National AIDS Strategy - Overview (Phase II)

HIV infection and AIDS continue to threaten the health and social well-being of all Canadians. Health and Welfare Canada is allocating $211 million over the next five years for Phase II of the National AIDS Strategy.

Phase II builds on what we have learned and what we have achieved. It is a framework for a social policy that promotes better health, understanding, care, treatment and support for those living with HIV and AIDS. Phase II reflects the evolving nature of AIDS and the need for effective partnerships among government, non-government and private sector organizations.
The main goals of the Strategy remain:

• to stop the transmission of the human immunodeficiency virus;
• to search for effective vaccines, drugs and therapies;
• to treat, care for and support people infected with HIV, their caregivers, families and friends.

Phase II will place increased emphasis on five main policy directions that emerged as a result of broad consultations during the summer of 1992. They are:

Enhancing Partnerships

Sustaining current partnerships, while encouraging new ones, will be ongoing during Phase II. This means continuing to strengthen collaboration among federal departments and with provinces, territories, community groups, the private sector and national and international non-governmental organizations.

Recognizing HIV Disease as a Chronic and Progressive Condition

Improved treatments and therapies for HIV-related illnesses mean that persons with HIV disease and AIDS are living a longer, higher quality of life. It also means, however, that some individuals must cope with periods of severe illness as well as the social and financial difficulties that often accompany this disease. This has placed increased demands on our health and social systems. Federal initiatives to address these problems during Phase II will continue to complement and be coordinated with provincial, territorial and municipal responsibilities in the delivery of health care and social services.

Health Promotion for Persons Living with HIV and AIDS

An important goal of Phase II of the Strategy is to enhance the ability of persons living with HIV and AIDS to cope with their illness, to delay the onset of symptoms through healthy lifestyle choices, and to improve their access to services, treatment, care and support.

Creating Supportive Social Environments

Programs in Phase II will aim to increase public participation in matters of health, to reduce discrimination, and to strengthen social and community networks and services.

Promoting and Sustaining Healthy Behaviour

Within the context of a supportive social environment, individuals, communities and groups require decision-making and negotiating skills to change and maintain healthy behaviour and to have input into public policy and service delivery. For people living with HIV disease, educational efforts will focus on preventing illness progression and maintaining health.

New directions for Phase II of the National AIDS. Strategy will include, among others, the following program initiatives:

Education and Prevention Initiatives

Continue and enhance funding for the work of the National AIDS Clearinghouse through the Canadian Public Health Association. Promote and distribute material developed in collaboration with the Council of Ministers of Education and selected provinces for a model curriculum on sexuality, AIDS and sexually transmitted diseases for Grade 9 students.

Extend the partnership between the National AIDS Strategy to address the prevention of HIV and AIDS associated with alcohol and drug use, particularly among Aboriginal people.

Sponsor the second National Workshop on AIDS, Alcohol and Drug Use early in 1994. Produce and distribute a report on the evaluation of the two-year pilot outreach studies on injection drug use, which were cost-shared by the provincial governments, by June 1993.

Fund the development and evaluation of innovative community demonstration projects targeted to the hardest-to-reach segments of the drug-using street population. Increase funding for Aboriginal community-based projects. These funds will be available to bands and community-based organizations through a funding program administered by Medical Services Branch regional offices.

Enhance preventive services, such as condom distribution and HIV-antibody testing and counselling, provided to Aboriginal communities through nursing stations and health clinics located on reserves.

Research

The Medical Research Council (MRC) will continue to support AIDS research at $2 million per annum for each of the next five years.

Facilitate and coordinate with research partners and other stakeholders a process for developing a national research plan for HIV/AIDS in Canada.

Expand efforts to broaden the base of private sector support for AIDS-related research as well as to increase coordination of federal and provincial research initiatives.

Continue support for the Canadian HIV Trials Network and encourage its future as an independent, internationally and nationally recognized institution for clinical research on new treatments.

Continue monitoring trends in HIV epidemics in different population groups through the National AIDS Case Surveillance System, monitor the spread of HIV infection in Canada through an enhanced National Seroprevalence Program, and assure the quality of laboratory HIV testing throughout Canada.

Strengthen tuberculosis prevention and control, and act to prevent possible interaction between HIV and tuberculosis through sponsor-ship of the May 1993 National Workshop on Tuberculosis, HIV and Other Emerging Issues.

Undertake National Welfare Grants research and development activities to address the social and economic dimensions of HIV and AIDS, building on extensive Phase I consultation. Community Development and Support to NGOs Enhanced funding for the AIDS Community Action Program (ACAP) to support community develop-ment and health promotion activities in the area of prevention education, strengthening the organizations, reducing barriers, and evaluation. Continued support for the work of existing and new national partners of the National AIDS Strategy, i.e., the Canadian AIDS Society, the Canadian Hemophilia Society and the Canadian Public Health Association.

Care, Treatment and Support

Collaborate with professional health and social service organizations to develop resources necessary for caregivers to provide improved quality care to persons with HIV and AIDS.

Continue support to the College of Family Physicians of Canada for the national Working Group on Comprehensive Care and Treatment.

Support for a national workshop to be held in the fall of 1993 on mental health and HIV/AIDS.

Implementation of the National AIDS Treatment Information Service (ATIS), that will provide reliable, up-to-date treatment information to people living with HIV/AIDS and their caregivers in all regions of Canada.

Strengthen the response of the social welfare network to HIV and AIDS by supporting targeted research and development activities, building stronger links between people living with HIV and AIDS, their communities and the social programs which serve them, and promoting the use of research outcomes for the development of responsive programs and policies.

Coordination and Collaboration

Continue support for the National Advisory Committee on AIDS (NAC-AIDS) and the Federal/ Provincial/Territorial Committee on AIDS.

Work with national partners to develop mechanisms to mobilize assistance and financing from the private sector for HIV/AIDS issues.

Correctional Service Canada (CSC) will develop a comprehensive Phase II policy and program approach to HIV and AIDS. Based on this approach, CSC will continue to undertake training and education for correctional staff and inmates, will review and update effective policies regarding testing for HIV, confidentiality, housing of HIV-positive inmates and provision of health care services, and will involve community-based service agencies and advocates in developing and operating institution-based programs.

Justice Canada will continue to address human rights issues in relation to federal laws, policies and activities dealing with HIV and AIDS.

Develop an ongoing training program through the National Immigration Training Centre to ensure continued implementation of the 1991 amendments to the visitor policy for people living with HIV and AIDS.

International

In order to enhance coordination, the Canadian International Development Agency and the International Development Research Centre will be recognized as formal partners in the National AIDS Strategy.

Canada will continue to support the World Health Organization's efforts to promote awareness of the global AIDS situation through World AIDS Day activities.

Conclusion

HIV infection is largely preventable by avoiding risk behaviours such as unprotected sexual intercourse and needle sharing. What must not be forgotten, however, is that individual decisions to reduce risk are strongly influenced by the social conditions and attitudes in which they are made. Creating a supportive social environment that fosters healthy and sustained behaviour change will remain a major challenge.

AIDS is a problem we all must address. It has significant implications for public health, human rights, and costs to our economy and health and social service systems. Within this context, collective effort by government, organizations, the private sector and individuals is not only a prerequisite for success - it is also sound social policy.