HIV/AIDS Communiqué - Volume 8, Number 3 - Fall 2009

Table of Contents

• Update on the Population-specific Status Report - Aboriginal Peoples
• Update on the Canadian HIV Vaccine Initiative
• The Public Health Agency of Canada's Response to the Review of Advisory and Coordinating Mechanisms under The Federal Initiative to Address HIV/AIDS in Canada
• Update from the Canadian Institutes of Health Research
• Interdepartmental Policy Forum on the Determinants of Health and HIV/AIDS
• Canada's 2008-2009 United Nations General Assembly Special Session Report
• XVIII International AIDS Conference

Update on the Population-specific Status Report - Aboriginal Peoples

An important component of The Federal Initiative to Address HIV/AIDS in Canada is the development of population-specific HIV/AIDS status reports in collaboration with the eight populations¹ most impacted by, or at risk of, HIV and AIDS in Canada.

The Public Health Agency of Canada (PHAC) is in the final stages of developing the second of these reports, the Population-Specific HIV/AIDS Status Report: Aboriginal Peoples. The report summarizes current evidence about the impact of HIV and AIDS among Aboriginal (First Nations, Inuit and Métis) populations in Canada, including demographic information; epidemiological data; information on the social determinants of health relating to the vulnerability and resilience of Aboriginal peoples to HIV and AIDS; a description of the current Canadian research; and a discussion of the current Canadian response to the disease.

A national expert working group composed of population representatives, non-governmental organizations, researchers, and policy and program officials assisted in the development of the report. PHAC also collaborated with Health Canada, Correctional Service of Canada, the Canadian Institutes of Health Research, provincial/territorial governments and non-governmental organizations to gather information for the report.

PHAC plans to release the report in winter 2010. PHAC officials presented the report’s findings this past fall at various locations, including Pauktuutit Inuit Women of Canada’s National Inuit Policy Forum on Sexual Health in Iqaluit (October 6-8), the Canadian AIDS Treatment Information Exchange’s and Pacific AIDS Network’s 2009 Pacific Region Educational Conference in Richmond, British Columbia (October 28-29) and the National Aboriginal Health Organization’s national conference, Our People, Our Health in Ottawa
(November 24-26).

For more information, please contact Clare Jackson by e-mail, at clare.jackson@phac-aspc.gc.ca, or by telephone, at 613-946-8110.

Update on the Canadian HIV Vaccine Initiative

The Canadian HIV Vaccine Initiative (CHVI), a collaborative partnership between the Government of Canada and the Bill & Melinda Gates Foundation, represents a significant Canadian contribution to the Global HIV Vaccine Enterprise in its ongoing global efforts to develop safe, effective, affordable, and globally accessible HIV vaccines. The Canadian International Development Agency (CIDA), Public Health Agency of Canada (PHAC), Industry Canada, Canadian Institutes of Health Research (CIHR), and Health Canada are responsible for implementing the CHVI. PHAC’s Office of HIV Vaccines serves as the CHVI’s Secretariat.

Recent Occurrences in HIV Vaccine Development Efforts

Results released from the six-year RV 144 Phase III clinical trial study in Thailand, involving more than 16,000 adult volunteers, showed that a prime boost combination of ALVAC HIV and AIDSVAX B/E lowered the rate of infection by 31.2% compared with placebo. The Thai Ministry of Health led the study, which was sponsored by the U.S. Army Surgeon General and the U.S. National Institutes of Allergy and Infectious Diseases. For more information on the Thai trial, please visit https://www01.hjf.org/apps/internet/hivnewscenter.nsf/phase3resources/$FILE/RV144-FAQs-20090924.pdf.

Discovery and Social Research

The CIHR, in partnership with CIDA, is responsible for the CHVI Discovery and Social Research component to which an amount of $22 million has been committed. Since 2008, the following funding opportunities have been launched:

• CHVI Operating Grants support Canadian researchers interested in conducting basic and social research related to HIV and AIDS. The grants are a means for enhancing research in prevention and for building future Canadian capacity in the field of HIV vaccine.
• CHVI Catalyst Grants provide seed money to support innovative HIV vaccine-related research activities. New proposals, tools, techniques, inventions and methodologies are expected to result from this funding opportunity.
• Emerging Team Grants are intended to support the creation or development of research teams of investigators undertaking collaborative research into the discovery of HIV vaccines and related research, as well as social, behavioural, and ethical issues related to HIV vaccines.

To date, 13 Operating and Catalyst Grants have been awarded, and the review process for Letters of Intent for the Emerging Team Grants is ongoing. For more information on the awards, please visit http://www.chvi-icvv.gc.ca/grants-subventions/2008/index-eng.html#cat.

