STILL TIME FOR OTTAWA TO DELIVER IN GLOBAL RESPONSE TO AIDS CRISIS

Two years ago, Canada hosted the largest global gathering in the
history of the AIDS pandemic -- the XVI International AIDS Conference
in Toronto.

Among more than 20,000 attendees, there was overwhelming consensus
about what needs to be done to prevent the further spread of HIV,
care for those living with and affected by the virus, and mitigate
its impact on entire communities and economies. We have, or could
easily have, the tools at hand to take effective action. What is
lacking is leadership from those making policy and committing funds.
Hence the theme of the 2006 conference: "Time to Deliver."

Canada was widely criticized at the conference for seemingly
abdicating its traditional role of leadership. Funding announcements
were delayed, the government was waffling about Vancouver's
supervised injection site, and Canada's high-profile promise to help
increase access to affordable AIDS medicines was still unfulfilled.

Fortunately, there is still time for Canada to deliver. This week,
the world meets again in Mexico City for the next International AIDS
Conference. Here are three areas in which the federal government should act:

1) Fixing Canada's Access to Medicines Regime. In 2004, Parliament
unanimously enacted a precedent-setting law aimed at helping
developing countries get more affordable generic medicines. But it
has proven lacklustre.

Recently Rwanda announced that it would use Canada's Access to
Medicines Regime to import a key AIDS drug from Canada's largest
generic pharmaceutical manufacturer, Apotex. This is a global first.
But even this breakthrough took four years! Given the unnecessary red
tape in the law, Apotex has indicated it is unlikely to try again,
while developing countries have repeatedly pointed out ways in which
Canada's law does not accommodate the practical realities of drug
procurement. Unless the system is made more user-friendly, this first
use of Canada's law could also be the last.

We have proposed to Parliament a simple "one-licence solution" that
would streamline the process for producers and purchasers, replacing
the existing cumbersome process of separate negotiations and
licensing for every single order of medicines by individual
countries. Yet Ottawa has declared that it would be "premature" to
make any changes. The AIDS conference would be a good opportunity to
commit to fixing the law.

2) Supporting harm reduction strategies as part of federal drug policy.

For reasons that appear ideological, the federal government has
dropped harm reduction entirely from its new National Anti-Drug
Strategy, choosing instead to spend money on U.S.-style approaches
that are proven failures, including pursuing mandatory minimum
sentences for drug offences. This money could be much better spent on
health services to treat addictions and prevent associated harms,
such as the spread of HIV and hepatitis, among people who use street drugs.

One high-profile example of such services is Insite, Vancouver's
supervised injection facility. Research demonstrating the benefit of
this health facility was confirmed recently by the federal
government's own expert advisory committee, and several other
Canadian cities have expressed interest in creating similar sites.
Yet Insite's operators had to go to court to prevent the government
from withdrawing its legal permission to operate -- protection
recently granted by a court order. In response, the government has
launched an appeal, while it maintains a moratorium on new
applications to open any other such facilities.

Were it to listen to reason -- and its own experts -- the federal
government would reintroduce harm reduction as a key part of any
pragmatic, evidence-based, comprehensive approach to dealing with
drugs. Doing so saves lives and money.

3) Reinstating funds cut from the federal AIDS strategy.

A few years ago, recognizing that federal AIDS funding had been
frozen for a decade (at about $1.40 a year per Canadian), all
political parties on a parliamentary committee recommended gradually
increasing that funding over a five-year period. This funding
supports community organizations doing HIV prevention education and
providing vital support services. The federal government of the day
agreed and began to phase in this increase.

But late last year, the federal government confirmed that it was
implementing cuts to domestic AIDS funding, as well as redirecting
some of the remaining funds to a new initiative on HIV vaccines in
collaboration with the Bill and Melinda Gates Foundation. In total,
funding for existing and planned programs and services was reduced by
almost 15 per cent last year, with further cuts expected this year.

While we support this new HIV vaccine initiative, there isn't
additional funding to go with it. This means it comes at the expense
of existing commitments to HIV prevention programs and support
services on the ground, even as the HIV epidemic continues to spread
and affects a growing and increasingly diverse cross-section of
Canadians. What could be an example of leadership in finding a long-
term solution is turning into a short-sighted exercise in sacrificing
services and prevention efforts needed now.

The federal government needs to recommit itself to the original plan,
endorsed previously by all parties in Parliament, to scale up federal
AIDS funding for existing needs, and ensure that the new HIV vaccine
initiative is supported by truly new funds, not monies diverted from
other needs.

At the 2008 AIDS Conference, Canada has an opportunity to signal its
intention to rejoin the global fight against AIDS. In the past two
years, we have lost ground. It's past time to deliver.