1.0 Message from the co-chairs
2.0 The canadian strategy on hiv/aids - a brief history
3.0 Ministerial council's mandate, roles and objectives
4.0 Membership and structure
5.0 Designation of issues
6.0 Ministerial council areas of work in 2002-2003
6.1 Promoting Intra- and Interdepartmental Collaboration
Overview
6.1.1 Citizenship and Immigration Canada
6.1.2 Solicitor General - Correctional Service of Canada
6.1.3 Justice Canada
6.1.4 Health Canada: Office of Canada's Drug Strategy
6.2 Ensuring Citizen Engagement
Overview
6.2.1 Populations from Endemic Countries (Africa and the Caribbean)
6.2.2 Women and HIV/AIDS
6.2.3 Gay Men and HIV/AIDS
6.2.4 Injection Drug Users and HIV/AIDS
6.2.5 Aboriginal Peoples and HIV/AIDS
6.3 Securing Resources and Sustaining a Structure to Fight the Epidemic
Overview
6.3.1 Canadian Strategy on HIV/AIDS Direction Setting
6.3.2 Social Justice Framework and Population Health
6.3.3 CSHA Funding Adequacy
6.3.4 CSHA Evaluation
6.3.5 CSHA Resource Allocation
6.3.6 Research
6.3.7 Health Care Reform
6.3.8 Drug Review Process
6.4 Supporting the Development of Critical Initiatives
Overview
6.4.1 Vaccines and Microbicides
6.4.2 Medicinal Use of Marijuana
6.5 Preparing Canada's International Response
Overview
6.5.1 World AIDS Day
6.5.2 United Nations General Assembly Special Session on HIV/AIDS (UNGASS) - Follow-up
6.5.3 Global Fund to fight AIDS, Tuberculosis and Malaria
6.5.4 Other International Issues
7.0 APPENDICES
Appendix 1: Terms of Reference for the Ministerial Council on HIV/AIDS
Appendix 2: Members of the Ministerial Council on HIV/AIDS
Appendix 3: How to contact the Ministerial Council on HIV/AIDS
Appendix 4: Date and Location of Ministerial Council meetings during 2002-2003
The Ministerial Council on HIV/AIDS is pleased to share with you the results of its work during 2002-2003 in this second Annual Report. This was a year of intense activity as you will see in the following pages.
The Canadian Strategy on HIV/AIDS has been in effect for five years. It is a good time to stop and take stock of our progress and to identify gaps and emerging needs. The Ministerial Council on HIV/AIDS has been active in the Five-Year Review of the Strategy and in the development of a pan-Canadian Strategic Plan for the next five years. This process involves a large community of stakeholders. We are optimistic that this work will help the Minister to build a strong case for increased funding for the Strategy.
The Ministerial Council on HIV/AIDS played a pivotal role in collaboration with other stakeholders in helping to raise the profile of HIV/AIDS research within the Canadian Institutes of Health Research (CIHR). A member of the Council will sit on the new HIV/AIDS Advisory Committee that will work to ensure that HIV/AIDS research benefits from an integrated approach involving all Institutes at CIHR. This year a new home for HIV/AIDS community-based research was created at CIHR. We hope that this program will flourish and we will monitor developments to ensure that the principles of community-based research are upheld.
In order to foster an effective pan-Canadian response to the epidemic, we placed a strong emphasis this year on inter-ministerial collaboration within the Government of Canada and on linkages with the Federal/Provincial/Territorial Advisory Committee on HIV/AIDS. The papers that we commissioned on inter-ministerial collaboration and on the determinants of health are important contributions to the process of developing more integrated working relationships. We also participated in the development of a social justice framework for the Canadian Strategy on HIV/AIDS which will require the partnership of all levels of government.
Canada works in partnership with many other countries to confront the global HIV/AIDS epidemic. The Ministerial Council therefore devoted particular attention this year to the ways in which Canada is honouring its commitments under the Declaration of Commitment developed at the United Nations General Assembly Special Session on HIV/AIDS in 2001. We have advised the Minister to encourage the federal government to increase its contribution to the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria. Our study of the impact of global trade agreements on health care has heightened our awareness of the interconnectedness of a variety of global initiatives. We believe that the work done by the Ministerial Council on HIV/AIDS on inter-ministerial collaboration, health determinants and social justice will contribute to Canada's ability to develop integrated policy approaches with other countries.
This year we have had the pleasure of advising and working with the Honourable Anne McLellan, Minister of Health. We are optimistic that her commitment to the issues raised by HIV/AIDS will encourage an increasingly effective response to HIV/AIDS in Canada and globally.
The first Canadian case of AIDS was identified in 1982. Since then, more than 50,000 Canadians have been infected with HIV. 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, and in the community. National surveillance systems were put in place. Guidelines for training health care professionals 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 number of new infections among gay men, while improvements to the blood system have meant that Canadians have access to safe blood and blood products. Progress has been made, but it is not enough because the epidemic has spread to other populations and remains a serious threat to some of the initially infected populations, particularly gay men.
In 1998 the Canadian Strategy on HIV/AIDS was developed. Ongoing annual funding for the Strategy was secured at $42.2 million.
The following policy directions guide the implementation of the Strategy:
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:
The 10 program components of the Strategy are:
One of the important innovations of the Strategy is the creation of a Ministerial Council on HIV/AIDS which brings together expertise that encompasses all aspects of HIV/AIDS in Canada, including a strong voice of people living with HIV/AIDS. The Council provides 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 groups at risk and responding to their needs; and assisting in the development of long term plans for future action on HIV/AIDS.
Mandate: To provide advice to the Minister of Health on pan-Canadian aspects of HIV/AIDS.
Role: To ensure that current and emerging issues regarding HIV/AIDS are being adequately addressed.
Objectives:
Role: To be visionary in providing long-term directions.
Objectives:
Role: To monitor and evaluate the implementation of the Canadian Strategy on HIV/AIDS (CSHA) and to support its effectiveness and its flexibility to meet changing circumstances.
Objectives:
See Appendix 1 for the Ministerial Council's Terms of Reference.
Council members are appointed by the Minister of Health and are chosen for their experience and collective expertise. Because the Council must be the voice of those infected with and affected by HIV/AIDS, five of its 15 members are people living with HIV/AIDS. The Minister of Health reviews the membership of the Council on a regular basis to ensure that it consists of members who can provide the best timely advice.
To encourage collaborative efforts with the provinces and territories, the Provincial Co-Chair of the Federal/Provincial/Territorial Advisory Committee on HIV/AIDS (Dr. Bryce Larke) holds an ex-officio position on the Ministerial Council. The lead Assistant Deputy Minister for the Canadian Strategy on HIV/AIDS (J. Scott Broughton or his representative, Dr. Howard Njoo) also holds an ex-officio position as Health Canada's standing representative on the Council.
See Appendix 2 for a list of Ministerial Council members and their biographies.
