Hon. John Horgan
Premier, British Columbia 

Hon. Adrian Dix
Minister of Health, British Columbia

Spencer Chandra-Herbert
MLA for Vancouver West End

Honourable Members,

We call on the provincial government to begin funding Pre-Exposure Prophylaxis (PrEP) as an HIV prevention tool, effective immediately.

British Columbia has led the world in providing access to HIV treatment, however the virus continues to disproportionately impact our communities. Gay, bisexual, and other men who have sex with men (gbMSM), including trans and two-spirit men, make up more than 50 percent of infections in B.C., a number which has not changed over the last decade. What has changed is the number of young gbMSM aged 20 to 24 diagnosed with HIV, which nearly doubled from 2012 to 2014. HIV diagnoses among ethnic minority gbMSM has also increased over the past decade, representing over a third of all cases.

The use of emtricitabine/tenofovir (TDF-FTC) for PrEP has been proven to prevent HIV in both clinical trials and real-world settings, and was approved by Health Canada for this purpose. PrEP is provided at no cost in San Francisco, Los Angeles, and New York City, and it is also publicly covered in Quebec. However, in British Columbia, Pharmacare still does not cover TDF-FTC for HIV prevention. Without public access, the most vulnerable individuals will not have access to this effective prevention tool, and British Columbians will not realize the decreases in new HIV infections being reported in cities as a result of access to combination prevention strategies, including PrEP. Given this government’s commitment to harm reduction, we are asking you to direct B.C. Pharmacare to immediately offer full coverage for TDF-FTC for HIV prevention.

On January 24, 2017, Mr. Horgan, opposition leader at the time, spoke to the need for PrEP, saying “Give people the medical devices that they need to protect themselves, and you’re going to reduce costs over time.” We couldn’t agree more. Every year more than 250 British Columbians get HIV, costing the healthcare system millions of dollars in treatment costs. We know making TDF-FTC publicly available will prevent HIV diagnoses. Adding PrEP to Pharmacare is not just the moral thing to do, it is the cost-effective thing to do.

As organizations that serve vulnerable populations, we know that PrEP works, and that stigma around talking about sex, HIV, and being gay is a continued barrier to reducing HIV diagnoses. We know more than ever about how to treat this virus and how to prevent it. Now is the time for this government to act. We share Premier Horgan’s hope that B.C. will cover PrEP as a medical service and that British Columbia will continue to lead Canada and the world in HIV elimination.

Signed,

AIDS Vancouver Island (AVI) in Victoria

Community Based Research Centre (CBRC) in Vancouver

Health Initiative for Men (HIM) in Vancouver

Living Positive Resource Centre (LPRC) in Kelowna

Dr Nathan Lachowsky, Assistant Professor, University of Victoria

YouthCO in Vancouver

And the physicians at Spectrum Health in Vancouver:

Dr Joss de Wet

Dr Carol Murphy

Dr Fraser Norrie

Dr Nivair Levitt

Dr Paul Gross

Dr Malcolm Hedgcock

Dr Kimberley Rutherford

Dr Tinus Wasserfall