People across Canada living with HIV feel abandoned by the federal government because of changes to the way the Public Health Agency of Canada funds the response to the virus, according to several organizations providing support services.
The full picture of which organizations and services have lost their funding as a result of the changes is still developing. This year, the agency spent $24.6 million on community-based programs through its HIV and Hepatitis C Community Action Fund.
Christian Hui, an HIV-positive man who co-ordinates the Ontario Positive Asians Network with Asian Community AIDS Services (ACAS) in Toronto, says the PHAC’s planned funding cuts will hurt those in the East and Southeast Asian community who are living with HIV or AIDS.
“I’m actually really disappointed because I really believe in the work that I do,” he says. “Also, I’m really sad that a community or a network that we have worked so hard on may not be able to survive because of the funding cuts.”
ACAS is one of 42 AIDS Service Organizations across Canada that previously received funding from PHAC for program delivery that now will have to search for new sources of revenue in order to keep operating.
Focus shifting to prevention
Citing a shift in focus from treatment support to prevention, the health agency said its funding of programs like Hui’s will end in March 2017. That, Hui says, will leave many in his community without culturally specific peer support and access to services.
“It’s catastrophic for Canada’s ability to respond to the needs of people living with HIV and hepatitis C,” said Gary Lacasse, executive director of the Canadian AIDS Society, which will also have between 30 and 50 per cent of its government funding cut.
Lacasse says the changes amount to a cut in social support services that ultimately help HIV-positive people access treatment, and they will have a cascading effect on the country’s ability to contain the epidemic. About 75,000 Canadians were living with HIV at the end of 2014.
With political letter-writing campaigns and a change.org petition gearing up, Lacasse is calling on Health Minister Jane Philpott to increase funding for HIV overall and create a national “seamless response” to HIV, hepatitis C and other sexually transmitted and blood-borne infections.
Aboriginal network could lose up to 70% of funding
The news of the changes came as a blow to organizers at the Canadian Aboriginal AIDS Network, who found out they will lose upward of 70 per cent of their funding, which could lead them to drastically reduce staff and cut programs.
An estimated 6,850 Indigenous people were living with HIV at the end of 2014 and represented nine per cent of new infections that year, according to the PHAC.
“Overall, it’s about the lack of voice for Aboriginal people across Canada to get care, treatment, and support services from Aboriginal AIDS service organizations in particular,” said Ken Clement, CEO of the Canadian Aboriginal AIDS Network.
However, Dr. Greg Taylor, Canada’s chief public health officer, says he hopes the work of those groups that lose their funding will be offset by 41 new organizations, including five additional First Nations organizations, invited to participate in the next round of applications.
‘Treatment is the side of the provinces and territories … prevention is where we want to focus.’
– Greg Taylor, chief public health officer
“Fundamentally, public health is about prevention, and, yes, we would want to prevent these infections, and that is the focus,” Taylor said. “Treatment is the side of the provinces and territories who are accountable for treatment. That’s their responsibility, and we’ll support them and assist them, but prevention is where we want to focus.”
Taylor says the decision of which groups receive federal funding was based not on past performance but solely on the new prevention mandate.
Changes made too fast
Taylor says the Community Action Fund can now focus on prevention in higher-risk populations, including sex workers and transgender people, and on geographic areas, which were added this year.
“Certainly, with HIV, we have a pretty good idea in some places, like Saskatchewan, the rates are fairly high compared to other parts of the country, like Nova Scotia, where it seems to be very, very low,” he said
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But many of those providing services say the changes have come too fast and don’t give them enough time to find new funders. The Aboriginal AIDS Network will have to close if it can’t find funding elsewhere because it is a national organization that the provinces won’t fund, Clement said.
Clement, Lacasse and others say the federal government is abandoning what they say is a more holistic approach to tackling HIV/AIDS at the national level.
Hui fears that once the programming disappears, people living with HIV who rely on social supports funded by PHAC will have worse outcomes.
“So, how will we be able to meet the needs of these individuals?” he said. “I don’t have the answer for that. But my guess is that their health outcomes will worsen, and they will end up costing the health-care system more in the long run.”