The Ministerial Council meets face-to-face three times a year. Between Council meetings the committees meet by teleconference. The Ministerial Council on HIV/AIDS has established the following standing committees:
Executive Committee
The role of the Executive Committee is to ensure that all of the work needed to ensure productive Council meetings is done in a timely manner. It ensures that evaluation and resource allocation procedures within the Canadian Strategy on HIV/AIDS are adequate. The Executive Committee carries the responsibilities of evaluating the effectiveness of the Council and suggesting ways to improve the efficiency of the Council's work.
Championing Committee
The role of the Championing Committee is to identify current and emerging HIV/AIDS-related issues. The issues identified are the object of an analysis by committee members in order to determine if recommendations will be developed for the Minister.
Communications and Liaison Committee
The role of the Communications and Liaison Committee is to participate in the development and updating of communications tools such as the website and to oversee processes put in place to communicate with the Minister and a diverse group of stakeholders. Committee members provide advice to the Minister on specific occasions such as World AIDS Day. This committee assumes responsibility for guiding the strategic planning of the Council's own work.
Research Committee
The role of the Research Committee is to monitor research issues arising under the Canadian Strategy on HIV/AIDS and to develop recommendations for the Council's consideration.
During 2002-2003, the Council dissolved the following committees:
Monitoring and Evaluation Committee
The Monitoring and Evaluation Committee was dissolved because the Council considered that sound monitoring and evaluation procedures had been developed under the Canadian Strategy on HIV/AIDS. The ongoing role of monitoring and evaluation was assumed by the Executive Committee.
Special Working Group on Aboriginal Issues
This working group was dissolved because a new relationship between the Council and the National Aboriginal Council on HIV/AIDS is being developed to address Aboriginal issues.
Ad-hoc Visioning Committee
This committee successfully completed its task of guiding the development of a strategic plan for the Council.
Issues are brought forward to the Ministerial Council table in a number of ways. First, and most commonly, the Minister of Health may request that the Council provide advice on a particular issue. The Minister has a unique opportunity to present requests during a yearly face-to-face meeting with Council members. Individuals or groups bring issues to the attention of the Ministerial Council by addressing a letter to the Council Secretariat. Please see Appendix 3 for the Council's contact information. Finally, Council members bring forward issues that have come to their attention through their ongoing involvement in the community and through their work and participation in conferences and committees. The Ministerial Council may invite guest presenters to provide the Council with information on an issue.
There are a significant number of issues that the Ministerial Council is working on or following at any given time. Some issues require ongoing follow-up and have been on the agenda since the Council's inception, while new issues are raised at most meetings. There are a number of factors that must be considered in determining where the committees of the Ministerial Council direct their energies. To guide them, the committees ask if the issue under consideration is:
In its 2002-2003 workplan, the Council designated the following priority issues:
The following report provides details on major areas of work for the Ministerial Council in 2002-2003. In addition to the areas of work described, the Council also studied many ongoing and developing issues in order to remain informed and prepared to provide advice to the Minister of Health when necessary.
Overview
Promoting both intra- and interdepartmental collaboration is an important function of the Canadian Strategy on HIV/AIDS because the issues raised by HIV/AIDS fall within the mandates of several areas of Health Canada and of several other federal ministries. In addition to Health Canada, the departments of Justice, Foreign Affairs and International Trade, International Cooperation, Citizenship and Immigration, and the Solicitor General have been involved in HIV/AIDS issues during the past year. It is vital that federal ministries work in a collaborative way in order to make the Canadian Strategy on HIV/AIDS most effective. In its meeting with Minister McLellan, the Council stressed the need for departments and agencies other than Health Canada to respond to the epidemic. Minister McLellan has reiterated her commitment to fostering interdepartmental collaboration and expressed the hope that some additional funds could be found to raise the profile of this collaborative work. The Minister has also made a commitment to go to Cabinet in the next year to seek its support for increased funding for the Canadian Strategy on HIV/AIDS.
In addition to interdepartmental collaboration within the Government of Canada, the Council is concerned with intergovernmental collaboration and has strong links to the Federal/Provincial/Territorial (FPT) Advisory Committee on HIV/AIDS (FPT-AIDS). The provincial co-chair of FPT-AIDS is an ex-officio member of the Ministerial Council. During 2002-2003, a representative of the Ministerial Council attended an FPT-AIDS consultation meeting on the issue of people who are unwilling or unable to disclose their HIV status and the impact of this on transmission.
This year the Ministerial Council decided to revisit the study Towards a Broader Vision of Health: Strengthening Inter-Ministerial Collaboration on HIV/AIDS in Canada that the Council commissioned in 2001, in order to ensure greater follow-up on the recommendations of the study. The Ministerial Council also finalized and published its paper HIV/AIDS and Health Determinants: Lessons for Coordinating Policy and Action, which is intended to guide interdepartmental collaboration. The paper was distributed to ministers of federal departments with an involvement in HIV/AIDS. The paper is available on the Ministerial Council's website at http://www.phac-aspc.gc.ca/aids-sida/fi-if/minister-eng.php . The objectives of the paper are:
The Issue
Under the present Citizenship and Immigration policy, HIV testing is mandatory for prospective immigrants 15 years of age and over. The Ministerial Council does not support the mandatory testing policy, arguing that prevention education is an approach more consistent with respect for human rights. According to officials of Citizenship and Immigration Canada, approximately 300 people living with HIV would be admitted to Canada each year (excluding visitors), which represents about 80% of those testing HIV-positive.
Role of the Ministerial Council
The Ministerial Council engages in ongoing dialogue with the Minister of Health, giving her advice and requesting that she raise pertinent issues with the Minister of Citizenship and Immigration.
Work Done During 2002-2003
The Ministerial Council followed up on the work it did in 2001-2002 and on its briefing with the Director General, Medical Services Branch, Citizenship and Immigration, which took place in March 2002. The Council had a second meeting with this official at its November 2002 meeting. The Council's concerns focused on:
The Council welcomed the willingness of CIC officials to work with the Council on developing a communications strategy on the issues of numbers of HIV-positive persons entering Canada as refugees.
Future Activities
The Ministerial Council will continue to advise the Minister of Health on these issues and will dialogue and work with officials of Citizenship and Immigration Canada.
The Issue
The rate of HIV infection in Canada's prisons is ten times higher than in the general population. The rate of seroconversion due to exposure in prison is thought to be high. Although injection drug use and sexual activity occur in prison, access to needle exchange, condoms and methadone maintenance is limited. During 2002-2003 a group of 12 community-based HIV/AIDS organizations and service providers withdrew from participation in HIV and Hepatitis C consultation committees of the Correctional Service of Canada (CSC) after a decade of involvement. The basis of the withdrawal was the stakeholders' lack of confidence that their participation would affect the policies and practices of CSC.
Role of the Ministerial Council
The Ministerial Council advises the Minister of Health and encourages her to meet with and support the Solicitor General in bringing about reforms.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to monitor and give advice to the Minister on this issue.
