Julio Montaner says it's “mind-boggling” that feds won't adopt Treatment as Prevention to fight HIV
One of Canada's leading authorites on AIDS, Dr. Julio Montaner, says that Canada is basically “looking the other way” when it comes to implementing a federal strategy on HIV.
During a presentation in Vancouver today (December 6), Montaner noted that B.C. has seen dramatically declining trends in new HIV infections under its Treatment as Prevention strategy, compared to increases in new infections in Saskatchewan and Manitoba.
“Unfortunately, at the federal level, there is zero appetite to develop a national strategy to deal with the problem,” he told a crowd assembled at the Bill Reid Centre for Northwest Coast Art Studies for an Aboriginal AIDS Awareness Week event. “Imagine how much easier it would be if the federal government was able to set some sort of standard of care for people infected with HIV across the country.”
Montaner, the director of the B.C. Centre for Excellence in HIV/AIDS, added that it’s “puzzling” that B.C. is the only province in the country that has truly free access to anti-retroviral therapy and other medical services for people with HIV.
“It’s all absolutely free, and that’s, I think, fundamental as a motivation to be able to engage people on these kind of services,” he said. “So we need to advocate for truly free services and treatment as prevention for the rest of the country if we’re going to be able to duplicate what we see in B.C. in the rest of the country.”
The need for a national strategy, in his view, is even more underscored by the fact that aboriginal people are disproportionately affected by HIV and AIDS.
“What’s failing is the system in terms of bringing these strategies, making them socially and culturally effective and adaptive to the different populations,” he said in an interview after his presentation.
“So to be perfectly truthful…the reason why the HIV epidemic is disproportionately affecting First Nations is because we are neglecting our brothers and sisters within that community, and this is no longer acceptable.”
Montaner called it “mind-boggling” that while other countries such as the U.S., Brazil, France and China have adopted the Treatment as Prevention approach pioneered at B.C.’s Centre for Excellence in HIV/AIDS, Canada has not followed suit.
“When our citizens understand the discrepancy between the HIV new cases in British Columbia going precipitously down, and Saskatchewan going exactly in the opposite direction, they will have to ask themselves: is this the Canada we want to live in?” said Montaner.
“And knowing that in Saskatchewan…75% of those cases are aboriginals, is that the way we’re trying to repair the wrongdoings of the past? I don’t think anybody would be able to stand by that.”
Montaner acknowledged that health care is under provincial government jurisdiction, but stated that a standardized HIV strategy at a federal level “would be incredibly helpful” to deal with the epidemic across the country, particularly given the impact on First Nations communities.
“My position is that if this was H1N1 or the flu, or some other infectious disease that doesn’t carry the connotations of sex and drugs that are so problematic for our colleagues in Ottawa, we would be all over it,” Montaner contended.
“The opportunity for us to do the right thing, to control the epidemic, would not be passed by," he added. "And I think that the real dilemma is that we are basically looking the other way, because somehow our federal government doesn’t have the appetite to deal with something that they somehow perceive as being associated with conducts that they are uncomfortable with, to say the least.”
Montaner noted that B.C.’s HIV strategies, including normalization of HIV testing and free access to treatment, have been “incredibly effective” in decreasing morbidity, mortality, and transmission of HIV. The Treatment as Prevention strategy, which has been endorsed by the World Health Organization, involves widespread HIV testing and early access to antiretroviral therapy.
The event in Vancouver today was part of a weeklong initiative across the country intended to raise awareness of HIV among aboriginal people. HIV infection rates are 3.5 times higher in indigenous communities than among nonaboriginal Canadians.