The Ministerial Council On HIV/AIDS

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Annual Report April 1, 2004 - March 31, 2005

6.2.1 Populations from countries where HIV is endemic (African and Caribbean communities)

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. It is estimated that 70% of all maternal HIV transmissions to children in Canada have occurred among women of African and Caribbean origin. An estimated 3700 to 5700 people who were born in countries where HIV is endemic were living with HIV at the end of 2002, accounting for 7%-10% of the national total. Most of them were infected since living in Canada. Close to 21.5% of AIDS cases in Canada in 2003 occurred in communities from countries where HIV is endemic (up from 8.3% in 1999); these communities represent 2% of the Canadian population. Diagnosis of HIV infection occurs among older children 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 in order to minimize the potential for stigmatization of communities. HIV is now reportable in all jurisdictions in Canada but most jurisdictions do not collect data on ethnicity. There is a growing recognition by communities of the need to do so in order to understand the HIV epidemic. This remains a contentious issue that must be resolved with the communities affected and that requires federal-provincial-territorial partnership with communities.

Ongoing issues for communities from countries where HIV is endemic include gender discrimination, confidentiality, homophobia in communities that may limit the access of men who have sex with men to services, the vulnerability of communities in Canada to HIV transmission and lack of culturally appropriate services. Communities from countries where HIV is endemic are concerned by mandatory HIV testing for prospective immigrants and the need to link immigrants who have tested HIV-positive to appropriate services (see section 6.1.2 for further details on immigration issues).

The Federal Initiative to Address HIV/AIDS in Canada is supporting a communications and social marketing campaign by and for communities from countries where HIV is endemic.

Work done during 2004-2005

• The Ministerial Council followed this issue closely and provided advice on approaches through its link with the Federal/Provincial/Territorial Advisory Committee on HIV/AIDS.
• The Ministerial Council had special presentations on immigration and HIV/AIDS, with input from leaders representing communities from countries where HIV is endemic. The Council did extensive follow-up after this meeting on the immigration issue (see section 6.1.2), including consideration of support for a Canadian HIV/AIDS strategy for immigrants, a symposium on immigrant issues at the 2006 International AIDS Conference in Toronto, and encouragement for federal-provincial-territorial partnerships with immigrant communities.

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.2 Women and HIV/AIDS

The issue

HIV infection rates among women in Canada have risen steadily in recent years. The number of diagnosed and reported HIV infections in women has increased, particularly in women aged 20-39 (many of whom are Aboriginal), African and Caribbean women from countries where HIV is endemic (most of whom were infected in Canada ) and injection drug users. Women now account for 25% of all new infections; this trend is particularly strong among women aged 15-39; women also account for 42% of AIDS cases among those aged 15-29. At the end of 2002, an estimated 7700 women were living with HIV in Canada. The women who are most at risk may not have the knowledge, resources or power within their relationships to protect themselves from infection.

In recognition of the vulnerability of women and girls, the Joint United Nations Programme on HIV/AIDS (UNAIDS) chose the theme of raising awareness of issues facing young women and girls for World AIDS Day 2004.

The Women's Health Bureau of Health Canada and the HIV/AIDS Policy, Coordination and Programs Division of the Public Health Agency of Canada plan to begin work in 2005 on a gender-based analysis of the Federal Initiative to Address HIV/AIDS in Canada. A communications and social marketing campaign launched in 2004 and funded by the Federal Initiative is aimed at raising awareness among women and youth.

As a result of the use of antiretroviral therapies during pregnancy, transmission of HIV from mother to child has been almost eliminated: the proportion of infants in Canada confirmed infected has dropped from 50% in 1991 to less than 2% in 2004; only three infants were confirmed HIV-positive in 2002. These numbers do not reflect all infants exposed to HIV because some women are unaware of their HIV status. Prenatal HIV testing programs are now in place in all provinces and territories in Canada. In some provinces, women have to give their consent to be tested (opt-in testing) while in others they are automatically tested unless they specifically ask not to be tested for HIV (opt-out testing). The Federal/Provincial/Territorial Advisory Committee on HIV/AIDS has issued Guiding Principles for HIV Testing of Women during Pregnancy that support the principles of voluntary testing, confidentiality and informed consent.