The Issue
The proposed Blood Samples Act, Bill C-217, was a private member's Bill that would allow justices of the peace to order a blood sample taken when there exist "reasonable grounds" to believe that a Good Samaritan assisting another person, or a peace officer, firefighter, health care worker or other frontline emergency worker (or someone helping those people to do their job) has been exposed to the risk of HIV infection. Health Canada and Justice Canada both raised serious concerns about this Bill before the House of Commons Standing Committee on Justice and Human Rights at its hearings into the proposed legislation. At the beginning of March 2002, the Standing Committee recommended to the House of Commons that the Bill not proceed, but that the issues raised in the Bill be discussed by federal, provincial and territorial ministers of justice and the Uniform Law Conference, and that Health Canada increase its efforts to gather statistics on the extent of occupational exposures to HIV. Ontario has passed a Bill similar to Bill C-217.
Role of the Ministerial Council
The Ministerial Council continues to monitor this issue following extensive work on Bill C-217 during 2001-2002.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to monitor developments on the issue of legislation authorizing compulsory HIV testing and provide further analysis, advice and assistance to the Minister as necessary.
The Issue
Canada's Drug Strategy, in place since 1998, has the goal of reducing the harm done by alcohol and drugs to individuals, families and communities. At issue is the question of whether the harm reduction aspects of the Drug Strategy are being given sufficient weight relative to the enforcement and control aspects. This is of special concern because drug policy has a significant impact on the spread of HIV and on the access that people who use illicit drugs (including people living with HIV/AIDS) have to care, treatment and support. A high proportion of new HIV infections are among injection drug users. Issues faced by Aboriginal peoples are of particular concern.
Role of the Ministerial Council
The Ministerial Council strongly urges the Minister of Health to strengthen the harm reduction aspects of the Strategy, and to consult widely with stakeholders, including drug users. The Council has been influential in having drug use seen as a health, rather than a criminal, issue.
Work Done During 2002-2003
Work during 2002-2003 built on the extensive work done by the Ministerial Council during 2001-2002.
Future Activities
The Ministerial Council will continue to follow and champion this issue.
Overview
One of the cornerstones of the Canadian Strategy on HIV/AIDS is the commitment that people living with HIV/AIDS will have a central role in providing expertise and leadership. This has been a fundamental approach to all HIV/AIDS work since the beginning of the epidemic. The Ministerial Council remains vigilant to ensure that persons living with HIV/AIDS are actively engaged as citizens in the Strategy. The Strategy also encourages the engagement of communities and populations that are vulnerable to, or disproportionately affected by, the epidemic. The Declaration of Commitment made at the 2001 United Nations General Assembly Special Session on HIV/AIDS (see section 6.5.2) highlighted as a key commitment the engagement of vulnerable populations at the national level. At the suggestion of the Ministerial Council, Health Canada is undertaking an initiative to engage vulnerable populations and people living with HIV/AIDS in the development of the Canadian Strategy on HIV/AIDS and in determining policies and practices that affect their lives. Representatives of affected communities will be involved in the development of this initiative.
The Issue
Surveillance data show that an increasing proportion of AIDS cases in Canada occur among persons from countries where HIV is endemic, mainly in African and Caribbean communities, with a growing number from Asian communities. It is estimated that 70% of all maternal HIV transmissions to children in Canada have occurred among women of African and Caribbean origin. Diagnosis of HIV infection is also occurring among older children in populations from countries where HIV is endemic, who were born before HIV testing during pregnancy became a policy issue. Possible reasons for this include late diagnosis of HIV because of limited access to information and services, reduced access to treatment, and increasing infection rates. Lack of uniformity in collection of ethnicity data by provinces and territories across Canada impedes monitoring of these trends. There is a need for direct community involvement in collecting and analyzing data. HIV is now reportable in all jurisdictions in Canada. Most jurisdictions do not collect data on ethnicity, but there is a growing recognition of the need to do so in order to track the HIV epidemic. This remains a contentious issue that must be resolved with the communities affected.
Role of the Ministerial Council
The Ministerial Council advises the Minister on issues involving the needs of populations from countries where HIV is endemic.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to champion this issue.
The Issue
HIV infection rates among women in Canada have been rising steadily in recent years. A National Reference Group on Women and HIV/AIDS, convened by Health Canada, met during 2000-2001 and gave advice on program and policy priorities that will inform Health Canada's work planning for several years. The group was disbanded in early 2001.
Mother to child transmission of HIV and treatment regimes used to lessen transmission are continuing concerns. As a result of the use of antiretroviral therapies during pregnancy, the rate of transmission of HIV infection from mother to child has been significantly reduced. There are no data regarding the potential long-term effects on the pregnant woman or her children. A national group of stakeholders has been working to develop the Canadian Perinatal Exposure to Antiretrovirals Registry.
Role of the Ministerial Council
The Ministerial Council continues to build on its earlier work and raises concerns with the Minister of Health.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to champion issues relating to women and HIV.
The Issue
Two-thirds of the people living with HIV/AIDS in Canada are gay men or other men who have sex with men. A resurgence of HIV infections, particularly among younger gay men, is a cause for concern. Members of the gay community are calling for an approach to HIV prevention and treatment in the context of gay men's health, including psychosocial health. Aboriginal two-spirited people are seeking to provide their perspectives on behalf of the two-spirited community.
A National Reference Group on Gay Men's Health produced two reports in 2000: Framing Gay Men's Health in a Population Health Discourse and Valuing Gay Men's Lives: Reinvigorating HIV prevention in the context of our health and wellness. These reports continue to inform work on gay men and HIV/AIDS. Health Canada has a policy framework for gay men's HIV prevention which will be a component of a comprehensive HIV prevention strategy that is being developed.
Role of the Ministerial Council
The Ministerial Council continues to champion the issues of gay men and supports a renewed emphasis on HIV prevention and care for gay men.
Work Done During 2002-2003
The Council continued to track the issue of gay men and HIV/AIDS.
Future Activities
The Ministerial Council will continue to champion these issues.
The Issue
Injection drug users are among the fastest growing populations of newly infected Canadians. Injection drug use is affected by Canada's Drug Strategy (see section 6.1.4). In 1999, the Canadian HIV/AIDS Legal Network published a report on injection drug use, Injection Drug Use and HIV/AIDS: Legal and Ethical Issues. In its August 2001 reply, Health Canada focused on: harm reduction; care, treatment and support; and involving drug users in policy making. Health Canada commissioned studies on drug use and HIV, including a study on the provision of controlled substances to HIV-positive injection drug users in care settings. Injection drug use has legal as well as health aspects, which necessitates interdepartmental collaboration between the departments of Health, Justice and the Solicitor General.
Role of the Ministerial Council
The Ministerial Council champions this issue and provides advice focused on interdepartmental collaboration, federal/provincial/territorial collaboration and congruence with Canada's Drug Strategy. The Council is linked to the Safe Injection Site Task Group through a member of Council who sits on the Task Group.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to take an active interest in this issue and will provide advice to the Minister of Health.
The Issue
The HIV epidemic is growing among Aboriginal peoples, a conclusion based largely on data collected in urban areas. The Canadian Strategy on HIV/AIDS has an Aboriginal component, with $2.6 million dedicated to Aboriginal communities. In addition, there are dedicated funds for an Aboriginal research program. The First Nations and Inuit Health Branch of Health Canada spends an additional $2.5 million annually on HIV programs.
