The BC-CfE is bringing comprehensive, wrap-around, health care to residents of Vancouver’s Downtown Eastside (DTES) through the services it offers at its Hope to Health Research and Innovation Complex (H2H). Opened in late 2019 and located in the heart of Vancouver’s Downtown Eastside (DTES), H2H is a multi-building complex that provides integrated harm reduction, safer supply, and primary care services to its clients with on-site laboratory services.
H2H’s founding was thanks in large part to the generosity of long-time friend of the BC-CfE and ardent supporter Carl P. Vanderspek. Funds graciously donated by him facilitated the creation of H2H in the 600 block of Powell Street. Vanderspek achieved tremendous success in business, and he brought this business acumen to his philanthropic endeavours as well, seeking out causes with the most potential for success and which would generate the most positive impacts on underserved communities.
Vanderspek, who died earlier this year, saw that potential in the central strategy of the BC-CfE, which is Treatment as Prevention (TasP). Originally devised to help in the eradication of HIV/AIDS, the TasP strategy has since been applied to diseases like hepatitis C, mental illnesses, and substance use.
Dr. Rolando Barrios, the BC-CfE’s Senior Medical Director, said, “Enrolling, engaging and empowering clients is at the centre of the care provided at the Hope to Health Complex. An interdisciplinary team support clients to meet their essential psychosocial needs (housing, income, food security) and to develop a care plan that is centred around the client’s own goals.”
Research shows that access to a primary care provider is a key determinant of positive health outcomes. Yet an estimated 7,500 residents living in the core of the DTES have limited access to primary care. H2H provides integrated and accessible healthcare to its clients, many of whom have multiple, complex conditions that can include HIV, hepatitis C, substance use, and mental health issues.
Alongside funds contributed by Vanderspek, BC’s provincial government, Vancouver Coastal Health, and Providence Health Care also support H2H and its goal of engaging up to 1,400 of the 7,500 clients in the DTES who are currently ‘unattached’ to primary healthcare. So far, despite the COVID-19 pandemic and a shortage of nursing staff, H2H now has about 1,100 clients.
At H2H, these clients can access a safer supply of drugs, protecting them from the increasingly toxic street drug supply. In addition to safer supply, H2H offers a supervised consumption area, wherein nurses monitor clients’ drug use and intervene if needed in a safe and judgment-free space. In providing this range of services, staff at H2H are able to guide clients towards comprehensive primary and specialty care, support their mental health needs, help in demonstrating the safest way to use drugs, and assist clients in other high-priority medical areas.
The on-site laboratory at H2H, led by Dr. Zabrina Brumme, serves as both a clinical service and a support system for research activities. Clients can have testing performed to monitor genetic changes in viruses within their bodies which could lead to tailored therapy. Other testing focuses on the client’s genetic make-up, which can influence whether drug side-effects may occur. For research purposes, the H2H lab offers therapeutic drug level monitoring, an important tool for investigating drug absorption, treatment adherence, toxicities, and side-effects.
By offering these services within the DTES community, the staff at H2H are reducing unnecessary hospital visits for non-urgent cases, decreasing overall hospitalization rates and relieving some of the current pressure on the healthcare system.