With the XVI International AIDS Conference only months away, Health Canada and the Public Health Agency of Canada, in collaboration with several other federal government departments and agencies, have been busy preparing for this important event.
The Federal AIDS2006 Secretariat, the interdepartmental committee comprised of representatives from close to 20 federal government departments and agencies , has been meeting regularly to plan and prepare for the Conference. M any government departments and agencies are eager to engage in the Conference and several of them are moving forward with their partners in the planning of satellite sessions or other events.
In terms of financial contributions to the Conference, the Government of Canada has made some important announcements leading up to World AIDS Day. CIDA announced that it would contribute $1.5M to the Conference's International Scholarship Programme and the Global Village and Health Canada announced a $1.5M contribution to the core costs of the event, including the Scholarship Programme for Canadian Residents. Other departments and agencies are also considering making financial contributions to the Conference.
Please note that important Conference deadlines are fast approaching. Proposals for abstracts and skills-building workshops, as well as applications for the International Scholarship Programme and the Scholarship Programme for Canadian Residents, were due on February 22, 2006. For further information about the Conference and these important deadlines, please consult www.aids2006.org.
For specific questions regarding Government of Canada engagement, please contact Amy Arnold at amy_arnold@hc-sc.gc.ca.
The Federal Initiative to Address HIV/AIDS in Canada made a commitment to develop a national HIV research plan. This idea was re-emphasized in the pan-Canadian document Leading Together: Canada Takes Action on HIV/AIDS. The development of a national HIV research plan will be necessary as Canada has agreed to identify strategic research priorities by 2010 as part of its Declaration of Commitment on HIV/AIDS from the United Nations General Assembly Special Session on HIV/AIDS.
In the second year of the Federal Initiative (2004/2005), the Public Health Agency of Canada (PHAC) and the Canadian Institutes of Health Research (CIHR) have collaborated on several pieces of work that provide a foundation for this process. CIHR is carrying out an environmental scan on the state of HIV/AIDS research in Canada, which will inform its own research priority setting and will also provide input for the broader Canadian research context. At the same time, PHAC has completed two small projects to inform a PHAC-led national planning process. The first is an overview of research priorities identified in recent documents and by key HIV/AIDS stakeholders. The second is a survey of collaborative national research priority-setting models from other health areas.
Over the next two years, consultations with key Canadian partners who fund, conduct and benefit from HIV research will define the breadth and scope of the plan, who will participate in it, what evidence will be required to identify priority areas, as well as how to renew and evaluate the plan.
For more information, please contact Ingrid Wellmeier at (613) 957-3035, or at: ingrid_wellmeier@phac-aspc.gc.ca .
The Institute of Infection and Immunity (CIHR-III) of the Canadian Institutes of Health Research (CIHR) has launched a national consultation on research priorities for extramural HIV/AIDS research in Canada . The CIHR HIV/AIDS Research Advisory Committee developed the draft priorities and reflect the Committee's opinion of the current needs in HIV/AIDS research and areas that would benefit from strategic research funding programs.
The list of proposed priorities for the CIHR extramural research program is driven by the need to take into account the complex and diverse range of issues contributing to transmission, treatment and care. The proposed priorities are responsive to all aspects of HIV/AIDS, from the behavioural basis of risk and acquisition, population-specific factors affecting access to care, testing and treatment (gender, age, ethnicity, etc.), and the basic biomedical advances in understanding the virus and developing new therapies. The draft priorities include the following:
CIHR-III is inviting feedback on the draft research priorities from all stakeholders in HIV/AIDS research. Input received will be valuable in refining priorities and developing targeted research funding programs.
For further information on the priority-setting process and on research priorities, please see the Draft Priorities for Extramural HIV/AIDS Research in Canada.
Nominations to the CIHR HIV/AIDS Research Advisory Committee
CIHR-III is also seeking qualified individuals to replace three members of the CIHR HIV/AIDS Research Advisory Committee. Nominations are invited for potential candidates in the categories of HIV/AIDS researcher and/or community representative. Two researchers, with expertise in health services and population health HIV research and in biomedical and clinical HIV research, are being sought. A new member to represent the HIV/AIDS community is also needed. For more information on the Committee and the nomination process, please see CIHR HIV/AIDS Res earch Advisory Committee on the CIHR-III Web site.