In 2001-2002, a National Aboriginal Council on HIV/AIDS (NACHA) was formed as a collaborative mechanism to provide advice to Health Canada on all aspects of the Canadian Strategy on HIV/AIDS and to become the single advisory group on Aboriginal issues. NACHA is composed of four caucuses: First Nations; Inuit; Métis; and Community.
Role of the Ministerial Council
The Ministerial Council maintains its advocacy for Aboriginal issues and its links to the National Aboriginal Council on HIV/AIDS and to other Aboriginal groups and processes. The Council's Situational Analysis report on Aboriginal issues continues to be a widely-used foundation document.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to support Aboriginal issues through its working relationship with the National Aboriginal Council on HIV/AIDS.
Overview
Funding levels for the Canadian Strategy on HIV/AIDS have not been increased significantly for almost a decade, despite an increase in the number of Canadians infected and the growing international epidemic. New populations have emerged which are marginalized, vulnerable and hard to reach. Compared to other countries such as Australia and the United Kingdom, which have also invested strategically in HIV/AIDS, Canada is falling behind.
The Issue
In October 2000, a representative group of stakeholders met with Health Canada to identify broad strategic directions for the Canadian Strategy on HIV/AIDS (CSHA) for the following year. At this meeting, the group proposed 10 directions:
A second national direction-setting meeting was held in April 2002 with the goals of updating partners on recent developments, furthering collaborative action on the implementation of the 10 directions and strengthening national collaborative planning capacity under the CSHA. At this meeting, preliminary action plans were developed for each of the 10 directions. Health Canada then worked with the Canadian Strategy on HIV/AIDS Direction-Setting Process Task Group to develop and implement a comprehensive follow-up and communications strategy that included:
Development of the five-year strategic plan envisioned by Direction 10 is proceeding in parallel with the five-year review of the Canadian Strategy on HIV/AIDS (see section 6.3.4) so that lessons learned from the review can inform planning for the next five years. The findings from the five-year review will influence the Minister's decision to recommend to Cabinet that funding for the Strategy be increased.
Participants at a strategic planning meeting in December 2002 discussed key issues and worked toward developing goals, objectives and actions, and identifying gaps. The key issues that will be addressed in the draft Strategic Plan are:
A draft plan was circulated for consultation in March 2003. The Strategic Plan, involving pan-Canadian stakeholders, is expected to be launched in December 2003. The Federal Action Plan, which may possibly include additional funding, is expected to be launched in March 2004.
Role of the Ministerial Council
In its roles of monitoring and evaluating, championing issues and providing long-term guidance, the Ministerial Council monitors follow-up activity by Health Canada and provides advice with respect to direction-setting for the Strategy.
Three members of the Ministerial Council and the ex-officio Ministerial Council member from the Federal/Provincial/Territorial Advisory Committee on AIDS attended the October 2000 stakeholders' meeting. The Ministerial Council delegated two members to sit on the task group that planned the second direction-setting meeting in April 2002. A third member of the Council sat on the task group that represented Aboriginal organizations.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to be involved in the process of acting on the 10 directions, developing the five-year strategic plan, and completing the five-year review.
The Issue
A social justice framework for dealing with HIV/AIDS addresses the social, economic and political factors that worsen the epidemic, such as gender-based inequalities, poverty, discrimination, social conditions and legal and government policy. It looks at the range of social determinants and their impact on health and recognizes that protecting, promoting and fulfilling human rights is fundamental to realizing social justice. Moving to a social justice framework was one of the 10 directions set for the Canadian Strategy on HIV/AIDS at the stakeholders' meeting in 2000. A preliminary action plan was developed at the April 2002 stakeholders' meeting.
The development of a social justice framework based on human rights concepts and principles, and linked to the determinants of health, builds on the work of HIV/AIDS pioneer Dr. Jonathan Mann. Human rights and social justice have increasingly been identified as key determinants of health by stakeholders during recent years. Support for this approach derives also from international human rights law and the positions declared at the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) in June 2001 (see section 6.5.2).
The socio-economic conditions that affect Aboriginal peoples and communities need to be included in a social justice framework for dealing with HIV/AIDS.
Role of the Ministerial Council
The Ministerial Council supports the social justice framework and contributes to its development.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to participate in the development of the social justice framework.
The Issue
Funding levels for the Canadian Strategy on HIV/AIDS (CSHA) have not increased since 1994, when they were set at $42.2 million. In the early 1990s, 30,000 Canadians were living with HIV; today that number is more than 50,000. Inflation has eroded the $42.2 million to $34 million in 1991 dollars. New needs have arisen that require adequate support. The Minister has reiterated the commitment made by her predecessor to seek additional funding for the Strategy provided that the results of the five-year review and the new five-year strategic plan make a sound case for more funding. It is expected that the Minister may approach Cabinet with a request for additional funding in the fall of 2003 and that additional funding may be available by 2004.
Role of the Ministerial Council
The Ministerial Council monitors and evaluates the implementation of the CSHA, including reviewing and recommending financial allocations under the CSHA, and advises the Minister on CSHA evaluations to ensure that the needs of stakeholders are being met.
The Ministerial Council advises the Minister and Health Canada officials on reallocation of surplus funds or deficits in each year, and on overall funding levels for the CSHA. For example, in 1998/99, the Council's advice led to Health Canada safeguarding $1.8 million in research funds. The Council's position has consistently been that more funds are needed for the Strategy.
In 2001, the Ministerial Council commissioned a study on the adequacy of federal funding for the CSHA, which found that the present funding level is inadequate. The study recommended that clear objectives be set for the CSHA and that new, adequate funding levels be determined based on these objectives. The study, Taking Stock: Assessing the Adequacy of the Government of Canada Investment in the Canadian Strategy on HIVAIDS, is available on the Ministerial Council's web site .
Work Done During 2002-2003
In its meeting with the Minister, the Council expressed its disappointment that the process to possibly secure additional funding for the Strategy will take until 2004. The Council expressed its willingness to work with Health Canada to create a case for additional funding by mid-December 2002 in order to be included in the February 2003 federal budget. The Minister discussed with the Council the many steps involved in securing funding increases and the need to build a solid case for Treasury Board and Cabinet to justify additional funding.
Future Activities
The Ministerial Council will continue to be involved in the effort to secure additional funding for the Strategy.
The Issue
An annual accountability report on the Canadian Strategy on HIV/AIDS is produced by Health Canada and released by the Minister of Health on World AIDS Day (December 1). In 2001-02, a Year Three evaluation of the CSHA was amalgamated with the annual report. In 2002-2003, the Five-Year Review and the CSHA strategic planning for the next five years were begun. The two processes are operating in parallel in an interactive way. The impetus for a five-year strategic plan developed at the two direction-setting meetings in 2000 and April 2002 at which stakeholders called for a more proactive and strategic approach to HIV/AIDS in Canada. The Strategic Plan will be pan-Canadian in nature while the Five-Year Review will focus only on the federal role in the CSHA. The Five-Year Review results from a commitment made to Cabinet in 1998. The Minister will be guided by the results of the Five-Year Review and the Strategic Plan in making a case to Cabinet for increased funding for the Strategy. The Five-Year Review is expected to be completed by June 2003. The Strategic Plan will be developed in consultation with stakeholders and is expected to be completed by late 2003.