Clinical Trials Capacity Building and Networks

The CHVI Clinical Trials Capacity Building and Networks program area is being led by the Global Health Research Initiative (GHRI). In July 2009, a call for Letters of Intent was launched by the GHRI. Building on lessons learnt from Phase I of the GHRI program, the Phase II program, comprising capacity-building grants and synergy and networking grants, will support clinical trial capacity building and networks in Africa, and collaborative networks of African, Canadian and international researchers and institutions involved in HIV/AIDS prevention trials. The deadline for the funding opportunity call was September 4, 2009. Decisions on the funding opportunity call are expected in spring 2010.

For more information on the CHVI, please visit www.chvi-icvv.gc.ca, or contact the CHVI Secretariat by e-mail, at secretariat@chvi-icvv.gc.ca.

The Public Health Agency of Canada's Response to the Review of Advisory and Coordinating Mechanisms under The Federal Initiative to Address HIV/AIDS in Canada

In January 2009, the Public Health Agency of Canada’s (PHAC) HIV/AIDS Policy, Coordination and Programs Division hired a consultant to conduct a review of current and emerging needs for advice and coordination in support of The Federal Initiative to Address HIV/AIDS in Canada. As part of the review, the consultant conducted interviews with federal employees and with current and former members of six advisory and coordination committees.

The consultant’s report, Summary Report of Findings and Conclusions for the Review of Advisory and Coordination Mechanisms Under The Federal Initiative to Address HIV/AIDS in Canada, submitted in September 2009, confirmed the continued need for a multiplicity of coordination and advisory mechanisms, given the complex and evolving nature of HIV and AIDS work. Nonetheless, the report also highlighted the need for structural and process changes to the current advisory and coordination bodies.

Regarding the six advisory and coordinating committees, the consultant proposed the following:

1. revise the mandate of the Government of Canada Assistant Deputy Minister Committee on HIV/AIDS to focus on the broader determinants of health;
2. consider the implications of a structural merger of the Federal/Provincial/Territorial Advisory Committee on AIDS with the Sexually Transmitted and Bloodborne Infections Issue Group to better deliver public health expertise;
3. consider moving the Leading Together Championing Committee secretariat outside of PHAC to better reflect the multi-sectoral scope of Leading Together;
4. maintain the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada and improve Council’s capacity to deliver strategic policy advice;
5. engage with the National Stakeholders’ Group to strengthen community-based and non-governmental input into government priorities/direction/emerging issues; and
6. maintain the National Aboriginal Council on HIV/AIDS, while rethinking the caucus structure and increasing the capacity of the Council to provide policy advice through training and membership review.

In addition, there were several general recommendations on improved process supports, including capacity building and support for community members and people living with HIV and AIDS to facilitate their engagement in committee work, and enhanced information-sharing and exchange.

PHAC has shared this report with the six advisory and coordinating committees addressed in the report. The committees are developing individual responses to the report. The HIV/AIDS Division is using the report’s recommendations to develop improved secretariat processes. Based on the committee responses and an internal analysis, PHAC will develop its formal response to the review, scheduled to be completed in March 2010.

Update from the Canadian Institutes of Health Research

Recognizing Excellence in HIV/AIDS Research

The Canadian Institutes of Health Research (CIHR) and the Canadian Medical Association Journal (CMAJ) honoured eight outstanding Canadian individuals and teams with the first-ever CIHR/CMAJ Top Canadian Achievements in Health Research Awards, which recognize and celebrate Canadian health research and innovation excellence. The winners, announced on September 28, 2009, were selected by a peer-review panel of Canadian and international experts, who looked for the discoveries and innovations that had the biggest impact on the health of people in this country and around the world.

Among the winners was CIHR-funded researcher, Dr. Stephen Moses, University of Manitoba, who demonstrated the effectiveness of male circumcision in reducing the transmission of HIV in Africa. Since Dr. Moses found that this procedure reduced the risk of HIV transmission by more than 50%, the World Health Organization and the United Nations have both endorsed male circumcision as an effective way to reduce the spread of HIV. Medical services are now being expanded throughout Africa to offer male circumcision.

For more information on Dr. Moses’ work and other recipients, please consult
http://www.cihr-irsc.gc.ca/e/40288.html.

Family Front and Centre Community Forum

The one-day Family Front and Centre community forum, The Role of Families in Adapting to and Preventing HIV/AIDS, was held in Toronto on August 6, 2009, and attracted nearly 200 participants from Canada and the United States. The objective of the event was to explore the impact of HIV on children and youth and the roles family can play in responding to and preventing infection.