Research Funding Opportunities
New funding opportunities in HIV/AIDS research will be launched by the CIHR in June 2006, including programs for community-based research.
For more information on the CIHR HIV/AIDS Research Initiative, please contact Jennifer Gunning at jgunning@cihr-irsc.gc.ca.
The Canadian HIV Vaccines Plan is nearing completion. This multi-sectoral collaboration began in 2003 with two expert round-table meetings involving governmental, research, community and international representatives. This large group elaborated a vision and principles for the plan, as well as an outline for the work to be accomplished. A Steering Committee was selected and has been meeting regularly for the past two years to complete the plan. This work has included extensive consultation with experts.
The Plan provides a detailed description in six sections of what Canada should do regarding HIV vaccines discovery, trials and testing, production, distribution, community engagement and political leadership and financial commitment. Currently, the draft plan is being used by the Government of Canada to help develop a business case for an enhanced Canadian investment in HIV vaccines efforts. In early 2006, the same experts who attended the original round-table meetings will be invited to a consultation on the Canadian HIV Vaccines Plan and the Government’s approach for HIV vaccine investment.
For more information, please contact Ingrid Wellmeier at (613) 957-3035, or at: ingrid_wellmeier@phac-aspc.gc.ca.
In August 2004, the previous Minister of Health announced that the Canadian Strategy on HIV/AIDS (CSHA) funding would double from $42.2M to $84.4M over the five-year period from 2004/05 to 2008/09. In January 2005, the Federal Initiative to Address HIV/AIDS in Canada (FI) was launched, replacing the CSHA, with a ramping up of AIDS Community Action Program (ACAP) grants and contributions across the country. In 2003/04, the total ACAP allocation was $7.4M; this will increase by $6.5M to a total of $13.9M in 2008/09 (see Figure 1).
Figure 1: ACAP Allocations under the New Federal Initiative to Address HIV/AIDS for the Period 2003/04 to 2008/09
The grants and contributions allocation formula used to allocate the initial FI increases in 2004/05 and 2005/06 was developed when ACAP was first introduced under the National AIDS Strategy and contains four criteria with the following weighting:
In 1998/99, the formula was reviewed by a working group that identified several limitations of the formula. The working group concluded that monitoring and development work should continue toward an improved ACAP Allocation Formula, based on relevant data and new formulas for combining multiple data sources to arrive at accurate and appropriate prevention and care/support indicators.
In summer 2005, the Regional HIV/AIDS Network (RHAN) established an Allocation Working Group comprised of representatives from each PHAC region to oversee the development of a new allocation formula for ACAP. In order to obtain sound advice on issues relating to epidemiology and data quality/availability, the Working Group formed the Epidemiological Advisory Group made up of staff from the Surveillance Risk Assessment Division, the Community Acquired Infections Division, and the HIV/AIDS Policy, Coordination and Programs Division, along with a few members of the Working Group who ensured links between the two groups.
The following are principles that the Working Group adopted to guide the undertaking of this project:
A contractor was hired to carry out a literature search to identify considerations for the allocation formula and available data, develop a framework for the allocation formula, prepare an interview guide and conduct a multi-stakeholder consultation on the framework, work with Surveillance Risk Assessment Division in developing the allocation formula, advise on the various options for allocating ACAP funding, and prepare a final report on the allocation process.
The literature review provided an overview of the state of HIV/AIDS in Canada , summarized key issues for the allocation processes, and identified datasets currently available and relevant to the allocation process. One of the key findings of the review was that four of Canada 's most populated provinces account for a very significant number of people living with HIV/AIDS. British Columbia , Alberta , Ontario and Quebec have accounted for 95% of all HIV positive cases reports since 1985. This will be an important consideration in identifying which provinces bear most of the HIV/AIDS burden and vulnerability in Canada .
