Agency of Canada], that the problem is the current government party and leadership view work that we do as enabling of conduct that they object to," said Montaner. Specifically, he said he's referring to homosexuality, injection drug use, and sex work, pointing to Bill C-2, the Respect for Communities Act, which makes it more difficult to open sites like Vancouver's Insite, as an example of the government's failure to embrace harm reduction.
When reached by VICE, the Public Health Agency of Canada said it "supports the principles of the proposed UNAIDS 90-90-90 treatment targets" and is looking to update its HIV guidance, which will move the country toward reaching those goals. It also said it recognizes the seriousness of the crisis in First Nations communities and is working on a framework to boost access to care on reserves.
Given the severity of the situation, you'd assume Canada's leading federal parties have a plan to tackle HIV/AIDS in Canada. But in terms of dollars and cents, the details are scarce.
NDP candidate Murray Rankin, who is running in Victoria, told VICE his party would adopt the 90-90-90 Target as a national program and, with community input, support the opening of more safe injection sites across the country.
"We think Canadians would accept the evidence, which is clear that these sites save lives," he said. He also said the party would attempt to improve access to health care in remote First Nations communities. The NDP recently made a string of healthcare announcements, including $300 million to build or expand 200 community health clinics or rural mobile clinics across the country.
Liberal candidate Carolyn Bennett told VICE she supports the goal of getting to zero new cases of HIV and that she would endorse the 90-90-90 Target. When asked about restoring funding to the Canadian Aboriginal AIDS Network, which told VICE its federal grants have been cut by 20 per cent over the last four years, Bennett said the party would consider it.
"I don't know how any Minister of Health can be cutting funding from this in something that's increasing," she said, adding "the government's policy on harm reduction and needle exchange is killing people."
But she admitted that because the party hasn't yet rolled out its healthcare platform, "I'm a little bit handicapped here." Overall, she said the Liberals want to focus on "reconciliation" with First Nations communities, including looking into the social determinants that lead to higher incidence of HIV/AIDS.
The Conservatives did not respond to numerous requests for comment and their website does not provide a health care platform. However, their current funding system works through transfers to the provinces, with cuts expected due to a new per-capita formula for calculating how much money each province receives. NDP Leader Tom Mulcair has said he would reverse the cuts.
The Green party directed VICE to its health care policy, which outlines goals such as reducing the stigma of having HIV and putting resources into the treatment and delivery of antiretroviral therapies as well as harm reduction.
With all of the medical advancements made in AIDS treatment, Montaner said it's inexcusable that Canadians continue to die from it today.
"This is a disease that is treatable, preventable, and it's a disease that should disappear from our language."
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