Mother-to-child transmission of HIV and optimization of the treatment regimes used to lessen transmission are continuing concerns. During 2004, 96% of known pregnant women living with HIV received at least some antiretroviral treatment. There are no data regarding the potential long-term effects of these treatments on women and their children. Recent research has shown possible developmental differences between HIV-negative children exposed to antiretrovirals before birth and those who were not exposed to either HIV or antiretrovirals. A national group of stakeholders has been working to develop the Canadian Perinatal Exposure to Antiretrovirals Registry in order to monitor such long-term effects.

During 2004, a National Women's Coalition began to form, involving several Canadian HIV/AIDS and women's organizations. There has not been a national women's group since the National Reference Group on Women and HIV/AIDS, which gave advice on policy and program priorities to Health Canada, was disbanded in 2001. One of the Coalition's goals is ensuring that the 2006 International AIDS Conference in Toronto will have a women's stream.

Work done during 2004-2005

• The Ministerial Council highlighted the needs of girls and women in its World AIDS Day message, with particular reference to the need for Canadian leadership on the development of microbicides and on initiatives to ensure access to antiretroviral treatments for those in the developing world.
• The Ministerial Council studied the issue of HIV screening for pregnant women and the need to make testing completely voluntary in all jurisdictions by informing women that they could choose to be tested (opting in) rather than making testing the default position unless women request to opt out of the test.
  • The Council wrote to the Minister of Health to express its concern about the position adopted by the Canadian Medical Association in 2002 that all pregnant women should be routinely tested for HIV. In the Council's view, this fails to protect a woman's right to informed consent. The Council strongly recommended that all women have the option of opting into testing in all provinces following pre-test counselling; only in this case can informed consent be considered to have been given by the woman. The Council urged the Minister to work with the Canadian Medical Association to reverse their decision to support "opt-out" testing and to replace it with support for "opt-in" testing.
  • The Council discussed provincial/territorial aspects of the issue through its link to the Federal/Provincial/Territorial Committee on HIV/AIDS.
• The Ministerial Council recommended to the Public Health Agency of Canada that women be explicitly recognized in the pan-Canadian Action Plan and in the Federal Initiative to Address HIV/AIDS in Canada. The Ministerial Council planned to participate actively in the proposed gender-based analysis of the Federal Initiative by Health Canada and the Public Health Agency of Canada.
• In its meeting with the Minister of State (Public Health), the Ministerial Council raised the issue of the need for post-approval surveillance of drugs in women (most medications are formulated for the average male), and particularly in immigrant women, who are often isolated.
• The Ministerial Council remained informed about the developing Women's Coalition and its proposed Blueprint for Action and sent an observer to the Coalition meetings.

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.3 Gay men and HIV/AIDS

The issue

Men who have sex with men (including gay and bisexual men) continue to be the group most affected by HIV/AIDS in Canada. Close to 60% 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 since 1990, particularly among younger gay men, is a cause for concern. In the past three years, more than 44% of new infections were in men who have sex with men, an increase of 7% over the late 1990s. Risky behaviours appear to be on the rise, which highlights the lack of investment in prevention programs targeted to gay men in recent years. It may also indicate a need for a greater understanding of the broader social and cultural factors that affect men who have sex with men, in order to support them in sustaining long-term healthy behaviours.

Members of the gay community have called for an approach to HIV prevention and treatment in the context of gay men's health, including psychosocial health. 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. The draft pan-Canadian Action Plan and the Federal Initiative to Address HIV/AIDS in Canada incorporate some of these approaches. Gay men are one of the priority populations for focus under the Federal Initiative and specific communications and social marketing campaigns will be targeted to them.

International health organizations have developed a new framework known as second generation HIV surveillance to focus surveillance resources on groups where HIV infection is most likely to be concentrated. Canada is implementing a second generation surveillance system for men who have sex with men which will track risk behaviours associated with HIV, viral hepatitis and sexually transmitted infections because recent evidence suggests that sexually transmitted infections are increasing in this population. This surveillance system results from a partnership of federal, provincial and territorial governments with community stakeholders and researchers.

