The Ministerial Council On HIV/AIDS

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Annual Report April 1, 2003 - March 31, 2004

2.0 The Canadian Strategy on HIV/AIDS - A Brief History

The first Canadian case of AIDS was identified in 1982. Since then, thousands of Canadians have been infected with HIV. Health Canada estimated that in 2003, 56,000 Canadians were living with HIV/AIDS, of whom 17,000 were not aware of their infection. 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 reduced the number of new infections among gay men, while improvements to the blood system gave Canadians access to safe blood and blood products. While progress had been made, the epidemic had spread to other populations including women, Aboriginal peoples and injection drug users, and remained 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:

• enhanced sustainability and integration
• increased focus on those most at risk
• increased public accountability

These policy directions are based on the goals of the Strategy, which were developed in collaboration with stakeholders following extensive consultation.
The goals of the Strategy are to:

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

The 10 program components of the Strategy are:

• prevention
• community development and support to national non-governmental organizations
• care, treatment and support
• research
• surveillance
• international collaboration
• legal, ethical and human rights
• Aboriginal communities
• consultation, evaluation, monitoring and reporting
• Correctional Service of Canada

One of the important innovations of the Strategy was the creation of the 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.

In order to review the impact of the Canadian Strategy on HIV/AIDS after its first five years of operation and to develop a renewed framework for the future, a number of recent steps have been taken. These steps are also discussed in more detail in section 6.3 of this report. In September 2002, the Minister of Health initiated a review of the current federal role in the Canadian Strategy on HIV/AIDS with the assistance of a stakeholder advisory committee. The review, completed in June 2003, examined the lessons learned over the past five years, identified current challenges, defined the most appropriate federal role within the broader Strategy and proposed the most appropriate level and allocation of federal funding for 2004-2008. The report of the Five-Year Review, entitled Getting Ahead of the Epidemic: The Federal Government Role in the Canadian Strategy on HIV/AIDS 1998-2008

In June 2003, the House of Commons Standing Committee on Health tabled a report entitled Strengthening the Canadian Strategy on HIV/AIDS . This report highlighted the need for substantially increased funding for the Strategy, enhanced initiatives with particular populations, increased research, stronger inter-departmental coordination at the federal level and attention to international issues. The Government of Canada's response to the report, made by the Minister of Health, stated that the report would contribute to the development of a renewed framework for the Canadian Strategy on HIV/AIDS .

In November 2003, a draft Action Plan developed by the Strategy partners was released for Canada-wide consultation and is expected to be finalized by the summer of 2004. The draft Action Plan provides a framework for greater engagement by many sectors and proposes nine strategic directions. The draft Action Plan, Leading Together: An HIV/AIDS Action Plan for All Canada 2004-2008 .

These initiatives, combined with an analysis of the current realities of the epidemic, will result in a renewed framework for the Strategy. The Ministerial Council on HIV/AIDS has been actively involved in the renewal process during the past year.

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