Canadians are rightly proud of the universal coverage provided by our national health care system.
Sadly, there are gaps in access with very grave consequences. In regions across the country, care and treatment is failing to reach those living with HIV.
Saskatchewan is among a number of areas in Canada – including Manitoba and even our nation’s capital – currently experiencing alarming spikes in the spread of HIV. In 2009, Saskatchewan saw rates of new HIV cases comparable to those in Nigeria.
Numbers have declined since this peak, partly due to that province’s four-year HIV strategy (concluded in 2014) that increased testing, treatment and support for people living with HIV and AIDS.
Unfortunately, rates of HIV in Saskatchewan continue to be the highest in the country. Incidence rates in 2012 were at 17 cases per 100,000. By comparison, the 2012 rates of HIV-positive test reports for B.C., Ontario and Quebec were 5.1, 6.2, and 5.6, respectively. Saskatchewan also continues to have high levels of HIV-related illness and death.
The province is looking for solutions. SHARE, the Saskatchewan HIV/AIDS Research Endeavour, is working to establish a research agenda and learn from successes in other provinces. They are turning to the trail-blazing work of the BC Centre for Excellence in HIV/AIDS for answers.
B.C. has an impressive track record for slowing the spread of HIV/AIDS in the province.
Between 1994 and 2013, the number of AIDS cases in B.C. went from 696 to 84, an 88-per-cent decrease. AIDS-related deaths went from 261 to 44, an 83-per-cent decrease.
Over the same period, mother-to-child transmission of HIV has been virtually eliminated, and overall HIV transmission has decreased by two-thirds.
How did they achieve this? The B.C. centre created a “Treatment as Prevention” strategy that provides widespread access to HIV testing, care, support and treatment. Keys to the strategy’s success have been political commitment, programmatic focus, ongoing innovation coupled with monitoring and evaluation, appropriate resourcing and free services (including fully free antiretroviral therapy, or ART).