The Ontario HIV Treatment Network and the Teresa Group co-hosted the event, in partnership with the National Institute of Mental Health and the CIHR Institute of Infection and Immunity (HIV/AIDS Initiative) as a satellite of the American Psychological Association’s 2009 Convention. Participants included academics, researchers, service providers, policy makers, community members, and people living with HIV.

Participants heard presentations and attended interactive workshops addressing effective American interventions, innovative Canadian programs and future directions for research, policy and practice. CBC Toronto ran a news story featuring one participant’s journey living with HIV and the important work of the Teresa Group. For more information on the event, see the Family Front and Centre website and the subsequent report for recommendations that will drive future research and program development at
http://www.ohtnweb.ca/FFCentre/frmWelcome.aspx?Lng=En.

Café Scientifique: From the Playground to HIV: If risks for gay men start early, when should prevention begin?

The CIHR HIV/AIDS Research Initiative and the Ontario HIV Treatment Network, in partnership with the Mental Health Commission of Canada, were pleased to hold their first café scientifique on November 17, 2009, at the Gardiner Museum, in Toronto. Mr. Rick Kennedy, Executive Director, Ontario AIDS Network, moderated the event, which engaged a distinguished panel of presenters, the public, community stakeholders and researchers in discussions on the connections between homophobia, mental health and HIV risk. Participants also addressed how to protect young gay men from negative attitudes and HIV.

Positive Spaces, Healthy Places Study

The CIHR has recently published Healthier Together: The CIHR Partnership Casebook, which highlights diverse partnership endeavours in health research. Among others, the publication recognizes the innovative partnerships developed through the Positive Spaces, Healthy Places (PSHP) study, jointly funded by the CIHR HIV/AIDS Research Initiative, the Ontario HIV Treatment Network, the AIDS Bureau of the Ontario Ministry of Health and Long-Term Care and the Ontario AIDS Network. The PSHP study is the first longitudinal community-based initiative in Canada to examine housing stability and housing outcomes among people living with HIV. This comprehensive three-year study, which began in 2005, has also been the catalyst for capacity development and for local, national and international partnerships that are leading to better housing and other supports for people living with HIV.

This community/academic/policy partnership has enhanced research quality and community relevance and has been successful in obtaining more funding for housing, policy changes and changes in housing services that would have been impossible if partners had acted alone. Through the process, team members learned lessons about building partnerships that are now being used to address other HIV issues (employment, mental health and HIV/hepatitis C virus co-infection) and to enrich learning opportunities for students. The legacy of this successful partnership will endure as additional CIHR funding was approved in 2008-2009, making this the first housing research project to be re-funded. In addition to the dramatic change in housing policy and services achieved by this partnership, new national and international partnerships and the integration of many of the questions raised by this partnership into ongoing clinical and cohort studies suggest that there will be more examples of successful research and partnerships in the future. For more information, please see http://www.cihr-irsc.gc.ca/e/39453.html.

CIHR Research Funding Opportunities

The CIHR HIV/AIDS Research Initiative develops and supports a variety of HIV/AIDS research programs, which promote Canadian research and build research capacity to increase our understanding of HIV, the epidemic and effective responses. The Research Initiative leads or supports the following list of new research funding opportunities:

• Spring 2010 Operating Grant Priority Announcement (HIV/AIDS);
• Spring 2010 Fellowship Priority Announcement (HIV/AIDS);
• Catalyst Grant: HIV/AIDS Community-Based Research;
• Master’s Award: HIV/AIDS Community-Based Research;
• Planning Grants Priority Announcement (HIV/AIDS);
• Dissemination Events Grants Priority Announcement (HIV/AIDS); and
• Knowledge Translation Supplements Priority Announcement (HIV/AIDS).

For more detailed information on CIHR funding opportunities, please consult the CIHR Funding Opportunities database.

For more information on the CIHR HIV/AIDS Research Initiative, please contact HIVAIDS-VIHSIDA@cihr-irsc.gc.ca.

Interdepartmental Policy Forum on the Determinants of Health and HIV/AIDS

The HIV/AIDS Policy, Coordination and Programs Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, in collaboration with the Strategic Initiatives and Innovations Directorate, hosted the Interdepartmental Policy Forum on the Determinants of Health and HIV/AIDS on September 14-15, 2009, in Ottawa. This event is part of a larger Agency plan to engage officials across departments and sectors to address the root causes of health inequalities in Canada.

Fifty-five representatives across 14 federal departments and agencies² attended the forum. Discussion centred on the determinants of health as they pertain to HIV and other health conditions–the social, economic, political and environmental factors–relating to health inequalities, including homelessness and migration.