Work done during 2004-2005

The Ministerial Council continued to monitor the issues of gay men and supported a renewed emphasis on HIV prevention and care for gay men

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.4 Sex workers

The issue

Sex workers are a population that is vulnerable to HIV transmission. Prevention, care, treatment and support programs for sex workers will be supported by the Federal Initiative to Address HIV/AIDS in Canada, largely through funding to community-based organizations. Current HIV/AIDS surveillance does not capture data about the sex trade, but some research has been funded by the Canadian Strategy on HIV/AIDS. During 2005 the federal government is reviewing Canada's solicitation laws, which could have implications for access to treatment by sex workers.

Work done during 2004-2005

The Ministerial Council kept a watching brief on issues involving sex workers.

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.5 Injection drug use (policy)

The issue

Injection drug users are among the fastest growing populations of newly infected Canadians. Issues faced by Aboriginal peoples are of particular concern. 20% of people living with HIV/AIDS in Canada are injection drug users. There has been some progress in prevention-in 2002, 30% of new infections occurred among injection drug users, down from 34% in 1999-but this population remains vulnerable. The Federal Initiative to Address HIV/AIDS in Canada includes a communications and social marketing campaign for injection drug users. Injection drug use has legal as well as health aspects, which necessitates inter-departmental collaboration between the departments of Health, Justice and the Solicitor General.

Canada's Drug Strategy, which is linked to HIV issues, but not funded by the Federal Initiative, is coordinated by Health Canada. The Drug Strategy has the goal of reducing the harm done by alcohol and drugs to individuals, families and communities. Stakeholders are still debating 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 access to care, treatment and support by people who use illicit drugs (including people living with HIV/AIDS).

During 2002 Health Canada issued guidelines for granting exemptions from the Controlled Drugs and Substances Act so that pilot supervised injection sites (often referred to as safer injection sites) could begin operating in jurisdictions that requested them with the goals of: reducing the risk of disease transmission and overdose; increasing access to health and social services; and reducing the community impact of public drug use. Vancouver opened a safer injection site in 2003. Some other cities have indicated an interest in having such sites. In addition, controlled trials of medically-prescribed heroin-assisted therapy have been designed and are moving through the review and approval process.

The Ministerial Council champions issues related to injection drug use and provides advice focused on inter-departmental collaboration, federal/provincial/territorial collaboration and congruence with Canada's Drug Strategy. The Council is linked to the Safer Injection Site Task Group through a member of Council who sits on the Task Group. The Ministerial Council has strongly urged the Minister of Health to strengthen the harm reduction aspects of the Drug 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.

The research aspects of injection drug use are discussed in section 6.4.5.

Work done during 2004-2005

• In its World AIDS Day message, the Ministerial Council highlighted the progress made in providing safer injection sites and said it would continue to advise the Minister of Health to strengthen harm reduction efforts, including the introduction of needle exchange programs in prisons.
• The Ministerial Council had a special presentation at its June 2004 meeting on the safer injection sites project underway in Vancouver and on international experience with these sites. Preliminary findings from the project indicate that the site is being used, but not extensively by those who may prefer to inject at home for fear of police intimidation or arrest, nor by those who live on the street. The evidence suggests that federal guidelines should be modified to allow for sharing of drugs, assisted injections and safe smoking rooms.

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister of Health.

6.2.6 HIV testing

The issue

At the end of 2002, an estimated 56,000 people in Canada were living with HIV and an estimated 30% of these (17,000 people) have not been tested and are therefore unaware of their infection and unable to access treatment, support and prevention services. HIV testing has several dimensions: health, legal, ethical, technical and economic. The advent of rapid, low-cost testing can make HIV testing more accessible both in Canada and in developing countries, which can lead to more effective prevention, care, treatment and support programs. At the same time, rapid low-cost tests, particularly those that are self-administered, reduce the possibility that persons being tested will receive adequate support, counselling and referral. Some rapid tests have had to be withdrawn from the market because of unreliability and new ones have replaced them.

