Canadian Strategy on HIV/AIDS : Moving Forward Together

Introduction

• The National AIDS Strategy - A Brief History
• A New Strategy For A Changing Reality

1. Funding

2. Program Components

i)	Prevention:
ii)	Community Development and Support to National Non-Governmental Organizations
iii)	Care, Treatment and Support
iv)	HIV/AIDS Research
v)	Surveillance
vi)	International Collaboration
vii)	Legal, Ethical and Human Rights Issues
viii)	Aboriginal Communities
ix)	Consultation, Evaluation, Monitoring and Reporting
x)	Correctional Service of Canada
	Conclusion

Introduction

HIV/AIDS remains a significant international and national issue. Despite advances in some areas, it is not going away.

The bulk of the HIV and AIDS burden lies ahead, not behind. More new casesof AIDS will be diagnosed in the last five years of this century than were diagnosed during the first fifteen years of the epidemic.

The human immunodeficiency virus (HIV) which leads to AIDS is mutating, evading therapies and making it more difficult to stop the epidemic.

The financial burden that will result from increased infections is matched only by the enormous human cost.

The challenges which lie ahead are too great and too complex for a single government or a single agency. The ability to build on partnerships already in place is essential if our country is to make further progress.

It is for these reasons that the Government of Canada has approved annual funding of $42.2 million to continue HIV/AIDS efforts. Previous HIV/AIDS initiatives were time-limited. This new funding will ensure the sustainability of our efforts well into the 21st Century.

The new Strategy will focus on those most at risk of infection by targeting high-risk behaviours in hard-to-reach populations. It will also consider the social, economic, legal, ethical and human rights issues involved in fighting HIV/AIDS within these populations. People living with HIV/AIDS will have a central role in providing expertise and leadership on these issues. HIV/AIDS research will be better integrated nationally and internationally. Our surveillance capacity will be expanded.

An unprecedented national consultation process that involved provinces and territories, organizations and individuals showed us the direction and the role of each of the players. It identified available resources, effective strategies, and efficient models for the task ahead. These consultations helped chart a new course for Canada's continuing response to HIV/AIDS We have listened and have learned what is needed to move forward.

The National AIDS Strategy. A Brief History

The first Canadian case of AIDS was identified in 1982. Since then, over 50,000 Canadians have been infected with HIV. Today, those infected with HIV may remain without symptoms for a period exceeding 10 years before AIDS develops. No vaccine exists to prevent HIV infection. There is still no cure.

In 1990, Phase I of the National AIDS Strategy was launched. This Strategy committed $112 million over three years to support a variety of research, surveillance and community development activities. Significant progress was made in education, prevention, care and treatment. It supported grassroots groups and other non-governmental organizations in their fight against HIV/AIDS, and it laid the groundwork for future partnerships with provincial and federal departments and agencies.

Phase II which committed $211 million over five years was launched in March 1993. It responded to the growing complexity of HIV/AIDS in Canada and the need for an extended commitment of time, funds and energy.

Phase II emphasized the building of partnerships . with other federal departments, provincial and territorial governments, non-governmental organizations, the private sector, professional groups and major stakeholders. Our knowledge base broadened significantly. Progress was made in educating Canadians . in schools, in the workplace, in the community. National surveillance systems were put in place. Guidelines for training health care professionals about HIV/AIDS were developed. Innovative models of individual and family care and support were introduced. More effective drugs and therapies were found and made available.

By the end of Phase II in March 1998, Canadians could look back on the substantial progress that had been achieved. Thanks to better treatment, there were 33% fewer AIDS cases in 1996 than in 1995, and 36% fewer deaths related to HIV. From their first appearance to the end of the 1980s, HIV infections were primarily concentrated in two population groups: gay men and people infected through the blood supply. Education and prevention efforts have greatly reduced the risk to many gay men, while improvements to the blood system have meant that Canadians have blood and blood products as safe as those used in any developed country. Progress has been made, but it is not enough.

A New Strategy for a Changing Reality

Every day, approximately 11 Canadians become infected with HIV. There have been disturbing increases among those who are often socially and economically vulnerable. Injection drug users, women living in poverty, Aboriginal peoples, young gay men and prison inmates are increasingly threatened by the disease.

Another troubling finding is that we have obviously not reached young Canadians. The median age of infection has dropped from 32 years in 1982-1983 to 23 years in 1986-1990. Fear, stigma and discrimination continue to work against prevention and treatment efforts. HIV/AIDS is not yet medically manageable or curable. We have to rethink our approach.

When we look beyond our borders, we find even more reasons to strengthen and expand our Strategy. It is estimated that there are 22 million people with HIV/AIDS worldwide. Six million have died. The disease respects no boundaries and discriminates against no one. We could not and cannot afford to be complacent. We and our partners have to engage in new HIV/AIDS efforts.

Our vision is to move towards a nationally shared Strategy with improved collaboration among all levels of governments, among communities, non-governmental organizations, professional groups, institutions and with the private sector.

The following policy directions will guide the implementation of the new Strategy:

• enhanced sustainability and integration . new approaches and mechanisms will be put in place to consolidate and coordinate sustained national action in the long term;
• increased focus on those most at risk . innovative strategies will be devised to target high-risk behaviours in hard-to-reach populations that are often socially and economically marginalized; and
• increased public accountability . increased evidence-based decision making and ongoing performance review and monitoring will ensure that the new Strategy continues to be relevant and responsive to the changing realities of HIV/AIDS

.These policy directions are based on the goals of the Strategy which were developed in collaboration with stakeholders.

The goals of the Strategy are to:

• prevent the spread of HIV infection in Canada;
• find a cure;
• find and provide effective vaccines, drugs and therapies;ensure care,
• treatment and support for Canadians living with HIV/AIDS, their families, friends and caregivers;
• minimize the adverse impact of HIV/AIDS on individuals and communities; and
• minimize the impact of social and economic factors that increase individual and collective risk for HIV.

One of the important innovations of the Strategy is the creation of a Ministerial Council on HIV/AIDS which will bring together expertise that encompasses all aspects of HIV/AIDS in Canada, including a strong voice of people living with HIV/AIDS. This Council will provide ongoing advice to the Minister of Health in four crucial areas: keeping the Strategy flexible and responsive
to the changing nature of the epidemic; promoting alliances and joint efforts; reaching and responding to the needs of groups
at risk; and assisting in the development of long-term plans for future action on HIV/AIDS. The Minister will meet with the Council at least once a year, and will report on the progress of the Canadian Strategy on HIV/AIDS each
December 1st: World AIDS Day