Three keynote speakers addressed participants:

• Dr. David Butler-Jones, Chief Public Health Officer, spoke about the shared responsibility and need for partnerships–across and within governments and with communities–to address factors influencing health inequalities;
• Senator Wilbert Keon, Chair, Senate Subcommittee on Population Health, shared his vision based on the June 2009 Senate report, A Healthy, Productive Canada: A Determinant of Health Approach; and
• Professor Ted Schrecker, Institute of Population Health, University of Ottawa, discussed issues related to homelessness and daily living illustrating the need and potential for action on the determinants of health.

Officials from Human Resources and Skills Development Canada’s Homelessness Partnering Strategy and Citizenship and Immigration Canada outlined the issues and successes of federal action related to homelessness and migration. Panels, posters and group sessions were also used to detail federal activities on the determinants of health.

The forum helped forge horizontal linkages and a shared understanding of synergies across federal mandates, target populations and priorities and identify common barriers to horizontal collaboration and how they could be overcome.

The keen involvement of the 14 departments and agencies in this event represents an emerging consensus and commitment towards a horizontal approach to improving the socio-economic conditions that promote health and well-being for all Canadians.

For more information, please contact Patricia Hurd by e-mail, at patricia.hurd@phac-aspc.gc.ca or by telephone, at 613-941-3352.

Canada's 2008-2009 United Nations General Assembly Special Session Report

The Public Health Agency of Canada’s (PHAC) HIV/AIDS Policy, Coordination and Programs Division is preparing the 2008-2009 Canada Country Progress Report on the Declaration of Commitment on HIV/AIDS (UNGASS Report) in collaboration with other government partners. This report is a broad overview of the epidemic and response in Canada, covering quantitative indicators; national responses to the epidemic; best practices; major challenges and remedial actions; and monitoring and evaluation environment.

The report will be accompanied by an annex–the National Composite Policy Index–which responds to a questionnaire from the Joint United Nations Programme on HIV/AIDS (UNAIDS). Part of this questionnaire–the NGO Annex–is administered by civil society organizations. The annex addresses human rights; civil society participation; prevention; and treatment, care, and support. PHAC has hired an external policy expert to develop the draft text of the annex in consultation with key national stakeholders and subject matter experts.

A draft of the report will be shared with The Federal Initiative to Address HIV/AIDS in Canada advisory and coordinating committees for comment and input. The final report will be submitted to UNAIDS in March 2010.

For more information, please contact Tanya Lary by e-mail, at tanya.lary@phac-aspc.gc.ca or by telephone, at 613-954-8639.

XVIII International AIDS Conference

The global HIV and AIDS community will gather July 18-23, 2010, in Vienna, Austria, for the XVIII International AIDS Conference (AIDS 2010) under the theme, “Rights Here, Rights Now”. Over 20,000 participants representing science, civil society, community and government will participate in this multidisciplinary forum for networking and sharing information related to new research and evidence-based programmes and polices on the major issues facing global and local responses to HIV. In particular, AIDS 2010 will facilitate stronger linkages between science and community and will explore in greater depth the important overlap and interaction among science, community, and leadership and accountability.

The conference presents an opportunity for the Government of Canada to demonstrate its progress and leadership towards domestic and global commitments, including:

• Millennium Development Goals (providing universal access to HIV prevention, treatment, care and support by 2010, and halting and reversing the spread of HIV by 2015)
• the United Nations 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration on HIV/AIDS
• the Global Fund to fight AIDS, Tuberculosis and Malaria
• the Federal Initiative to Address HIV/AIDS in Canada
• the Canadian HIV Vaccine Initiative

The conference also provides a unique opportunity for the Government of Canada to strengthen working relationships with global partners, such as the Joint United Nations Programme on HIV/AIDS, the Bill and Melinda Gates Foundation, the World Health Organization, the United States Centers for Disease Control and Prevention and the governments of other countries to advance HIV/AIDS and broad-based public health responses.

The AIDS 2010 Federal Secretariat³ will act as a single point of contact for all inquiries to the Government of Canada related to AIDS 2010, and will coordinate the federal government’s engagement in the conference. As in past years, the Federal Secretariat will be led by Health Canada’s International Affairs Directorate.

The Public Health Agency of Canada AIDS 2010 Task Force⁴ will be the focal point to plan, coordinate and share information on the Public Health Agency of Canada’s (PHAC) participation at AIDS 2010. Over the coming months, the task force will provide regular updates on opportunities and activities that will showcase PHAC’s work on HIV/AIDS and other public health issues.

For more information, at PHAC, please contact Patricia Hurd at patricia.hurd@phac-aspc.gc.ca or Matt Sumner at matthew.sumner@phac-aspc.gc.ca, and at Health Canada, please contact Sharon Peake at sharon.peake@hc-sc.gc.ca.

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