Ethical issues involving testing include: whether to request information on ethnocultural origin when testing and whether and how to report this information as part of HIV/AIDS surveillance in ways that do not lead to increased stigma and discrimination; and whether those being tested are genuinely giving informed consent. The development of policies and programs involving HIV testing requires intra- and inter-departmental collaboration at the federal level, collaboration at the federal/provincial/territorial level and partnership with a variety of stakeholders. HIV testing is also discussed in this report in sections 6.1.2 (Citizenship and Immigration Canada), 6.2.1 (Populations from countries where HIV is endemic), 6.2.2 (Women and HIV/AIDS) and 6.4.7 (Epidemiological surveillance).

Work done during 2004-2005

• In its World AIDS Day message, the Ministerial Council noted that treatment efforts are increasing in developing countries and encouraged Canada to resist calls for HIV testing that do not fully respect human rights, including mandatory HIV testing of pregnant women without their informed consent.
• The Ministerial Council wrote to the Minister of Health, requesting that he work with the Canadian Medical Association (CMA) to reverse the CMA's decision to support routine testing of all pregnant women without explicit consent (see section 6.2.6 for a fuller discussion of this issue).

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.7 Medical use of marihuana (policy)

The issue

Marihuana has been recognized as a useful therapy for some persons living with HIV/AIDS. Following a series of court decisions that declared unconstitutional the denial of access to marihuana for medical purposes and required the government to provide a lawful source of seed and dried marihuana, Health Canada began granting exemptions in 1999 for medical marihuana use. In doing so, Canada became the first government in the world to provide medical marihuana. The Ministerial Council played a role in reshaping this as a medical, rather than a legal, issue. In 2000, Health Canada began to develop new regulations and interim policies and entered into a contract with a Saskatoon company to produce marihuana for research purposes (and by 2003 for distribution purposes to patients). In 2003 Health Canada announced the amendment of the Marihuana Medical Access Regulations to provide for reasonable access to a legal source of marihuana for medical purposes. The amended regulations reduce barriers to access. Several hundred people in Canada are authorized to possess marihuana for medical purposes and close to 500 persons are authorized to cultivate or produce marihuana. Health Canada established a Stakeholder Advisory Committee on Marihuana for Medical Purposes and has held a stakeholder consultation.

People living with HIV/AIDS who choose to use marihuana as part of their therapy still have difficulty accessing the program because physicians are reluctant to prescribe it. Under present regulations, the need for medical marihuana must be attested by a physician and only specialists may prescribe marihuana, whereas the majority of HIV-positive patients are cared for by primary care physicians rather than specialists. Professional medical bodies have advised physicians not to put themselves at risk of prosecution by prescribing marihuana. Health Canada provides a research literature summary for health care professionals on the medical use of marihuana so that they may become better informed. The research aspects of the medical use of marihuana are discussed in section 6.4.6 of this report. Further details of Health Canada's medical marihuana programs .

Work done during 2004-2005

• The Ministerial Council studied the position of the Canadian Medical Association on prescribing medical marihuana.
• The Ministerial Council monitored information provided to it by Health Canada's Office of Cannabis Medical Access.
• The Ministerial Council requested an update from the Stakeholders Advisory Committee with respect to the latest development on this issue.
• The Ministerial Council received a progress report from the Canadian AIDS Society on its project Cannabis as Therapy: Access and Regulation Issues for People living with HIV/AIDS. The project's goals are to develop resources for the HIV/AIDS community regulatory and medical aspects of medical marihuana, to examine issues facing stakeholders and to make recommendations to address those concerns.

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.8 Co-infections (policy)

The issue

Many persons who are vulnerable to HIV infection or living with HIV/AIDS are also living with other infections or diseases such as tuberculosis, Hepatitis C, syphilis and a variety of other sexually transmitted infections, and the co-morbidities of addictions or mental illness. Prevention, care, treatment and support programs must recognize the complex nature of living with more than one infection or medical condition. Persons living with a sexually transmitted infection may have an increased risk of HIV infection. Effective responses to co-infection require research, intra- and inter-governmental collaboration, and involvement by a variety of stakeholders. Some provincial governments have combined their HIV/AIDS and Hepatitis C programs.

