Summary of NACHA meeting

March 7 and 8, 2005
Ottawa, Ontario

The meeting opened with a prayer from elder Cliff Thomas. The Council’s co-chairs offered greetings, meeting attendees introduced themselves and the Secretariat provided an update on housekeeping issues.

The National Aboriginal Council on HIV/AIDS received several presentations from Health Canada and the Public Health Agency of Canada (PHAC). The HIV/AIDS Policy, Coordination and Programs Division provided overviews of the Federal Initiative to Address HIV/ADIS in Canada and Leading Together: Canada’s Action Plan. The most significant emerging issue regarding the Federal Initiative was the allocation of funds for on- and off-reserve programs. Over the five-year lifetime of the Federal Initiative, on-reserve funding will increase from $1.1 million to $4 million while off-reserve funding will increase from $1.2 million to $1.75 million. The Council expressed concern over the prioritization of on-reserve funding over off-reserve under the Federal Initiative and encouraged the Government to facilitate linkages between off-and on-reserve HIV/AIDS planning and programming activities. An overview of the process that has been Leading Together was provided to the Council and areas for NACHA’s collaboration were identified. It was noted that the Council’s co-chairs would be invited to meeting to build a common understanding of Leading Together on April 14^th & 15^th, 2005.

The Council also received two presentations from the First Nation and Inuit Health Branch (FNIHB) of Health Canada. The Council received a presentation from Non-Insured Health Benefits regarding its HIV/AIDS Drug Formulary. Several specific concerns regarding the access to drugs at the pharmacy level and the relationship between doctors, patient, pharmacist and FNIHB were addressed. The Council also received a presentation from FNIHB’s Northern Secretariat regarding programming North of 60. Some concern was expressed by the Council regarding the Federal Initiative’s evidence based approach and the possibility that the lack of hard data may lead to the marginalization of the Inuit as a group. While there may not be specific evidence of significant HIV incidents amongst Inuit in the North, it is generally recognized that the due to the characteristics of life in the North, once introduced the disease will spread rapidly.

The Risk Assessment and Surveillance Division of PHAC presented the Council with an updated Aboriginal Epi Note. Several figures were particularly revealing:

• Aboriginal communities make up 6.0% of the populations in provinces and territories that report ethnic information with positive HIV tests but account for 23.4% of reported positive tests.
• Reported AIDS cases among Aboriginal people increased 1.2% in 1993 to 13.4% in 2003.
• Prior to 1993, 10.9% of reported AIDS cases among Aboriginal peoples were attributed to injection drug use. This had increased to 58.3% by 2003.
• Prior to 1993, 11.9% of reported Aboriginal AIDS cases were women. This has increase to 44.0% by 2003.

PHAC’s HIV/AIDS Policy, Coordination and Programs Division offered a final presentation on the Off-Reserve Fund Evaluation offered a final presentation. The Council was presented an overview of the off-reserve fund evaluation, describing the justification for undertaking the evaluation, the expectation of results, the evaluation’s methodology, the timeline for completing the evaluation, and NACHA’s role in the Evaluation. Following the presentation, the consultant hired to undertake the evaluation presented the findings-to-date to get feedback from NACHA.

The Council also made significant strides in its strategic planning process. A NACHA sub-committee charged with responsibility to draft a 5-year strategic plan met for one prior to this face-to-face meeting and in coordination with a consultant. It was decided that a draft would be circulated within a week and a teleconference was scheduled for March 21 st, 2005 to discuss the latest draft.

In addition, individual caucuses met and identified the following issues:

First Nations

• Improve partnerships with FNIHB regional offices and AASOs
• Strengthen relationship between NACHA and FNIHB

Métis Caucus

• The term 'Aboriginal' must be understood that it encompasses many different populations with differences. The differences within must be honored.
• There are 'ethnographic descriptors' and these need to be addressed.

Can HC/PHAC help with this?

Inuit Community

• Inuit Community and NACHA as a whole should look into working more closely with the Northern Secretariat.

Community Caucus

Aboriginal communities need to get on the same page, so that their comments can become part of changes as a result of program review.

Meeting closed with Peetanacoot

Next Meeting: July 7& 8, 2005 in Toronto