British Columbia’s record of combating AIDS has been recognized internationally, and its policies are being adopted by countries around the world, but not by the Canadian government. Ottawa should create and implement national strategies on HIV/AIDS, using B.C.’s policies as a template.
The fight against the virus is spearheaded by the B.C. Centre for Excellence in HIV/AIDS. When the centre was opened in 1992, B.C. had the worst AIDS rate in the country — a B.C. resident was dying from the disease almost every day. Now, B.C.’s infection rate is far below the national average.
That’s the result of B.C.’s aggressive Treatment as Prevention policy, pioneered by the centre’s director, Dr. Julio Montaner. HAART (Highly Active Antiretroviral Therapy) costs $15,000 per patient per year, but it’s free to B.C. patients, at a cost of $100 million a year. That seems like a large sum, but the cost to society, financially and otherwise, would be much higher without the treatment.
The AIDS pandemic has already proved costly throughout the world; unchecked, it would be devastating. Proper treatment means those infected with the virus can lead normal lives and the transmission rate is greatly reduced. The B.C. experience offers hope to those countries where AIDS is rampant, and where no one is untouched by the disease.
It’s not a time to be complacent, at home or abroad. It takes a concerted effort, and that effort is growing around the world. The United Nations aims to reduce AIDS to a sporadic disease by 2030, following a strategy based on B.C.’s policies. That strategy has been adopted by countries that include the U.S., China, France, Brazil, Spain, Argentina and Panama — but not Canada.
In fact, says Montaner, who has been appointed as a special adviser to the UN, Ottawa is hampering the effort by failing to show national leadership. He said the federal government has allowed the standard of treatment to vary across the country, even allowing some provinces to require patients to make co-payments for therapy, which, he says, is a barrier to treatment.
Ottawa has been willing to form national strategies on SARS and Ebola, but not on HIV/AIDS, which afflicts thousands of Canadians.
Furthermore, the Harper government interferes with public-health efforts in several ways, says Montaner, including taking steps to stop supervised injection sites and discouraging harm-reduction initiatives, criminalizing sex workers and their clients, and withdrawing services from immigrants (who are disproportionately affected by AIDS).
“At the international level, they have failed to embrace the made-in-B.C. Treatment as Prevention strategy that has now become the standard of care around the world,” said Montaner.
For its part, the federal government said health care is a provincial jurisdiction. Given that AIDS is a threat to millions of Canadians, that’s a bit like leaving national defence up to each province.
Great strides have been made in the treatment and prevention of AIDS. The battle reached a tipping point in 2013, when the number of people added to treatment programs was greater than the number of people newly infected. But it is still a terrible and costly disease. We cannot afford complacency.
Ottawa has said good things about B.C.’s program.
“We are following with interest the implementation of the Treatment as Prevention approach in British Columbia,” said a Health Canada spokesman. But despite statements of support, the federal government lacks the commitment other countries have demonstrated.
The government of Canada should be on the field leading as a serious player, not sitting in the bleachers cheering politely.