The ACAP Regional Resource Allocation Framework has been designed to strike an appropriate balance between the principles of equity, burden and vulnerability. These are the three principles that together most reflect the purpose of ACAP funding:
In October 2005, external stakeholders were asked to comment on the proposed allocation framework. Twenty-nine stakeholders reviewed the draft ACAP Resource Allocation Framework and responded to the review questions in writing and/or via telephone interviews. While the consultation reached community, provincial and territorial government, and RHAN representatives in all seven PHAC regions, there were limitations in the consultation due to time and resources. Complete results of the consultation and the list of consulted stakeholders will be provided in the final report, and will be available upon request.
Based on the results of the consultation, the Working Group developed proposed options for allocating ACAP funding. Currently, the Public Health Agency of Canada is reviewing and assessing these options. It is expected that the review of ACAP grants and contributions Allocation will be completed in March 2006 in time for the results to be implemented in the new fiscal year beginning April 2006. For the latest update on the review, please contact the ACAP Program Consultant at your PHAC regional office.
The Federal Initiative to Address HIV/AIDS in Canada signals a renewed and strengthened federal role in the Canadian response to HIV/AIDS. To ensure that the work of the Public Health Agency of Canada (PHAC) is aligned with the new goals and policy directions of the Federal Initiative, the AIDS Community Action Program (ACAP) is undergoing a program review.
ACAP supports a community response to the HIV/AIDS epidemic. ACAP provides both operational and regional project funding to community-based AIDS organizations in four program areas:
PHAC periodically conducts solicitations for projects funded through this program.
With the aid of an external contractor, PHAC will be reviewing its programs and achievements under previous federal HIV/AIDS strategies to determine the extent to which ACAP has been, and remains to be, aligned with the aims of the Federal Initiative. This review will be conducted through a literature review and consultations with key internal and external informants. The results of the literature review and consultations will be used by the contractor to develop options and recommendations that will assist PHAC regions to position ACAP appropriately within the policy framework of the Federal Initiative.
The ACAP Program Review has just begun, and the literature review is in its initial stages. The next step will be to consult with key internal and external stakeholders, including representatives from the federal and provincial governments, and key partners, including national, provincial and local non-governmental organizations from across the country. A series of questions will be posed to solicit stakeholder opinions and advice regarding the alignment of ACAP to the Federal Initiative. The program review is expected to be completed by mid-summer 2006.
For more information, please contact Fiona Chin-Yee at (902) 426-0933, or at Fiona_Chin-Yee@phac-aspc.gc.ca .
A national AIDS Community Action Program (ACAP) evaluation framework is being developed for ACAP-funded initiatives, which will allow the Public Health Agency of Canada (PHAC) to measure the progress of these initiatives in achieving the planned outcomes of the Federal Initiative. To reduce the burden on community-based groups, the national ACAP evaluation is being coordinated with other evaluation work underway, specifically the work led by the Population Health Evaluators Network (PHEN) to develop common outcomes and indicators across a number of PHAC community-funded programs, including ACAP and national projects of the Federal Initiative, Population Health Fund, Diabetes and others.
PHEN has been actively working on a common evaluation framework and an on-line data collection system that will assist PHAC in collecting the same information in a consistent way across a number of funded programs. In this manner, gathered information will help to assess the ways in which community-based programs are making a difference in the health of communities and for specific populations.
Project data will be entered by funded recipients through a secure on-line tool (or as hard-copy/paper tool). The tool will contain guiding questions that are consistent across programs. The questions relate to theoretically grounded indicators of program effectiveness and to program logic models. In addition, ACAP will add program-specific questions to this tool to ensure that information being collected reflects ACAP-specific objectives. To reduce the burden on community-based groups, work is underway to ensure that current regional evaluation systems for ACAP will be compatible with the new system being developed, so that groups do not have to enter data in different systems.
Internal consultations on common outcomes and indicators, led by members of PHEN, are underway across program areas, and in regional and national offices. The Regional HIV/AIDS Network, comprised of program consultants and managers working on ACAP and other regional HIV/AIDS initiatives, will be consulted in mid-February 2006. A process for community validation of questions and involvement in these evaluations/activities will be developed, following internal consultations. A tool will be created and piloted with selected programs, including ACAP, in the spring/summer of 2006, and fully launched approximately a year later, in 2007.
