Editor's note: This open letter was sent to Conservative Leader Stephen Harper, as well as NDP Leader Tom Mulcair, Liberal Leader Justin Trudeau, Green Leader Elizabeth May, and Assembly of First Nations national chief Perry Bellegarde.
September 22, 2015
Dear Prime Minister,
It gives me great pleasure to report that our 90-90-90 Target will be further considered as the strategy for the global control of HIV/AIDS, as part of the agenda on Sustainable Development Goals (SDGs) this September 27th, at a Special Session within the 2015 UN General Assembly (UNGASS) in New York City.
The 90-90-90 Target, based on the BC Centre for Excellence in HIV/AIDS-pioneered Treatment as Prevention® model, was formally embraced by Secretary General of the United Nations Mr. Ban Ki-Moon at the 2014 UNGASS. The 90-90-90 Target calls for at least 90% of all people living with HIV (PLWH) to know their sero-status by 2020, at least 90% of all PLWH to have access to high quality antiretroviral therapy, and at least 90% of those on treatment to have sustained HIV viral suppression. Meeting the 90-90-90 Target by 2020 will lead to a 90% reduction in the global burden of HIV/AIDS by 2030, when compared to a 2010 baseline (including AIDS-related morbidity and mortality, as well as HIV transmission).
Over the last year, numerous countries around the world, including the United States, China, South Africa, Brazil, India, Panama, Sierra Leone, Argentina, France, and Spain – among many others – have rallied behind the 90-90-90 Target. Most notably, Pope Francis gave thanks for the lives saved by “Treatment as Prevention” and noted such efforts “give witness to the possibilities for beneficial outcomes when all sectors of society unite in common purpose.”
Despite having corresponded repeatedly regarding this issue with the Prime Minister’s Office, the Health Minister, and officials at the Public Health Agency of Canada, our country has officially remained silent regarding these developments. This is puzzling, particularly as the proposed 90-90-90 Target is one of the most significant Canadian contributions to global health in the recent past.
Of particular note, First Nations people in Canada are disproportionately affected by the HIV/AIDS epidemic. While First Nations represent roughly 4% of the Canadian population, they accounted for 16% of new HIV infections and 21% of new AIDS cases in 2013. Equally troubling, HIV-positive First Nations are only half as likely to have access to life-saving antiretroviral therapy as non-First Nations individuals.
Global matters do not respect election cycles and demand continued attention. It is in this spirit that I am calling on you, Prime Minister, to embrace the 90-90-90 Target domestically, and to formally endorse the 90-90-90 Target during 2015 UNGASS. I similarly encourage you to ensure there is a strong Canadian delegation present at 2015 UNGASS to support the 90-90-90 Target.
In addition, I am calling on our federal electoral candidates to make this an issue, and to carry forward nationwide the successes achieved in BC using Treatment as Prevention®. Increasing testing and access to sustained treatment will lead to the elimination of AIDS. This would be a world-leading historical accomplishment for the next leader of Canada.
I would be happy to provide you with further insights regarding this issue.
Julio S. G. Montaner, OC, OBC, MD, DSc (hon), FRCPC, FCCP, FACP, FRSC
Professor and Head, UBC-Division of AIDS
UBC and St. Paul's Hospital Foundation Chair in AIDS Research
Faculty of Medicine, University of British Columbia;
Director, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Providence Healthcare;
UNAIDS Special Advisor on HIV Therapeutics;
Past-President, International AIDS Society