Role of the Ministerial Council
In its monitoring and evaluation role, the Council participates in all evaluations of the Canadian Strategy on HIV/AIDS. Its particular role is to monitor and advise on CSHA evaluations to ensure that the needs of stakeholders are being met. The Ministerial Council is represented in the strategic planning process and on the Advisory Committee for the Five-Year Review. The Council will provide its advice to the Minister on the final reports.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to play an advisory role with respect to evaluation of the Strategy.
The Issue
Resources are allocated at fixed levels to specific components of the Canadian Strategy on HIV/AIDS, based on the recommendations of a National Stakeholder Group in 1997. Health Canada reports annually to the Treasury Board and has created a process for reviewing Strategy allocations as part of its accountability framework. Ongoing work is needed to assess whether the allocations established in 1998 are still relevant and whether reallocation is needed to existing or newly-created components of the Strategy.
Health Canada uses a Quick Response Reallocation Mechanism (QRRM) to reallocate surpluses within the fiscal year. The QRRM reallocates funds in four stages:
The Auditor General recommended in 2001 that all funding for projects be decided through a competitive process. As a result, Health Canada has discontinued directed funding for projects which lengthens the time cycle for awarding contributions.
Role of the Ministerial Council
The Ministerial Council monitors and evaluates the implementation of the Canadian Strategy on HIV/AIDS in order to support its effectiveness and flexibility to meet changing circumstances. As part of this role, the Council reviews allocations under the Strategy and provides advice.
In previous years, the Council collaborated with Health Canada on the development of the Quick Response Reallocation Mechanism for dealing with potential surpluses within a fiscal year.
Work Done During 2002-2003
The Issue
Research is a major component of the Canadian Strategy on HIV/AIDS, with more than 30% of the Strategy funds being dedicated to research. Research is conducted in bio-psycho-social fields in the effort to find effective prevention and treatment for the diverse populations infected and affected by HIV.
The Strategy supports community-based research ($1 million annually) and an Aboriginal Community-Based Research Program ($800,000 annually). Both the community-based program and the Aboriginal Community-Based Research Program have a capacity-building component to enhance the ability of communities to engage in research. At issue during the past year was the need to find a home for both the community-based research program and the Aboriginal research program, which were formerly included in the National Health Research Development Program (NHRDP) which ended in March 2001. Health Canada commissioned a study, Building on the Strengths of Communities: Options for Redesigning and Relocating the Community-Based Research Program, to inform the process of decision making. A Community-Based Research Steering Committee has been working with Health Canada and the Canadian Institutes of Health Research (CIHR) on resolving this issue. During 2002-2003, a decision was made to locate the general community-based research program at CIHR. An agreement between Health Canada and CIHR is expected to be completed early in 2003-2004.
The question of relocating the Aboriginal Community-Based Research Program is being considered through a separate process in consultation with the National Aboriginal Council on HIV/AIDS and the Canadian Aboriginal AIDS Network.
Community stakeholders have voiced concerns over the amount of paperwork required when applying for community-based research grants, as well as the lack of access to ethics review boards and liability insurance for community-based research projects.
A further issue is the integration of HIV research into the structure of the Canadian Institutes of Health Research (CIHR). HIV/AIDS is currently housed within the Institute of Infection and Immunity. The Ministerial Council and stakeholders, including researchers, have called for a stronger presence for HIV/AIDS research within CIHR.
An issue for all types of research is the transfer of research findings to those working on the front line.
The continuing emergence of antiretroviral-resistant strains of HIV and the need to find new therapies to counteract resistance are ongoing issues. Health Canada monitors drug-resistant HIV through the Canadian HIV Strain and Resistance Surveillance Program. The report of a working group on the issue was completed in 2002-2003 and presented to the Federal/Provincial/Territorial Advisory Committee on HIV/AIDS and given to the Ministerial Council. In March 2003, a second national workshop on drug resistance was held.
Role of the Ministerial Council
The Ministerial Council plays both monitoring and championing roles with respect to research issues, which include epidemiology, basic science, clinical science, psycho-social and community-based research. The Council has representation on the Canadian Institutes of Health Research HIV/AIDS Advisory Committee and on the Community-Based Research Steering Committee.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to provide advice on the issues of community-based research, the creation of suitable research infrastructures at CIHR, surveillance and emerging areas of research.
The Issue
The Commission on the Future of Health Care in Canada (the Romanow commission) released its report in late 2002. In recent years, there have been a number of health care reform reports commissioned by the provinces. In addition, the Senate of Canada has an active commission on health reform (the Kirby Commission) which has issued several reports. Following the release of the Romanow report, the First Ministers' Accord on Health Care Renewal was reached in February 2003. The Accord focuses on primary health care, home care, catastrophic drug coverage, access to diagnostic/medical equipment and information technology, and electronic health records. At issue in the debate about health care reform is the future of public health care in Canada, and specifically the Canada Health Act. The public health system is a vital support for all Canadians, and particularly for vulnerable populations and people living with HIV/AIDS.
Role of the Ministerial Council
The Ministerial Council plays the role of champion in ensuring that current and emerging issues are being adequately addressed. It also has a role of being visionary in providing long-term directions and anticipating the consequences of existing trends and policies. The Council accordingly takes an active interest in health care reform in Canada.
Work Done During 2002-2003
The Council reviewed the interim and final reports of the Romanow commission, the Kirby commission reports and the First Ministers' Accord. The Council's concerns focused on:
Future Activities
The Ministerial Council will continue to follow health reform developments in Canada and will provide advice to the Minister of Health.
The Issue
Health Canada is responsible for the review for approval of sale of new drugs and for the post-approval surveillance of drugs. The HIV/AIDS community has consistently pressed for a more efficient review and approval process, and for more extensive post-approval surveillance of drugs. The Common Drug Review Process was established in 2002 by federal/provincial/territorial ministers of health (except Quebec) to harmonize drug review and formularies (list of drugs reimbursable under the public health plan). This process is being coordinated by the Canadian Coordinating Office for Health Technology Assessment and is still in development.
Role of the Ministerial Council
The Ministerial Council is a strong advocate for more effective drug review.
As a result of its recommendation to the Minister of Health in 1998, a Therapeutic Products Program Working Group on HIV/AIDS was formed. This group made 29 recommendations, many of which could be extended to diseases other than HIV/AIDS. These recommendations led to the establishment of an Advisory Panel on Product Licensing Process with a mandate to include HIV and other diseases. A member of the Ministerial Council sat as an observer on the Therapeutic Products Program Working Group and on the Therapeutic Products Directorate Advisory Panel on the Product Licensing Process.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to monitor this issue and provide advice to the Minister.
Overview
As part of its role of championing existing and emerging issues, the Ministerial Council uses its collective expertise and experience and requests regular briefings on critical issues and initiatives in order to give the Minister of Health the best possible advice. The Council works concurrently on a number of critical issues (see section 5). Those described below were the subject of particularly intensive work in 2002-2003.
