November 28, 2011 - As World AIDS Day (December 1st) draws near,
the Canadian HIV/AIDS Legal Network would like to draw your attention to some of the most pressing issues
for people living with or vulnerable to HIV and AIDS. Of course, this list is by no means exhaustive,
as the fight to stem the tide of this epidemic is multi-faceted and complex. But these are the
issues playing out here at home which demand immediate attention. As you prepare for any
stories you may be considering for World AIDS Day 2011, we would be happy to provide
experts to comment on any of the following issues:
1. Access to medicines, globally and domestically
At the end of 2010, of the estimated 15 million people in clinical need of life-saving antiretroviral (ARV) drugs, an estimated 9 million
were without access. This number will grow unless concerted action is taken. Over the last decade, significant progress has been made in
scaling up access to AIDS treatment, thanks largely to harnessing the power of generic competition. But developing countries are
facing pressure to refrain from adopting policies that would increase access to lower-cost generics and new trade agreements
are being negotiated that would impose even more impediments to generics access. On a smaller scale, these pressures are
also facing developed countries. As Canada and the EU negotiate a Comprehensive Economic and Trade Agreement,
intellectual property issues are one of the remaining contentious points. Leaked text of the draft agreement
suggests Canada and the EU are on the verge of finalizing proposals that would further restrict the
introduction of cost-saving generics into the Canadian market when patents expire, unnecessarily
driving up health care costs at a time of budget pressures.
Canada 's Access to Medicines Regime - passed unanimously by Parliament in 2004, but unusable because of unnecessary red tape - could help
ease the burden for millions of dying people in the developing world. A bill to streamline the law passed with a large majority in
Parliament in March 2011, but was fatally stalled in the Senate at the behest of Big Pharma until it died on the Order Paper.
With strong public support (80% in a nation-wide poll last year), this bill needs to be reintroduced in Parliament and
passed once and for all.
2. Drug policy, prisons and harm reduction
The Supreme Court of Canada's recent decision in favour of Insite - Vancouver 's safe injection site - was a great victory for science
and reason. But questions remain whether the federal government will abide by this decision and consider new applications for safe
injection sites in other municipalities, or whether it will continue to force service providers to go to court each and every
time, wasting taxpayer dollars in opposing evidence-based, life-saving health services for some of Canada's most
marginalized and at-risk populations.
The federal government's attitude toward the needs of these populations is again on display in its short-sighted omnibus crime bill.
Bill C-10 will implement mandatory minimum sentences for even minor drug offences, despite the abundantly documented harm such
measures will have - to the public purse, to human rights and of course, to public health. As prisons become overcrowded
through increased convictions, more people will be exposed to risks of infection by HIV and Hepatitis C - particularly
since the government also refuses to implement basic prevention measures for prisoners, such as needle exchange
programs. This prison epidemic will ultimately find its way back into the community at large.
3. Criminalization of HIV non-disclosure
In recent years, a surge of prosecutions against people living with HIV has included troubling charges for some of most serious offences
in the Criminal Code, even in cases where there has been no significant risk of transmission of HIV - in effect, criminalizing a
person simply on the basis of his/her HIV-positive status. Sensationalized accounts of these cases appearing in certain media have only
served to further stigmatize people living with HIV. The lack of clarity, reason and fairness in the law has highlighted the
importance of getting police and prosecutorial guidelines in place to ensure that prosecutors are guided by the best
available science when deciding whether and how to proceed with charges. In Ontario , a community coalition has
done consultations around the province and is calling on the Attorney General to follow through on earlier
commitments to develop such guidelines, working with community. Interest is growing in other provinces as well.
At same time, two important appellate court decisions (in Manitoba and Quebec ) have recognized that there must be limits to the use of
the criminal law, as the Canadian HIV/AIDS Legal Network has long argued, maintaining that the law needs to evolve with the science of
HIV. In hearing appeals to both these cases early next year (February 7, 2012), the Supreme Court of Canada will have a chance to
revisit its original 1998 decision on this issue ( R. v. Cuerrier ) and clarify the law. As part of a broad coalition,
the Legal Network will be intervening to urge the Court to affirm that disclosure is only required where there is a
"significant risk" of HIV transmission and that this clearly excludes certain situations, such as cases of condom
use or an undetectable viral load on the part of the HIV-positive person.
4. HIV among Aboriginal people
HIV has taken a significant and disproportionate toll on Aboriginal communities across Canada , fuelled by various factors that undermine
the health of Aboriginal people generally. Approximately 3.8 percent of Canadians self-identify as Aboriginal, yet in 2008 (the most
recent year for which data has been issued by the Public Agency of Canada), Aboriginal people accounted for an estimated 8
percent of all people living with HIV and about 12.5 percent of all new HIV infections. Overall, infections are seen at a
younger age among Aboriginal people and also affect a higher proportion of women than in the non-Aboriginal population.
The lived experience of HIV-positive Aboriginal persons sits at the intersection of several systemic issues, including discrimination,
poorer access to health services (including delayed uptake of HIV treatment), and addiction. With injection drug use as the single
greatest category of exposure to HIV for Aboriginal persons, they are thus disproportionately vulnerable to policies that punish
people who use drugs, such as the "tough-on-crime" law enforcement measures that Bill C-10 will impose and barriers to harm
reduction services, both inside and outside of prison.
5. Funding the response to AIDS, domestically and globally
At home, federal funding for HIV has been flat-lined since 2007 and, as of this writing; it is unknown whether federal funding will be
cut even further next year. Cuts and delays in funding would have serious implications for front-line community services that do HIV
prevention and support services, and most importantly, the people who depend on those services.
On the global front, just as we are seeing results from sustained global investments in HIV prevention and treatment, funding is
stalling and governments are failing to support what is needed. In 2010, UNAIDS estimated a $10 billion shortfall for a
comprehensive and effective global AIDS response. In the US , PEPFAR funding is stagnating and eroding. Globally,
donor support for the Global Fund to Fight AIDS, Tuberculosis and Malaria - the most effective multilateral
source of funding for prevention and treatment of HIV, TB and malaria - has fallen short of the minimum
required just to sustain current efforts, let alone expand to maintain its momentum in turning the
tide on the epidemic. In fact, just last week the Global Fund was forced to take the
extraordinary decision to cancel the latest round of funding opportunities and
exclude many countries from applying for current renewals in funding as well
as future funding opportunities. Though Canada made a welcome increase of
20 percent in its latest round of commitments to the Global Fund, our contribution
still comes to just over $5 per Canadian per year - 1/3 of the price of a movie ticket.
We can and should double that amount and make a commitment of at least 5 years. We also
must pay our annual share by December 31, 2011, just to honour our current commitment. This
modest contribution would still leave our overall official development assistance (ODA) far
below the internationally agreed-upon target for of 0.7 percent of Canada 's gross national
income - a target Canada helped set at the UN more than 4 decades ago but has never reached.
Further resources can be found at www.aidslaw.ca.
Janet Butler-McPhee , Director of Communications, Canadian HIV/AIDS Legal Network
(416) 595-1666 ext. 228, email: email@example.com
About the Canadian HIV/AIDS Legal Network
Since 1992, the Canadian HIV/AIDS Legal Network ( www.aidslaw.ca ) has been promoting
the human rights of people living with and vulnerable to HIV/AIDS, in Canada and internationally, through research, legal and policy
analysis, education, and community mobilization. The Legal Network is Canada 's leading advocacy organization working on
the legal and human rights issues raised by HIV/AIDS.
Reproduced with permission - "Canadian HIV/AIDS Legal Network"
Canadian HIV/AIDS Legal Network