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'HIV Policy Rubbish': Expert Slams Canada's 'Backwards' Approach
Feds' lack of support for clean needles latest deadly embarrassment says head of Dr. Peter AIDS Foundation.
Federal Health Minister Leona Aglukkaq: Leadership questioned.
Condoms and clean needles. Two basic remedies that could help stop the HIV/AIDS epidemic dead in its tracks.
It's that simple, says Maxine Davis, executive director of the Dr. Peter AIDS Foundation and Canada's leading voice when it comes to AIDS treatment.
If only the government would listen.
At the 18th International AIDS Conference in Vienna last month, Davis and Canadian colleagues watched as their government, refusing to stand behind the Vienna Declaration, slipped from its respected leadership role in the global fight against the disease.
Catching up on Canadian news coverage in the early days of the conference, Davis came across a Winnipeg Free Press article quoting a Public Health Agency spokesperson saying that the declaration -- calling for the decriminalization of drug users to prevent the spread of AIDS -- is inconsistent with Canada's anti-drug use policy.
"That is HIV prevention policy rubbish. It is complete rubbish," she said of the Public Health Agency's statement.
The quote prompted Davis to confront Health Minister Leona Aglukkaq at a government of Canada reception hosted for Canadian delegates in the Austrian capital that evening.
"I decided to ask her was she supportive of clean needle distribution," she said.
So she asked. Aglukkaq squirmed.
Waiting for a response, Davis told Aglukkaq about former U.S. president Bill Clinton's support for clean needle distribution. At the 2008 AIDS Conference in Mexico, Clinton told the audience he did not support clean needle distribution when he was president and that he was sorry about that, because now he has changed his mind. His policy caused many people to suffer and die, Clinton acknowledged.
Now the Clinton Foundation is putting money toward funding for clean needles.
"He's really clear that clean needles are absolutely necessary if we're going to get a grip on the epidemic with injection drug users," she told Aglukkaq.
So, Davis pushed, how about it, Minister Aglukkaq?
But the minister, according to Davis, gave no clear answer. "She refused to confirm that the federal government would support clean needle distribution," Davis said. "That is like taking us backwards by years."
A call for leadership
Most frustrating for Davis was Minister Aglukkaq's position that clean needle provision is a provincial responsibility.
"We're looking for a national voice," Davis said. "And it's interesting that aboriginal communities in this country are particularly struggling with injection drug use. The minister, being aboriginal herself, has an unprecedented opportunity to be a leader -- to articulate and encourage the aboriginal community to embrace the use of clean needles as one of the ways of stemming the epidemic.
"I think this revelation that the government doesn't even support the provision of clean needles, to my mind, shows that we need to draw a line in the sand and say enough is enough," she told The Tyee in a phone call from her Austrian hotel room hours after the conference's end.
Refusing to join the week-long conversation about specific prevention strategies, the health minister instead announced Canada's donation of $88 million in partnership with the Gates Foundation for HIV/AIDS vaccine research.
"They waltzed into Vienna, made their grand announcement of $88 million, extolling how wonderful it was that Canada was contributing internationally to a global research initiative to find a vaccine," Davis said. "It was so stunning to me that they were aiming internationally while they were abandoning people with HIV/AIDS at home."
'Rage at the Canadian government'
For Maxine Davis and other leaders in the global fight against HIV/AIDS, the 2010 Conference saw the Canadian government's retreat from progressive research initiatives that seek to prevent, rather than just treat, HIV/AIDS affected individuals.
On July 29, a group of Canadian activists trashed the government of Canada's exhibit booth at the conference.
Davis missed the attack, but she was not surprised.
"I think it was a symptom of the level of anger amongst AIDS organizations around the federal government's lack of leadership on this," she said.
"Violence is certainly not going to solve this epidemic, and nobody endorses violence, but I have never been at a conference where Canadian booth property has been marred in any way, shape or form.
"I think it's reached a boiling point, a sense of rage at the Canadian government."