The Issue
The hope for a cure for HIV/AIDS has been present since early in the epidemic. Two of the goals of the Canadian Strategy on HIV/AIDS are: find a cure; and find and provide effective vaccines, drugs and therapies. Research is ongoing to find both a curative and a preventive vaccine. A preventive vaccine is currently in clinical trials. Canada is part of this international effort. During 2002, the Canadian HIV/AIDS Legal Network released its report HIV Vaccines in Canada: Legal and Ethical Issues - An Overview. Among other recommendations, the report called for a Canadian HIV Vaccine Plan.
Health Canada has struck an internal Working Group on HIV Vaccine Development and Equitable Distribution. The Working Group will convene a panel of government and non-governmental stakeholders to explore research requirements and legal, ethical and human rights issues with respect to the Government of Canada's role in the equitable distribution of an HIV vaccine in Canada and globally. The Working Group will hold a consultation in the Spring of 2003 and expects to produce a national HIV Vaccine Plan by the Fall of 2003.
Microbicides are also an active focus of research. Microbicides are substances that can substantially reduce the transmission of sexually transmitted infections when applied either in the vagina or rectum.
Role of the Ministerial Council
The Ministerial Council champions the development of vaccines and prevention agents.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to monitor progress on vaccines and microbicides and provide advice to the Minister.
The Issue
Marijuana has been recognized as a useful therapy for some persons living with HIV/AIDS, although formal research data are scarce. Clinical trials are currently underway in Canada. Under present regulations, only HIV specialists may prescribe marijuana, whereas the majority of HIV-positive patients are cared for by primary care physicians. Professional medical bodies have advised physicians not to put themselves at risk of prosecution by prescribing marijuana. This reduces access to medical marijuana by persons living with HIV/AIDS. During 2002-2003, Health Canada established a Stakeholder Advisory Committee on Marijuana for Medical Purposes which met late in 2002. Under the Marijuana Medical Access Regulations, approximately 800 authorized persons can possess and cultivate marijuana for medical purposes. Clinical trials to assess the medical effectiveness of marijuana are also being sponsored by Health Canada.
Role of the Ministerial Council
The Ministerial Council studies and provides advice on this issue.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to monitor this issue and advise the Minister.
Overview
HIV/AIDS is a global issue, with more than 42 million people infected worldwide and an infection rate of five million people a year. The Canadian Strategy on HIV/AIDS has a component of international collaboration, with a budget of $300,000, focused on information sharing and coordination of Canada's international activities, housed within Health Canada. In addition, the Canadian International Development Agency (CIDA) spends more than $50 million a year on international HIV/AIDS programs.
Of continuing interest this year were the World Trade Organization's discussions on intellectual property and the question of mechanisms to ensure that developing countries can access affordable HIV/AIDS treatments. This year the Council took a particular interest in the impact of international trade law and policy on health care in Canada and abroad. Also of interest was Canada's contribution to the Global Fund to fight AIDS, Tuberculosis and Malaria. The Council has monitored these issues and the work that stakeholders in Canada have done to address them.
Canada has taken a leadership role within the international community on issues involving Africa. Partnerships and action for Africa's development were championed by the Prime Minister at the 2002 G8 Summit held in Canada.
Several Council members participated in the XIV International AIDS Conference in Barcelona in 2002.
The Issue
World AIDS Day, December 1, has been the annual global observance of HIV/AIDS since it was declared by the United Nations in 1988. The theme chosen by the United Nations for World AIDS Day 2002 was "Live and Let Live" which focused on eliminating stigma and discrimination. The communications activities associated with World AIDS Day are an opportunity to draw public attention to key areas where efforts need to be strengthened. On each World AIDS Day since 1997, the Minister has released an annual report on the Canadian Strategy on HIV/AIDS. The 2002 World AIDS Day report was entitled Lessons Learned: Reframing the Response - Canada's Report on HIV/AIDS 2002. December 1 is also Aboriginal AIDS Awareness Day in Canada. During 2002-2003, work was begun on a pan-Canadian HIV/AIDS Awareness Campaign to "put HIV/AIDS back on the map". This campaign will be launched on December 1, 2003.
Role of the Ministerial Council
The Ministerial Council helps the Minister to develop the key messages for her World AIDS Day speech and for the Annual Report on the Canadian Strategy on HIV/AIDS, released on December 1 each year. The Council also helps the Minister to plan appropriate activities for World AIDS Day.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to advise the Minister and Health Canada staff about the messages and activities planned for World AIDS Day and about the Annual Report released on that day.
The Issue
In June 2001, the United Nations held a General Assembly Special Session on HIV/AIDS (UNGASS). During the Session, a Declaration of Commitment was made to help set the direction for the global response to HIV/AIDS for the next decade. A global fund was also announced (see section 6.5.3). The Declaration of Commitment requires governments to report annually on their implementation of the Declaration. Because of the urgency of the issue, the United Nations General Assembly passed a resolution in March 2002 asking the UN Secretary General to submit a progress report to the General Assembly in September 2002. Canada was one of the countries that submitted a report for incorporation into the Secretary General's report to the September 2002 General Assembly. The report was prepared by Health Canada (International Affairs Directorate on behalf of the Canadian Strategy on HIV/AIDS) with stakeholder input.
A second national progress report will be submitted in 2003, when the first set of targets of the Declaration of Commitment becomes due. This report will be composed of contributions by Health Canada and the Canadian International Development Agency which will be combined into a single report by the Department of Foreign Affairs and International Trade.
As part of Canada's response to UNGASS, the International Affairs Directorate of Health Canada prepared a report for distribution to the Canadian business community, Enhancing Canadian Business Involvement in the Global Response to HIV/AIDS. The report was launched at the 2002 Barcelona International AIDS Conference. The report is intended to stimulate discussion and involvement by Canadian businesses within the context of international corporate social responsibility.
Role of the Ministerial Council
The Ministerial Council acts as a champion and advocate with the Minister for these issues. The Council contributes its perspectives on inter-ministerial collaboration and social justice with respect to international issues.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to monitor Canada's follow-up to UNGASS and advise the Minister of Health.
The Issue
The Global Fund to Fight AIDS, Tuberculosis and Malaria was announced by the United Nations Secretary General in 2001. The United Nations Secretary General called for contributions of US$7-10 billion per year. Canada announced a contribution of CDN$150 million over a four-year period to the Global Fund during the United Nations General Assembly Special Session on HIV/AIDS meeting in June 2001. Leaders at the 2001 G8 Summit made a commitment to support the Global Fund. Contributions to the Fund have been less than 10% of the amount required.
Canada's contribution to the Global Fund is the responsibility of the Canadian International Development Agency (CIDA) which reports to the Minister for International Cooperation.
Role of the Ministerial Council
The Ministerial Council advises the Minister about the course that Canada should take with respect to the Global Fund.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to monitor Canada's contribution to the Global Fund and advise the Minister.
The Issues
In 2002, leaders of G8 countries held their annual Summit in Canada. This presented the Council with an opportunity to advise the Minister on health and HIV/AIDS issues, particularly with respect to Africa, that Canada could champion at the Summit. The Prime Minister had declared his support for African development and was leading the initiative on a New Partnership for Africa's Development that was discussed at the Summit.