For more information, please contact Fiona Chin-Yee at (902) 426-0933, or at Fiona_Chin-Yee@phac-aspc.gc.ca.
The latest HIV and AIDS in Canada Surveillance Report is now available. Published in November 2005, this report summarizes HIV and AIDS surveillance data to June 30, 2005, as reported by Canadian provinces and territories to the Centre for Infectious Disease Prevention and Control at the Public Health Agency of Canada.
HIV and AIDS surveillance data provide a description of persons who have been diagnosed with HIV and AIDS in Canada. The most recent report shows that the number of positive HIV test reports has amounted to approximately 2,500 a year during the 2002 to 2004 reporting period, which is a slight increase from the 2000 to 2001 reporting period when just over 2,100 positive tests were reported to PHAC. In terms of exposure category, this report also demonstrates the change in relative composition of positive HIV test reports with a slight increase among men who have sex with men, a decrease among injecting drug users, and an overall increase in the heterosexual exposure category. More years of observation are required to determine if these trends will persist.
The latest surveillance report is available on the Agency's Web site at: http://www.phac-aspc.gc.ca/publicat/aids-sida/haic-vsac0605/index-eng.php .
For more information on this report, please contact the HIV/AIDS Surveillance Section at HASS@phac-aspc.gc.ca .
Epi Updates are compiled annually by the Surveillance and Risk Assessment Division (SRAD) to summarize recent trends and developments related to the HIV epidemic in Canada. The Epi Update entitled HIV in Canada Among Persons from Countries where HIV is Endemic is new to the series.
This Epi Update was produced in consultation with a National Working Group that included representatives from the British Columbia Centre for Disease Control, the African and Caribbean Council for HIV and AIDS in Ontario, the University of Toronto, the Ottawa Public Health Department, GAP-Vies in Montreal, and Dalhousie University in Nova Scotia.
The Epi Update provides the most current information on the status of the HIV/AIDS epidemic in Canada among persons from countries where HIV is endemic includes the following highlights:
This Epi Update is posted on the Agency's Web site at: http://www.phac-aspc.gc.ca/publicat/epiu-aepi/epi-1205/index-eng.php.
You may also obtain a hard copy of the Epi Update by calling the Canadian HIV/AIDS Information Centre, Canadian Public Health Association, at (613) 725-3434, or SRAD at (613) 954-5169.
For more information about this Epi Update, please contact the HIV/AIDS Surveillance Section at HASS@phac-aspc.gc.ca
Leading Together: Canada Takes Action on HIV/AIDS (2005-2010) was released on October 26, 2005. Developed collaboratively by a broad spectrum of stakeholders involved in the Canadian response to HIV/AIDS, Leading Together reflects the best of the wisdom, experience and current practices, while presenting a collective view of what specifically needs to happen in the future, so that "the end of the epidemic is in sight." The release of Leading Together marks a turning point in the collective response to HIV/AIDS, by setting out a specific, ambitious, and coordinated national approach to tackling the epidemic on all fronts.
The final version of the document can be downloaded at www.leadingtogether.ca. The website also allows quick access to specific sections of the document, and includes a built-in search functionality. Hard copies of the document can be obtained by contacting the HIV/AIDS Infocentre at 1-877-999-7740, or at aidssida@cpha.ca. A summarized version is also being prepared for convenience, and is expected to be available shortly.
A multi-sectoral Championing Committee is currently being set up to further encourage the use of Leading Together throughout the country.
For additional information, please contact Fernand Comeau at fernand_comeau@phac-aspc.gc.ca or at (613) 946-6674.
The Government of Canada Report to the Secretary General of the United Nations on the United Nations General Assembly Special Session (UNGASS) Declaration of Commitment on HIV/AIDS for the period from January 2003 to December 2005 has been completed and submitted to the United Nations Joint Programme on HIV/AIDS (UNAIDS).