HIV rates rising steadily in Canada
With the conference over, Canadians working in the HIV/AIDS field returned home to a country where infection rates are rising steadily -- with no promise from the government to assess its anti-drug policy.
"For Canadian AIDS organizations, there is almost a sense of 'we're in it alone,'" Davis said. "Even international colleagues were commenting to us that it's so sad that Canada used to be the leader with progressive harm-reduction policies."
According to a May 2010 AIDS Committee of Toronto report, the number of people living with HIV and AIDS in Canada rose from roughly 57,000 in 2005 to 65,000 in 2008. And these numbers continue to rise, the report stated.
For Ron Rosenes, vice-chairman of the Canadian Treatment Action Council, the federal government's anti-drug use policies -- and failure to back the Vienna Declaration -- are troubling for the HIV/AIDS epidemic on Canadian soil.
The government's position will exacerbate a volatile HIV/AIDS epidemic, where prevention measures like safe injections sites are desperately needed, he said.
"It's unfortunate, because many of us believe that were it not for the fact that the Canadian government is opposed to supervised injection sites, we would have a few more in cities where it would make sense to have them," he added.
And it's in places like Saskatchewan -- Canada's most affected province, where the HIV/AIDS infection rate is four times it was in 2005 -- that the federal government should permit safe injection sites, Rosenes said.
According to a 2010 Saskatchewan ministry of health report, the prairies province has the highest rates in Canada, at twice the national average -- 20.8 cases per 100,000 versus Canada's average of 9.3 cases per 100,000 people.
And 75 per cent of Saskatchewan's new HIV cases are associated with injection drug use.
Saskatchewan nixed safe injection site
Saskatchewan ministry of health officials responded with a four-pronged HIV strategy in a 2010 report that underlines 'prevention and harm reduction' as necessary. The strategy highlights the need for "prevention and well-being centres with expanded access to needle exchange programs and other harm reduction measures to promote and encourage safe behaviours."
But Saskatchewan health officials silenced calls for provincial safe injection facilities at the 2010 National AIDS Conference in Saskatoon in May, stating that -- in line with federal anti-drug use policies -- HIV studies don't prove that safe-injections site are necessary.
The health officials' comments came months after the federal government tried to shut down InSite, Canada's only supervised safe injection site in Vancouver, which opened in 2003. The provincially run facility, located in Vancouver's Downtown Eastside, remained open after the B.C. Court of Appeal affirmed its right to exist.
"The Government of Canada... identifies people who use injection drugs as a key population at risk for HIV in Canada," Canada's Public Health Agency said in an email to The Tyee. But "the National Anti-Drug Strategy aims to prevent illicit drug use, treat those with illicit drug dependencies, and combat the production and distribution of illicit drugs," rather than supplying clean needles and safe injection sites.
"The government of Canada would rather build prisons and lock people up for illicit drug use than implement evidence-based prevention approaches that would actually reduce the amount of drug use as well as the onward transmission of the virus," Rosenes said.
'If this were cancer prevention'
For Davis, one of the most challenging policy issues around HIV/AIDS is getting treatment to injection drug users, due to the federal government's anti-drug use policies.
"They are so stuck in their anti-drug use policy that they're failing to respond to an epidemic in a leadership way," she said. "We have let this government go on and on and on with approaches to the HIV epidemic that are not based in scientific research."
"We would never let them get away with this in any other disease," she added. "If this were a cancer prevention tool that has been known for years to prevent cancer, I doubt very much that the federal government would be going on with this level of silliness," she added.
Asked whether she remains optimistic about the future of AIDS prevention and treatment in Canada, Davis expressed mixed emotions.
"There is a mixture of pride and despair," she said. "Pride that the work of Vancouver and British Columbia is so leading-edge -- Vancouver in particular has always been a rock star when it comes to leading initiatives. And despair that our federal government just doesn't get it."
"The provision of clean needles is about the security of person. It's about right to healthcare, to be free from the impact of an epidemic," Davis said.
"The good thing is, we're talking about a government that isn't a dictatorship," she added. "One day, if the Canadian public gets itself together, we can vote them out." ![]()




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CanadianLatitude
1 year ago
Well when we have young
Well when we have young earth creationists in office, what do you expect? Science is a thorn in their side...As well No indication this will change anytime soon either as no alternative.
Greg RN
1 year ago
Saskatchewan is Catching up
If you live and work in Saskatchewan and work with key populations at-risk or affected by HIV, you would know that things are happening. We do have increasing rates of HIV BUT this is due to increased testing, more people at-risk actually being tested, and accessing care; we are really just catching up after years of lower than expected rates. Also, in Saskatchewan, First Nations and Inuit Health fund HIV programming on First Nations reserves, and there ARE reserves in Saskatchewan with Needle Exchange Programs, and some for more than a decade. The federal health minister may not state that she or her department supports clean needle distribution, but it is happening, we’re just not supposed to ask any questions related to Harm Reduction for any programs that have ‘federal’ attached to them. Canada has a long way to go in addressing HIV and the people that HIV affects and this is not going to change with the current Health Minister’s leadership and government Anti-caring strategies.
jim1966
1 year ago
It's Time To Take A Stand
As a person living with HIV I found this article revealing. I know Ms Davis and she is a caring and respected individual. The one thing that did grab my attention about this article was the fact that the rate of new infections is increasing. I think that the clean needle program is only "one" aspect of reducing the infection rates. Thanks to Gordon Campbell and Co many Aids front line services like Aids Vancouver etc have seen their budgets cut, further adding more misery to this was the recent cuts to those on provincial disability. The facts are that more people are going to get sick and some will not seek out treatment. I asked one person why they would not seek treatment and that person told me that dealing with the entire system is "mind boggling". I may not agree but that person does have a point. Current government idealogies, policies and the like are clearly the wrong way to proceed in combating HIV/Aids. Like Ms Davis mentions at the end of this article, "One day, if the Canadian public gets itself together, we can vote them out". I agree and the sooner the better.
Bobbi
1 year ago
Vienna Declaration
No country has signed the Vienna Declaration.
popper
1 year ago
Why sure. Free needles
Free needles for those who had a choice as to use drugs or not and those with diabetes who had no choice have to pay for their needles and drugs to keep living. Does this seem a little backwards to you? It sure does to me.
John Greg
1 year ago
popper
Yes, diabetes treatments should be more accessible and less expensive, especially for the poor, who are more prone to diabetes problems in the first place.
However, how many times does it need to be said: Addiction is not a choice.
ASKBiblitz.com
1 year ago
Saving drug addicts who deal 'n steal - that's the perception
It's hard to make palatable the prospect of spending public money to save drug addicts, who are forced by their chosen habits to rob the rest of us of about $10k worth of cherished household goods a year and more. Frankly, I'd feel better about safe injections if there were secure facilities to house addicts and prevent them from robbing me. I pass no moral judgment. Gosh knows, we all have varying degrees of pain and suffering the brain-dead medical establishment won't properly address. I just object to the stealing, which quite often involves physical violence. Strangely, in my experience, anyway, when you say the word, 'victim,' to these characters, they invariably think you're referring to them!
Byrun
1 year ago
Figured I'd share
I wrote Rob Nicholson a while back about how I thought the government was being short sighted in opposing the Safe Injection site in Vancouver. I am a former resident and I would say that the site has done more good than harm from I what I had seen while I was still living there. Conventional approaches to dealing with drugs will not work in Vancouver, especially not for the issues surrounding addiction. I suggested the minister spend time in the city before towing the party line. This was his response.
Dear Mr. Stedmann:
Thank you for your correspondence concerning Insite, the Vancouver Safe Injection Site. I regret the delay in responding.
As you may be aware, the Court of Appeal for British Columbia has ruled on the matter of Insite in PHS Community Services Society v. Canada (Attorney General). This case raises important constitutional questions, and the Government of Canada believes that the Supreme Court of Canada should rule on this matter. As you may know, the Government filed an application seeking leave to appeal on February 5, 2010. As this case is currently before the court, it would be inappropriate for me to comment further.
While I note your concerns, the Government recognizes that illegal drug use is a serious concern for many Canadians. It may interest you to know that more than $230 million over five years has been allocated to the National Anti-Drug Strategy, which focuses on three priority areas: preventing illicit drug use, treating those with illicit drug dependencies, and combating the production and distribution of illicit drugs.
Thank you again for writing and sharing your views on this important matter.
Yours truly,
The Honourable Rob Nicholson
John Greg
1 year ago
Yes, well ...
making drugs legal would of course almost certainly stop all forms of dealin' an' stealin'.
Oh but, we really don't want that now do we? I mean, then what would we do with all those pages of draconian legislation, the overflowing jails (and the Happy Up they provide for the GDP), and the millions upon millons of dollars in budget to clean up the wild frontier? My oh my. Lions and tigers and bears.
John Greg
1 year ago
Note:
My former post was directed towards ASKBiblitz.com, not Byrun.
RickW
1 year ago
Canadian Latitude
Except when it comes to fighters, tanks, ships, bombs and bullets.........anthing to promote The Rapture.
RickW
1 year ago
Why Canada’s drug policy won’t check addiction
http://www.walrusmagazine.com/articles/2007.12-health-rat-trap/
Bob Watts
1 year ago
So?
So, many ideas on this topic. Today in Canada Hep-C is the killer, HIV is bad but Hep-C is now worse. I worked for a needle exchange for years. Harper and these ministers should be forced to watch the harm their policies do to their fellow humans. (Shame and stupid).
I'm Diabetic 3 shots a day plus 20 other R/X, I'm covered. Living in poverty is the trade off, oh well...
Imagine Harper with full power to kill us all, at will.
$23 billion for planes to kill a talaban on a bike, yet no needles based on a health need in our society.
zalm
1 year ago
Let's not drag the Charter and the UN into this
""The provision of clean needles is about the security of person. It's about right to healthcare, to be free from the impact of an epidemic," Davis said."
Wrong, Ms Davis. This is [b[]not[/b] about security of person, no matter how you stretch it. There is harm done by dirty needles certainly, but so is there harm done by clear rushing streams with "beaver fever" in them. Yet the government is not called upon to clean up the streams, but merely to warn the people against drinking from them. So too, is the government called to warn addicts against sharing needles. Or you enter into the minefield of what the provision is - provide needles only? Ensure they use them? Lock them up under medical direction to ensure they use them correctly? What's the difference? None of these solutions is good, none is effective.
It's for others who care more, to enforce that practice with the addicts they care about. And, frankly, that's not me any more. After more than 25 years of dealing with my ill school-chum, I recognize that I can't help him any more than 10% of the time, and he's still going to live an unhealthy lifestyle whether he uses drugs or not, because that's the way he's been for more than 50 years.
Which is why Rick W's quote from Bruce Alexander makes so much sense. If I could just help John enter a taste of culture.....
puppyg
1 year ago
Glory day coming?
If one goes out on a limb and assumes that the core Harper gang is making preparations for The Rapture, then these policies begin to make sense.
Divisiveness will mean clear divisions between those who will and will not be zapped up to heaven on Judgement Day. Prisons will mean safe containment of the latter when chaos and the clarion calls descend. Compliant minions and bolstered armies will ease the pains of transition.
Why would he expend precious resources on protecting the environment or funding assistance to gays, drug addicts and the godless masses? Only those who can help him consolidate power and advance his mission shall find favour.
Still, with that pesky election lurking, there must be balance; he has to throw some crumbs. All in good time...
Yes, I see it.
dorothy
1 year ago
Quote of a quote
"The only way we’ll ever touch the problem of addiction is by developing and fostering viable culture.”
And that's not going to happen unless a mighty grass-roots movement makes it happen. Everything we get served in school, in the media, in the workplace, 'out and about', goes in the opposite direction. Everything we encounter outside our own door is geared at one purpose only: to send us back behind that door with less than we had when we walked out through it. Everyone wants his cut. Everyone wants to 'make money', and whatever that takes will happen. People spend money when they're unhappy, so attempts are made at making us unhappy, fearful, devoid of self-esteem and self-confidence, culture, rootedness or even connection to the ground we stand on.