The 2003 reorganization of Health Canada's Centre for Infectious Disease Prevention and Control was intended to provide greater opportunities for collaboration between staff working with HIV/AIDS and those working on Hepatitis C, tuberculosis and sexually transmitted infections. With the transfer of lead responsibility for HIV/AIDS to the Centre within the Public Health Agency of Canada, greater collaboration on co-infections is foreseen and an integrated infectious disease strategy is being discussed within the Agency. Stakeholders are concerned that approaches to co-infections under the Federal Initiative to Address HIV/AIDS in Canada may reduce the impact of HIV/AIDS programs or that funds may be taken from HIV/AIDS budgets to support work on other diseases. Community-based HIV/AIDS service organizations report pressure from funders to devote their scarce resources to Hepatitis C. Some national stakeholder organizations active in HIV/AIDS issues are forming partnerships with other organizations on co-infection issues. These are of particular concern for gay men, injection drug users and prison inmates.

Work done during 2004-2005

• The Ministerial Council wrote to the Minister of State (Public Health) stressing the need to include HIV-Hepatitis C co-infections in planning the new Public Health Agency of Canada.
• Through its links to the Federal/Provincial/Territorial Committee on HIV/AIDS, the Ministerial Council remained informed about provincial and territorial approaches to co-infection, particularly HIV-Hepatitis C co-infection and liver transplants.
• The Ministerial Council discussed approaches to co-infections with officials of the Public Health Agency of Canada, encouraging effective ways of approaching co-infections while maintaining the strength and integrity of HIV/AIDS initiatives.

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.9 Youth

The issue

Canadian youth are at risk of HIV transmission. A study by the Council of Ministers of Education in 2003 revealed that: students in Grades 7, 9 and 11 across Canada had lower levels of sexual knowledge than those surveyed five years earlier; two-thirds of Grade 7 students and half of Grade 9 students believed there was a cure for HIV/AIDS; fear of harmful outcomes had only a slight impact on decisions to become sexually active; and students are familiar with condom use but use them less than half the times they have intercourse.

A national community-based social marketing campaign to reduce stigma and discrimination facing persons living with or at risk of HIV/AIDS transmission focused in 2004 on youth and women. The campaign challenged the perceptions of youth about who can be infected with HIV.

The Centre for Infectious Disease Prevention and Control of the Public Health Agency of Canada is partnering with other federal departments and public health organizations in a national surveillance system that is tracking rates of sexually transmitted infections, blood-borne pathogens and associated risk behaviours among Canadian street youth aged 15-24. The results of this surveillance will support the development of more effective programs and services to help prevent the spread of infectious diseases, including HIV/AIDS among street youth.

Work done during 2004-2005

• The Ministerial Council wrote to the Minister of Health stating the need for better education in the schools on sexual health and sexually transmitted infections and suggesting that a meeting be held of officials from provincial and territorial ministries of health and education and that the Minister could play a catalytic role on this issue.
• The Ministerial Council wrote to the Federal/Provincial/Territorial Committee on HIV/AIDS (FPT-AIDS) suggesting that FPT-AIDS could play a useful role in promoting the need for better education in the schools on sexual health and sexually transmitted diseases and suggesting that FPT-AIDS promote a meeting of officials from provincial and territorial ministries of health and education.
• The Ministerial Council recommended to the Public Health Agency of Canada that youth be explicitly recognized in the Action Plan and the Federal Initiative.
• The Ministerial Council continued to monitor issues related to youth.

Future activities

The Ministerial Council will continue to monitor these issues and provide advice to the Minister.

6.2.10 Aboriginal peoples and HIV/AIDS

The issue

The HIV epidemic is growing among Aboriginal peoples (First Nations, Inuit and Métis). An estimated 3000-4000 Aboriginal people in Canada were living with HIV at the end of 2002, accounting for 5-8% of the national total. Aboriginal peoples now account for 6-12% of new infections even though they constitute only 3% of Canada's population. These figures may understate the problem because most jurisdictions do not collect information on the ethnicity of persons diagnosed with HIV; in addition, these figures are based primarily on information collected among First Nations peoples and do not include Métis, Inuit or First Nations peoples living off-reserve.

