CLEMENT'S BIAS EMBARRASSING CANADA AT HOME AND ABROAD

In three weeks, federal Health Minister Tony Clement has twice shown
his reliance on ideology over sound science. His performances at the
Canadian Medical Association's conference in Montreal and at the XVII
International AIDS Conference in Mexico City were stark reminders
that elected officials do not necessarily represent Canadians' best interests.

By challenging the efficacy of safe injection sites, Clement
tarnished Canada's image abroad and hampered efforts to contain the
spread and impact of HIV and hepatitis in Canada.

The AIDS conference is synonymous with grand polemical commitments
repeated by national politicians and global civil servants. This
month's meeting in Mexico City attracted practiced rhetoricians,
including Bill Clinton, UNAIDS head Peter Piot, Mexican President
Felipe Calderon and United Nations Secretary General Ban Ki-moon.

Their shared sentiments stressed harmonizing services, increasing
financial resources and adhering to global best practices to assist
those infected and affected by the disease and prevent new
infections. These best practices call for interventions based on
contextual particularities and local need.

Although such rhetoric does not necessarily lead to greater synergy
among donors and recipients, nor adherence to proven programs, for an
elected official to disagree with universally lauded initiatives
attracts deserved criticism.

In Mexico, Clement was a lone voice deviating from this platform,
embarrassing Canadians by questioning human rights, doubting years of
clinical research and challenging the authority of the B.C. Supreme
Court, the CMA, the World Health Organization and UNAIDS.

Claiming that safe injection sites are a "harm addition," rather than
part of a comprehensive "harm reduction" strategy, Clement also
discredited the lived experience of those working at the fore of
substance abuse and disease prevention in Canada.

It is important to separate fact from fallacy in Clement's position.
When questioned whether there was insufficient evidence to support
safe injection sites or if he was fundamentally opposed to such
programs, Clement argued there was simply not "enough proof" for the
public health measure.

Such reasoning speaks more to moral opposition than to sound judgment
deduced from the wealth of available research.

Outside of sub-Saharan Africa a primary vector for the transmission
of HIV and hepatitis is intravenous drug use. Safe injection sites
are proven to mitigate the spread and impact of these diseases. These
programs also diminish petty crime, reduce dangerous
injection-related litter and limit users from overdosing from drugs
with unknown potency and purity. This translates into less risk to
the public -- one reason for the court ruling in favour of
Vancouver's safe injection site, Insite.

A fallacy in Clement's stand is his claim Insite "only saves one life
per year." In fact, of 453 overdoses at Insite over two years, none
resulted in death. It is difficult to imagine these deaths being
prevented on the street. The efficacy of Insite is documented by
respected scientific journals including the British Medical Journal,
The Lancet and the New England Journal of Medicine.

To argue that banning safe injection sites will stop injection drug
use is naive. Instead, it would drive drug users further underground,
making it more difficult to provide treatment and care for this
stigmatized group. Fearing prosecution, this marginalized population
is less likely to seek assistance.

Safe injection sites do not hand out heroin or cocaine. They provide
comprehensive harm reduction strategies including counselling, drug
substitution therapy, support groups, needle exchanges and medical
aid. These programs also decrease the associated risks of intravenous
drug use for the general populace.

Clement's inaccurate perceptions reiterate the need to continually
question those claiming to speak for us.

When substantiated, objective knowledge is available, elected
officials are responsible for implementing interventions that
incorporate this research. Clement, a lawyer, would be wise to
recognize gaps in his knowledge and surround himself with those who
have taken the Hippocratic Oath. Consulting informed individuals
separates statesmen from politicians, the latter preferring
subjective judgment over empirical research.

Clement is a politician towing a line in the wrong direction. He was
invited to Mexico as an example of best practices, but failed to be a
model. He preached ideology over learned experience to the CMA,
performing a disservice to Canadians.

One service he has rendered is to remind us that skepticism is
essential when politicians deviate from fact.

I found comfort in seeing young Canadians confront Clement at the
AIDS conference. The challenge from our country's medical
professionals is an endorsement of their commitment to Canadian health care.