Over the last three months, government departments and agencies involved in HIV/AIDS (the Public Health Agency of Canada, Health Canada, the Canadian Institutes of Health Research, Correctional Service Canada, Foreign Affairs Canada and the Canadian International Development Agency) were widely consulted in preparing the report, as well as key stakeholders participating in the Canadian response to HIV/AIDS, such as the Ministerial Council on HIV/AIDS, the Federal/Provincial/Territorial Advisory Committee on HIV/AIDS, the National Aboriginal Council on HIV/AIDS, the Consultative Group on Global HIV/AIDS Issues, and the National Partners Group.
The 2003-2005 report follows UNAIDS reporting guidelines, describes the current status of the epidemic in Canada, and illustrates Canada's recent progress due to the launch of the Federal Initiative to Address HIV/AIDS in Canada and Leading Together: Canada Takes Action on HIV/AIDS (2005-2010).
The report will be used by UNAIDS, in part, to prepare the global report and the Secretary General's report for the UNGASS, which will take place in New York from May 31-June 2, 2006. As well, the report will be posted on the UNAIDS Web site and on the PHAC Web site in English and French, and will be disseminated to stakeholders.
For further information, please contact Shane Rhodes at:
Shane_Rhodes@phac-aspc.gc.ca, or by telephone at (613) 946-3636.
Knowledge Exchange and Transfer is one of the areas that the Knowledge and Awareness Section of the HIV/AIDS Policy, Coordination and Programs Division is exploring this year. The direction to explore this topic came from numerous sources, including the Federal Initiative to Address HIV/AIDS. The ultimate goal is to develop a framework for Knowledge Exchange for the Policy, Coordination and Programs Division and to create the new Knowledge Exchange Fund.
There are numerous activities that the Division has planned on doing in this area, which started with hiring a consultant to write a report on Knowledge Exchange Definitions and Models. The report recommended a few different models that could work for Knowledge Exchange in the area of HIV/AIDS. One of the many recommendations in the report was that a Knowledge Transfer framework for HIV/AIDS should have a heavy emphasis on tailoring messages and interventions to audience needs.
The next step in the Knowledge Exchange plan is to conduct a needs assessment of front-line organizations. The purpose of this needs assessment is to find out from Aids Service Organizations, community-based organizations and other organizations that serve the front-line, what kind of information is currently being used, where it comes from, and what other information would be useful in order to facilitate work. The needs assessment should be completed by the end of March 2006.
A consultation on Knowledge Exchange is being planned for the end of March. This consultation is intended to bring together individuals from organizations across Canada who are either from front-line HIV/AIDS organizations, provide information to front-line HIV/AIDS organizations, or who work with those at risk. The goal of the consultation is to develop a better understanding of knowledge exchange, the needs for knowledge exchange, and how to address those needs.
The information from the needs assessment and the consultation will be used to inform the development of the new Knowledge Exchange Fund. This new fund will be replacing the
existing HIV/AIDS Information Services Initiative (HISI) Fund and is scheduled to be released in early summer.
For more information, please contact Jo-Anne Stead at (613) 941-9766 or at jo-anne_stead@phac-aspc.gc.ca.
The Federal Initiative to Address HIV/AIDS in Canada pinpoints the need for increased federal action in national and front-line communications as well as social marketing activities to improve Canadians' knowledge of HIV, to address community and societal attitudes, and to reduce the stigma and discrimination that fuels the epidemic. Over the past year, the HIV/AIDS Policy, Coordination and Programs Division has been working with stakeholders both internal and external to government to develop the Public Health Agency of Canada (PHAC)-led national social marketing campaign, which will focus on HIV/AIDS-related stigma and discrimination.
2006 HIV/AIDS Attitudinal Tracking Survey
Since November 2005, the HIV/AIDS Division has been working with the Public Opinion Research and Evaluation (PORE) Division of PHAC to develop the 2006 HIV/AIDS Attitudinal Tracking Survey – an updated and expanded version of the 2003 HIV/AIDS Attitudinal Survey. Research findings from the 2003 HIV/AIDS Attitudinal Survey pointed to the fact that HIV/AIDS-related stigma and discrimination persists in Canada. While the HIV/AIDS 2006 Attitudinal Tracking Survey will build on previous research conducted, and provide an overview of how the environment has evolved since 2003, it will also include a number of enhanced questions on HIV/AIDS-related stigma and discrimination. The survey will help guide the PHAC-led HIV/AIDS social marketing campaign that is currently under development. Fieldwork has begun, and a final report is expected by the end of March 2006.