Lead responsibility for providing health services to on-reserve First Nations and some Inuit communities rests with the First Nations and Inuit Health Branch of Health Canada. Under the Federal Initiative to Address HIV/AIDS in Canada, $5.5 million will be allocated annually to programs for Aboriginal communities by 2008-2009. In addition, there are dedicated funds for an Aboriginal research program. The Public Health Agency of Canada is currently conducting a review of the Non-Reserve First Nations, Inuit and Métis Communities HIV/AIDS Project Fund provided by the Federal Initiative to ensure that the Fund remains responsive to the changing nature of the HIV/AIDS epidemic in Aboriginal communities.

The First Nations and Inuit Health Branch (FNIHB) of Health Canada spends additional funds on HIV programs for Inuit and on-reserve First Nations peoples. FNIHB participates in the Federal/Provincial/Territorial Advisory Committee on HIV/AIDS in order to facilitate inter-governmental collaboration.

The draft pan-Canadian Action Plan and the Federal Initiative designate Aboriginal peoples as a priority population. The Federal Initiative will fund a communications and social marketing campaign developed by and for Aboriginal peoples.

In October 2003 an Aboriginal Strategy on HIV/AIDS was developed in partnership between the national Aboriginal stakeholder organizations and Health Canada following an extensive consultation. The Aboriginal Strategy, Strengthening Ties - Strengthening Communities, offers a vision for First Nations, Inuit and Métis peoples to respond to HIV/AIDS. The Aboriginal Strategy identifies nine strategic areas of activity: coordination and technical support; community development, capacity building and training; prevention and education; sustainability, partnerships and collaboration; legal, ethical and human rights; engaging Aboriginal groups with specific needs; supporting broadly-based harm reduction approaches; holistic care, treatment and support; and research and evaluation.

The National Aboriginal Council on HIV/AIDS (NACHA) has primary responsibility for advising Health Canada, the Public Health Agency of Canada and other stakeholders on the HIV/AIDS-related needs of Aboriginal peoples in Canada. NACHA is composed of four caucuses: First Nations, Inuit, Métis and Community. NACHA was involved in the renewal process that resulted in the draft pan-Canadian Action Plan and the Federal Initiative to Address HIV/AIDS in Canada, as well as the transfer of the Aboriginal Community-Based Research Program from Health Canada to the Canadian Institutes of Health Research. Further information on the National Aboriginal Council on HIV/AIDS.

December 1 is Aboriginal AIDS Awareness Day in Canada and the week before December 1 is national Aboriginal AIDS Awareness Week.

The Ministerial Council remains aware of Aboriginal issues and works through its links to the National Aboriginal Council on HIV/AIDS. Following each meeting of the Ministerial Council a summary of the issues discussed is sent to NACHA. NACHA plans to send the Ministerial Council a summary of the advice it provides to the Public Health Agency of Canada and Health Canada. Priority issues for NACHA include: medications on the First Nations and Inuit Health Branch formulary; the inclusion of Métis under Non-Insured Benefits (those not covered by provincial/territorial health services); prevention in Inuit communities; harm reduction approaches; and the need for operational funding for Aboriginal HIV/AIDS service organizations.

Work done during 2004-2005

• In its World AIDS Day message, the Ministerial Council said that it continues to strengthen its working relationship with the National Aboriginal Council on HIV/AIDS to ensure that the Government of Canada upholds its commitments to issues affecting First Nations, Inuit and Métis populations.
• The Ministerial Council developed mini-reports following each Council meeting to keep the National Aboriginal Council on HIV/AIDS informed of Ministerial Council activities. The Ministerial Council invited NACHA to suggest ways in which the two councils could continue to work together.
• The Ministerial Council kept informed on Aboriginal issues and of the work of the First Nations and Inuit Health Branch of Health Canada with respect to HIV/AIDS.
• As part of its involvement in the transfer of the Community-Based Research Program from Health Canada to the Canadian Institutes of Health Research, the Ministerial Council participated in some discussions about the transfer of the Aboriginal Community-Based Research stream. For more details about community-based research, see section 6.4.2.

Future activities

The Ministerial Council will continue to support Aboriginal issues through its working relationship with the National Aboriginal Council on HIV/AIDS.

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