The impact of international trade agreements on health was also an issue of concern to the Council.
Role of the Ministerial Council
The Ministerial Council studies international issues that have an impact on HIV/AIDS in order to provide advice to the Minister.
Work Done During 2002-2003
Future Activities
The Ministerial Council will continue to remain informed about international issues that have an impact on HIV/AIDS.
For further information, please see the following appendices:
Appendix 1 |
Terms of Reference for the Ministerial Council on HIV/AIDS |
Appendix 2 |
List of Ministerial Council members with brief biographies |
Appendix 3 |
Contact information for the Ministerial Council on HIV/AIDS |
Appendix 4 |
Date and location of Ministerial Council meetings in 2002-2003 including the presenters at each meeting |
Mandate: To provide advice to the Minister of Health on pan-Canadian aspects of HIV/AIDS
Role:
Reporting and Scope:
The Ministerial Council on HIV/AIDS will provide independent advice to the Minister of Health on pan-Canadian aspects of HIV/AIDS, and will report to the Minister annually. Meeting minutes, recommendations and other materials produced by the Council will be available to the general public.
The Minister will meet at least once a year with the Council and review its recommendations, and every December 1st, the Minister will announce what progress has been made towards achieving the goals of the Canadian Strategy on HIV/AIDS. The Council has no decision-making authority over operational or regulatory functions or programs, nor will it be responsible for the implementation of its advice.
Membership
Appointments and Structure
The Minister of Health will appoint a maximum of 15 members to the Ministerial Council on HIV/AIDS. A minimum of five (5) seats will be held by people living with HIV/AIDS, and consideration will be given to ethnocultural diversity, gender and regional balance on the Council.
From among Council members, the Minister will appoint Co-Chairs, one of whom will be a person living with HIV/AIDS. To help ensure that the Council influences a truly integrated approach that cuts across lines of government, the provincial Co-Chair of the FPT Advisory Committee on AIDS will hold an ex officio position on the Council. In order to provide technical advice and to facilitate coordination, one or more officials from Health Canada may hold ex officio positions. Federal and provincial government observers may attend meetings as required.
The membership structure of the Council will provide five (5) seats for professional/technical experts to be drawn from the following areas: the private sector; biomedical research; clinical trials; psycho-social research; and medicine (education, primary care physicians/nurses, regional/public health). The balance of the voting membership (10 seats) will be drawn from national HIV/AIDS organizations, community organizations and front-line workers. These members should have expertise in treatment issues, ethics/law/human rights and/or international issues, knowledge and experience with one or more groups at risk of HIV/AIDS.
Member Selection
In selecting members, consideration will be given primarily to: individual expertise in a number of issues that reflect the diverse realities of HIV/AIDS in Canada and, in particular, knowledge and front-line experience concerning emerging at-risk groups; and the need for an overall balance of expertise on the Council.
Accountability
Although Council members will be expected to conduct themselves as individual experts, affiliation with a national stakeholder organization, community organization, business, or institution with HIV/AIDS activities will enable a strong link for policy and advice based on direct experience from those infected and affected, including those potentially at risk, as well as those working in the field. Many emerging at-risk groups, however, have neither a community identity nor a national voice. For this reason, it is essential that experts, lacking an affiliation with a recognized HIV/AIDS organization, not be excluded from the Council. Members should bear responsibility for the needs of the plurality of individuals, communities, organizations, and sectors infected and affected by HIV/AIDS, while rising above any corporate interest of an organization with which they might be affiliated.
Term of Appointment
Members will be appointed by the Minister of Health for such periods as the Minister may determine, but usually for terms of one to two years. Appointments will be scheduled to ensure continuity as well as systematic rotation of membership. At the expiration of that period, the appointment normally will end; however, the Minister may review the appointment when renewal is warranted by specific Council activities. After one year, and thereafter at the Minister's discretion, the mandate, terms of reference and membership of the Council will be reviewed and adjusted to respond to changing needs.
Committees and Working Groups
The Council may establish an executive committee, standing committees and working groups to assist it in its work. Standing committees and working groups must include at least one Council member, and they will report to the Co-Chairs of the Ministerial Council on HIV/AIDS.
Support
Health Canada will provide administrative and technical support to the Council.
Legal Consideration
Conflict of Interest
Council members, who are also a member of any HIV/AIDS organization in receipt of government contributions, would find themselves in a conflict of interest situation if they were to influence the Council in a way that would benefit that member's organization.
While it is acceptable that a Council member be affiliated in some fashion with an HIV/AIDS organization, that individual must conduct him/herself as an independent expert and comply with Health Canada guidelines on conflict of interest.
Responsibilities
Members
Council
Health Canada
CO-CHAIRS
Louise Binder
Louise Binder, a retired lawyer, is Chair of the Canadian Treatment Advocates Council, Chair of Voices of Positive Women, a member of the University of Toronto's HIV/AIDS Human Subjects Review Committee, and a former board member of the HIV/AIDS Legal Clinic Ontario. She was the recipient of the YWCA of Metropolitan Toronto's 1999 Women of Distinction award for social action. Ms. Binder received an honorary Doctorate of Laws from Queens University in October 2001.
Lindy Samson
Dr. Lindy Samson is a pediatric infectious disease specialist and HIV physician at the Children's Hospital of Eastern Ontario (CHEO) and assistant professor at the University of Ottawa. She is Director of the CHEO HIV clinic and is a strong advocate for mothers and children dealing with HIV infection. Dr. Samson has participated in studies and programs that have led to the early recognition of HIV in pregnancy and the peri-partum management of HIV to prevent infection of children. She is Chair of the Canadian Pediatric AIDS Research Group.
MEMBERS
Margaret Dykeman
Dr. Margaret Dykeman has been working in HIV/AIDS in various capacities for more than 10 years as a nurse practitioner, researcher, community representative and advocate. She is an Associate Professor in the University of New Brunswick's Faculty of Nursing. Dr. Dykeman is President of AIDS New Brunswick, the provincial HIV/AIDS organization. She has broad experience and knowledge of the injection drug user population which is one of the most vulnerable to HIV infection.
Richard Elliott
Richard Elliott, a lawyer formerly in private practice, is Director of Policy and Research for the Canadian HIV/AIDS Legal Network. The Legal Network is a non-governmental organization working on HIV/AIDS and human rights issues. The Legal Network is a partner organization of the AIDS Law Project, South Africa and has Special Consultative Status with the Economic and Social Council of the United Nations. Mr. Elliott has written numerous papers and articles on legal and human rights issues relating to HIV/AIDS, and has presented to community groups and national and international conferences. He is currently on a one-year leave of absence from the Legal Network, completing a Master of Laws degree on international trade and the human right to health at Osgoode Hall Law School, York University.
