The Ministerial Council On HIV/AIDS

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Annual Report April 1, 2004 - March 31, 2005

2.0 Federal involvement in 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. By 2003, an estimated 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. 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. National surveillance systems were put in place. By 1996 more effective drugs and therapies were found and made available.

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 goals of the strategy focused on: prevention; care, treatment and support; finding a cure; minimizing the adverse impact of HIV/AIDS on individuals and communities; and minimizing the impact of social and economic factors that increase individual and collective risk for HIV infection.

One of the important innovations of the Canadian Strategy on HIV/AIDS 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 federal response 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 steps were taken. 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 and defined a new federal role within the broader Strategy.

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.

In response to these reviews of Canada's response to HIV/AIDS, the renewal process has now resulted in a more integrated pan-Canadian approach guided by two policy frameworks, one developed by all stakeholders to provide guidance at the pan-Canadian level and the other developed by the federal government to define its involvement in the pan-Canadian response. Both approaches have a strong emphasis on social justice, determinants of health and human rights.

In November 2003, a draft Action Plan developed by the Strategy partners was released for Canada-wide consultation and will be finalized in Summer 2005. The pan-Canadian draft Action Plan, Leading Together: Canada's HIV/AIDS Action Plan 2005-2010, is expected to provide a framework for greater engagement and collaboration by many sectors and is intended to guide the involvement of all partners, including all levels of government. It will have a strong emphasis on social justice and concerted action by all sectors of society. Its goals are expected to be:

• Reduce the social inequities, stigma and discrimination that threaten health and well-being
• Prevent HIV transmission
• Provide timely, safe and effective care, treatment and support for all Canadians living with HIV/AIDS
• Contribute to global efforts to fight the epidemic and find a cure.

The draft Action Plan is available at: www.phac-aspc.gc.ca/aids-sida/index-eng.php, as will be the final version.

The federal government, as one of the partners in Canada's response to HIV/AIDS, elaborated its approach for 2005-2010 in the 2004 policy document, The Federal Initiative to Address HIV/AIDS in Canada. In May 2004, the Government of Canada announced that funding for the Federal Initiative would be increased by annual increments from $42.2 million in 2003-2004 to $84.4 million by 2008-2009. Together the Action Plan and the Federal Initiative will guide the federal government's involvement to 2010. The Federal Initiative provides support for the implementation of the pan-Canadian Action Plan by all partners. The Federal Initiative has the following goals:

• Prevent the acquisition and transmission of new infections
• Slow the progression of the disease and improve quality of life
• Reduce the social and economic impact of HIV/AIDS
• Contribute to the global effort to reduce the spread of HIV and mitigate the impact of the disease.

The policy directions of the Federal Initiative are: partnership and engagement; integration of federal HIV/AIDS programs with other health and social programs as appropriate; and accountability. Five areas have been identified for increased federal action and investment with the following planned funding by 2008-2009: program and policy interventions ($35.4 million); knowledge development ($31.9 million); coordination, planning, evaluation and reporting ($10.2 million); communications and social marketing ($4.7 million); and global engagement ($2.2 million). Priority populations for intervention are highlighted, but not limited to: gay men; Aboriginal peoples; injection drug users; prison inmates; youth; women; persons from countries where HIV is endemic; and all persons living with HIV/AIDS.

The Federal Initiative is a partnership of the Public Health Agency of Canada, Health Canada, the Canadian Institutes of Health Research and Correctional Service Canada. The Public Health Agency of Canada is the lead department for the federal response and reports to Parliament through the Minister of Health.

The Canadian International Development Agency makes a major contribution to Canada's global response to HIV/AIDS and Foreign Affairs Canada takes an increasingly active role. Other federal departments that have invested resources in HIV/AIDS include Citizenship and Immigration Canada (immigrant screening), Justice Canada (drug policy) and Social Development Canada (disability and income support). The Federal Initiative aims to expand the engagement of other federal departments related to the determinants of health.

The federal government issues a public annual report on the pan-Canadian response to HIV/AIDS on World AIDS Day (December 1).

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