2006 Aboriginal HIV/AIDS Attitudinal Survey
PHAC and Health Canada's First Nations and Inuit Health Branch are jointly implementing the 2006 Aboriginal HIV/AIDS Attitudinal Survey, the first study of its kind in Canada. Gaining Aboriginal-specific information will help to inform a variety of initiatives, including the PHAC-led HIV/AIDS social marketing campaign. The survey will obtain baseline data on the knowledge, awareness and behaviour of First Nations living on- and off-reserve, of Métis and Inuit, with respect to HIV/AIDS, in order to provide an accurate understanding of their attitudes regarding HIV/AIDS and HIV/AIDS-related stigma and discrimination. This survey will borrow heavily from the 2006 HIV/AIDS Attitudinal Tracking Survey, but will be adapted for Aboriginal audiences in consideration of cultural and linguistic differences. Fieldwork is expected to begin in late February 2006, and a final report is expected by the end of April 2006.
Social Marketing Strategy
The Social Marketing Strategy for the PHAC-led National HIV/AIDS Social Marketing Campaign continues to be developed. Although the strategy has not yet been approved, once completed, it will outline the rationale for presenting an HIV/AIDS-related stigma and discrimination focus for the national campaign, and will pinpoint target audiences and tactics. Once a draft strategy has been approved internally, key partners will be consulted in spring 2006.
Fore more information related to the 2006 HIV/AIDS Attitudinal Tracking Survey or the 2006 Aboriginal HIV/AIDS Attitudinal Survey, please contact Maxxine Rattner at (613) 957-7351 or at maxxine_rattner@phac-aspc.gc.ca.
For more information on the Social Marketing Strategy, please contact Steven Sternthal at (613) 946-3635, or at steven_sternthal@phac-aspc.gc.ca.
To achieve greater coherence, complementarity and collaboration within federal HIV/AIDS policy and programming, an interdepartmental committee has been created. The Government of Canada Assistant Deputy Minister Committee on HIV/AIDS is comprised of the Assistant Deputy Ministers of 14 federal departments and agencies with mandates that impact on the determinants of health or are related to Canada's response to HIV/AIDS.
The committee will promote greater linkages and alignment of federal government policies and programs relating to HIV/AIDS. It also provides a common platform to promote horizontal coordination and program coherence across federal departments and agencies.
As an initial step toward developing a coordinated approach to addressing the epidemic, the Committee is developing a Government of Canada Position Statement on HIV/AIDS. This Position Statement is expected to promote greater federal collaboration on addressing the determinants of health, which will have an impact on individuals and populations who are vulnerable not only to HIV/AIDS, but also to other health conditions. The Position Statement is expected to be completed by spring 2006.
For more information, please contact Liz Kusey at (613) 952-1909, or at: liz_kusey@phac-aspc.gc.ca .
One of the shifts in the new Federal Initiative to Address HIV/AIDS is to develop specific approaches for populations vulnerable to HIV/AIDS (gay men, injection drug users, Aboriginal people, federal inmates, at-risk women and youth, people from countries where HIV/AIDS is endemic, and people living with HIV/AIDS). An overarching framework on population-specific approaches is currently being developed. This framework will build on a population-based and determinants of health approaches to HIV/AIDS to address the root causes of the epidemic.
HIV/AIDS Policy, Coordination and Programs Division staff is taking the opportunity to engage and collaborate with communities, other governments, and people living with HIV/AIDS who
are already working on issues related to specific populations. Meetings have taken place with members of the Blueprint for Action on Women and HIV/AIDS project, with gay men and injection drug users, and a meeting was held in February with members of the national steering committee for Springboarding a National HIV/AIDS Strategy for Black Canadian, African and Caribbean Communities project.
For more information, please contact Kathleen de la Salle at kathleen_de_la_sale@phac-aspc.gc.ca,or at (613) 957-1773.