Dionne A. Falconer
Dionne Falconer has extensive knowledge of HIV/AIDS issues through her involvement with community-based AIDS service organizations since the late 1980s. She is Managing Director of her own consulting firm in Toronto and works nationally and internationally on HIV/AIDS, health and social issues. Her previous staff positions include Clinical Director of Lawrence Heights Community Health Centre, Interim Executive Director of Access Alliance Multicultural Community Health Centre and Executive Director of the Black Coalition for AIDS Prevention (Black CAP). Ms. Falconer has many years of active community service and is a past member of the Board of Directors of the Ontario AIDS Network and the Canadian AIDS Society. She is currently a member and Past President of the Board of Directors for the Interagency Coalition on AIDS and Development. She holds a Master of Health Science degree in Health Administration.
William Flanagan
William Flanagan is an Associate Professor in the Faculty of Law of Queen's University and Executive Director of the Canada AIDS Russia Project, an HIV/AIDS research and training project in Russia sponsored by the Canadian International Development Agency. He has published numerous HIV/AIDS legal articles and has been actively involved in HIV/AIDS community and legal issues for many years. He has served as Chair of the Board of the AIDS Committee of Toronto and as a board member of the HIV/AIDS Legal Clinic of Ontario.
Jacqueline Gahagan
Jacqueline C. Gahagan, PhD, is an Assistant Professor in the School of Health and Human Performance of Dalhousie University. She holds cross appointments in Community Health and Epidemiology, Women's Studies, and Nursing at Dalhousie University. Dr. Gahagan is a Research Associate at the Atlantic Centre of Excellence for Women's Health where she leads the development of the research arm of the proposed International Institute on Gender-Mainstreaming and HIV/AIDS. She serves as a Commissioner on the Nova Scotia Advisory Commission on HIV/AIDS and was a member of the National Reference Group on Women and HIV/AIDS. Dr. Gahagan has extensive research experience in the field of HIV and gender. She teaches courses in program planning, measurement and evaluation and community health promotion strategies. Her current research studies include: HIV and Hepatitis C prevention, care, treatment and support needs of women in federal prisons; HIV prevention education needs of young heterosexual males; and the impact of unpaid caregiving on women's health.
Sholom Glouberman
Sholom Glouberman is Philosopher in Residence at Baycrest Centre for Geriatric Care, Associate Scientist at the Kunin-Lunenfeld Applied Research Unit and Adjunct Assistant Professor at the University of Toronto. He holds a BA from McGill University and a PhD in Philosophy from Cornell University. For the past 25 years Dr. Glouberman has applied philosophical methods and conceptual analysis to organizations and systems. In recent years, he has focused increasingly on the notoriously intractable area of health and health care as the single most challenging and little-charted frontier. Dr. Glouberman recently completed a major policy research effort, A Toolbox for Improving Health in Cities, which presents and tests ways of intervening in complex systems. This and other studies are available at www.healthandeverything.org .
Michael Grant
Dr. Michael Grant has been involved in the basic science of HIV/AIDS research since 1987. He trained in Vancouver and Hamilton and is now an Associate Professor of Immunology in the Faculty of Medicine of Memorial University of Newfoundland. Dr. Grant has been a member of the Canadian Association of HIV Research since its inception.
Barney Hickey
Barney Hickey (RN, MScN, CPMHN(C)), is a registered nurse with more than 20 years of extensive experience with the populations most affected by HIV/AIDS. In 2001 he received an award of excellence in AIDS care from the Canadian Association of Nurses in AIDS Care. In 2002, he received a similar award from the Registered Nurses Association of British Columbia. Mr. Hickey has been involved with the Canadian HIV/AIDS community movement since his HIV diagnosis in 1985. He has formed international ties as a result of his work with UNAIDS and international HIV/AIDS nursing groups in the United States, the United Kingdom and Africa.
René Lavoie
René Lavoie is the coordinator of the Réseau Sida/maladies infectieuses du Fonds de recherche en santé du Québec. He is former Executive Director of Séro-Zéro, a community-based HIV/AIDS prevention organization for gay men in Montreal. He is a co-researcher for the Omega Study and participates in other research on gay men. Mr. Lavoie is a long-time gay activist and founder of a number of programs for gay men. He was a member of the National Reference Group on Gay Men.
Gerry McConnery
Gerry McConnery is an active front-line volunteer worker in Alberta. He has been Co-Chair of the Alberta Positive Network since 1999 and works closely with the Alberta Community Council on HIV. Mr. McConnery has six years experience as an HIV peer-support worker and is active in the AIDS Calgary Speakers Network. He is an advocate for improved access to blood-testing facilities in rural southern Alberta. Mr. McConnery sits on the boards of directors of AIDS Calgary and the Canadian AIDS Society.
Sheena Sargeant
Sheena Sargeant is Coordinator of Education Programs at YouthCO AIDS Society in Vancouver. She has worked directly with youth to develop prevention education programming. Ms. Sargeant was selected as the Canadian youth representative to the UN Theme Meeting on Youth in 2001. In 2002, she was selected by the Canadian Public Health Association to deliver HIV/AIDS peer education best practices training for UNICEF in Eastern Europe. After serving as a member of the British Columbia Ministry of Health Planning's HIV/AIDS Advisory Committee for a year, Ms. Sargeant was appointed Co-Chair in 2001.
Esther Tharao
Esther Tharao is a graduate student in the University of Toronto's Department of Public Health Sciences, Social Science and Health Program. She also works on HIV issues with Women's Health in Women's Hands in Toronto. Ms. Tharao is considered one of Canada's primary voices on issues facing countries where HIV is endemic. She has spoken on this subject at many conferences, including the annual conference of the Canadian Association for HIV Research. Ms. Tharao is a member of the Ontario Advisory Committee on HIV/AIDS and the HIV Endemic Task Force. She is Co-Investigator on two HIV studies: the Polaris Seroconversion Study and the East African HIV/AIDS Study at the University of Toronto.
Art Zoccole
Art Zoccole is a two-spirited Anishnawbe (Ojibway) from Lac Des Mille Lacs First Nation in Ontario. He has been a community-based HIV/AIDS activist since 1989. Mr. Zoccole has coordinated the Aboriginal Women and AIDS Forum, the 3rd Canadian Conference on HIV/AIDS, and initiatives on related issues in Aboriginal communities. Considered one of Canada's leading voices on HIV/AIDS issues facing Aboriginal peoples, he was Coordinator of the B.C. Aboriginal HIV/AIDS Task Force from 1997-1999. Mr. Zoccole is former coordinator of British Columbia's Red Road HIV/AIDS Network Society and former Executive Director of the Canadian Aboriginal AIDS Network. He is Executive Director of 2-Spirited People of the First Nations.
You may write to the Ministerial Council on HIV/AIDS at:
Ministerial Council on HIV/AIDS
c/o Secretariat
AL 1918B1, Jeanne Mance Building
Tunney's Pasture
Ottawa ON K1A 1B4
To find out more about the Ministerial Council on HIV/AIDS, visit the Council's web site at:
http://www.phac-aspc.gc.ca/aids-sida/fi-if/minister-eng.php (english)
http://www.phac-aspc.gc.ca/aids-sida/fi-if/minister-fra.php (français)
June 8-10, 2002 Ottawa
Special Presentations:
November 17-18, 2002 Ottawa
Special Presentations:
Meeting with the Minister
March 1-3, 2003 Toronto
Special Presentations: