On the occasion of World AIDS Day on 1er December, you would be forgiven for believing that HIV is no longer a threat to public health in Canada: indeed, we have new prevention options such as PrEP, a pill to be taken regularly by HIV-negative people to stop the infection; We also heard the good news about treatments that are now so effective that they can restore a person living with HIV to a normal life expectancy and completely eliminate the possibility of transmitting it sexually.
But the statistics tell us a whole different story. The Public Health Agency of Canada estimates that between 2013 and 2018, HIV infections in Canada increased by 31%.
Why are these infections on the rise when we have more prevention options and they are more effective than ever?
Ask this question of the federal government, which since 2008 has not increased funding for the fight against HIV and has not even spent the funds that had been allocated to the federal initiative on HIV. At the same time, the federal government has broadened the reach of this fund – once devoted exclusively to HIV – to also tackle hepatitis C and other sexually transmitted and blood-borne infections – an approach that might make sense if funded. appropriately. But in practice, we see more organizations and more health issues competing for a piece of the same pie. The expanded reach of the identical fund allocation has resulted in funding cuts and service cuts for community-based HIV programs.
When properly funded, these programs have the power to stem the HIV epidemic. They are used to counsel people who are at risk of infection, educate them about current prevention options and help them access them. These programs support people living with HIV to initiate and continue treatment, helping to improve their own health and that of partner communities. Some of these programs even offer free HIV testing in the community: the first step in referring people who are HIV negative and positive to the prevention or treatment services they need.
Community-based programs are also better placed to engage members of communities who have been marginalized by mainstream health services, including those most affected by HIV in Canada: gay and bisexual men, trans women, Indigenous peoples, African, Caribbean and Black communities, and people who use drugs.
Programs that have proven their worth
It’s a fact: these programs work when governments give them money. While there has been an increase in estimates of HIV infections in Canada in recent years, the opposite trend is emerging in the United Kingdom: 50% less among heterosexual men and 22% less among women (between 2014 and 2017), and an incredible drop of 71% among gay and bisexual men (between 2012 and 2018). These convincing results are no accident: they correspond to an increase in community HIV testing, PrEP programs and better access for people living with HIV to treatment and care.
Are these programs expensive? No, compared to the cost of an increased number of infections – a cost associated with a lifetime of daily medication, regular visits to the doctor and a skyrocketing need to invest in more and more. prevention, screening and treatment programs.
Long-term policymakers see HIV financing as an investment rather than a cost, and the COVID-19 pandemic has illustrated what happens when we don’t proactively invest in our collective health.
No particular political party deserves to be blamed for this approach. It is the fault of successive governments that neglected the federal response to HIV and ignored the House of Commons Standing Committee on Health which recommended increased funding to $ 100 million per year for HIV programs. HIV. A drop in the ocean compared to the cost of treating more people with HIV.
Mathematical models show that with more emphasis on prevention, testing, and linkage to treatment and care, we could in fact eliminate HIV as a threat to public health by 2030. The government Canada has publicly committed to this goal in 2016, but has never allocated additional funds to achieve it.
Knowing that Canadians sent MPs back to Ottawa this fall with a mandate to work together to get things done, I hope the political will will prevail to deliver on that promise and finally end HIV as a threat. for public health once and for all.