It takes never-ending vigilance to protect against the onslaught of other people's wants. Not to deny that there is such a thing as fair exchange. It's the fairness that one must be vigilant about. Not to deny there is such a thing as generosity. It's the direction and intent of generosity one must be vigilant about. Be awake and aware. So many of us grow up with no provision for defending against the jungle we will live in. In fact, for many of us, the growing up is part of the jungle. Mom and Dad have limited time for us, because they want things and security for themselves, sometimes at the cost of our wholeness. We get used to be of less or no account. The African children who get their own song at birth are wealthier at least in that regard, even if they never own a pair of shoes in their life. What makes us human? To know what we're doing, why we're doing it, and what we are de-selecting by every single option we exercise. You can't miss what you never had, but strangely, you still do. We carry a blueprint of who we could be but aren't, and it hurts. If we want things to get better, we need to do something that can fill that gap. It needs to be inclusive and not too terribly rule-bound, and it can't be something that could be taken over and made profitable, nor can it look dangerous in a way that will give an excuse to shut it down. It has to meet the most stringent criteria for unobtrusive subversion, not in the state-political sense, but in the upsetting the economical exploitation applecart sense. Any ideas?
RickW
1 year ago
'The Empathic Civilization' (Part First)
http://www.huffingtonpost.com/jeremy-rifkin/the-empathic-civilization_b_416589.html
'The Empathic Civilization': Rethinking Human Nature in the Biosphere Era
- Jeremy Rifkin
Extract:
The problem runs deeper than the issue of finding new ways to regulate the market or imposing legally binding global green house gas emission reduction targets. The real crisis lies in the set of assumptions about human nature that governs the behavior of world leaders--assumptions that were spawned during the Enlightenment more than 200 years ago at the dawn of the modern market economy and the emergence of the nation state era.
The Enlightenment thinkers--John Locke, Adam Smith, Marquis de Condorcet et. al.--took umbrage with the Medieval Christian world view that saw human nature as fallen and depraved and that looked to salvation in the next world through God's grace. They preferred to cast their lot with the idea that human beings' essential nature is rational, detached, autonomous, acquisitive and utilitarian and argued that individual salvation lies in unlimited material progress here on Earth.
The Enlightenment notions about human nature were reflected in the newly minted nation-state whose raison d'être was to protect private property relations and stimulate market forces as well as act as a surrogate of the collective self-interest of the citizenry in the international arena. Like individuals, nation-states were considered to be autonomous agents embroiled in a relentless battle with other sovereign nations in the pursuit of material gains.
It was these very assumptions that provided the philosophical underpinnings for a geopolitical frame of reference that accompanied the first and second industrial revolutions in the 19th and 20th centuries. These beliefs about human nature came to the fore in the aftermath of the global economic meltdown and in the boisterous and acrimonious confrontations in the meeting rooms in Copenhagen, with potentially disastrous consequences for the future of humanity and the planet.
If human nature is as the Enlightenment philosophers claimed, then we are likely doomed. It is impossible to imagine how we might create a sustainable global economy and restore the biosphere to health if each and every one of us is, at the core of our biology, an autonomous agent and a self-centered and materialistic being.
Recent discoveries in brain science and child development, however, are forcing us to rethink these long-held shibboleths about human nature. Biologists and cognitive neuroscientists are discovering mirror-neurons--the so-called empathy neurons--that allow human beings and other species to feel and experience another's situation as if it were one's own. We are, it appears, the most social of animals and seek intimate participation and companionship with our fellows.
RickW
1 year ago
'The Empathic Civilization' (Personal Conclusion)
It is difficult, for me at least, to imagine any world leader (except perhaps the leader of Bhutan) even entertaining Rifkin's assertion - especially the current Canadian PM and his coterie. Yet this, or some version thereof, must prevail or every approach is simply playing politics with the lives of others, or is at best a bandaid.