HEALTH CANADA SAW VANCOUVER SKID ROW HIV CRISIS AS A TEST: DOCUMENT

VANCOUVER (CP) - Health Canada saw the disturbing spread of HIV among
injection drug users in Vancouver's skid row as a test of its ability to
fight similar outbreaks it expected in other Canadian cities, a report
suggests.

As the federal health department rallied other federal agencies to deal with
the situation in early 1998, department officials in B.C. hoped their work
would yield relevant lessons, suggests a document obtained by The Canadian
Press through federal access to information legislation.

"It is believed that our success developing a comprehensive model of
intervention for interrupting the HIV epidemic among injection drug users in
the (downtown eastside) would be of great importance in preventing similar
crises, which are looming in other major urban centres in Canada," said the
January, 1998 memo.

Vancouver has become notorious among HIV experts because of its gritty
downtown eastside neighbourhood - a poverty-stricken, high-crime quarter of
the city that is home to hundreds of addicts.

Estimates vary, but many addicts in the tough neighbourhood are thought to
be infected with HIV acquired by shooting up cocaine and heroin with
contaminated needles.

"We have always thought that what is going on in Vancouver, when documented,
will be very useful for other regions in terms of what worked and what
didn't work," said Lisa Mattar, manager of Health Canada's Office of
Alcohol, Drugs and Dependency Issues.

The 1998 Health Canada memo, prepared to bring 11 other departments up to
speed on the issue, does not list other urban centres where the problem is
said to be looming.

But Dr. Don Sutherland of Health Canada's Laboratory Centre for Disease
Control offered some examples in an interview.

"You have some cities that have got the lid on the epidemic and other cities
where it's not under control - Ottawa, Quebec City and in Montreal," he
said.

"I think other cities in Canada need to be paying a lot of attention to what
is happening in Vancouver."

Downtown eastside advocates have been expressing their concerns about the
issue in Vancouver since the early 1990s.

But Sutherland suggested new infections among addicts may be greater in
Montreal than Vancouver. Toronto figures for 1998 were not immediately
available.

Some have said infections of Vancouver addicts have hit a saturation point.

But Health Canada officials are especially concerned about the spread of a
practise focused on the downtown eastside.

Addicts are switching from injecting heroin to injecting cocaine, said
Elaine Scott, a regional Health Canada director.

Cocaine use tends to be more frenzied than heroin, with addicts shooting up
to 20 times a day at a rate that causes many to ignore safety rules about
using clean, unused needles to avoid being infected with HIV.

One 1998 report by a coalition of Canadian addiction experts notes that the
troublesome heroin-cocaine mix has become the "dominant pattern" of drug use
in Vancouver which could spread to other cities.

"Is there another city that has exactly the same problem as Vancouver? The
simple answer is No," said Scott.

"But we did know there were certain practises that were beginning to move
east."

In Vancouver, Health Canada has put up $1 million for a drop-in centre and
housing.

It is also negotiating with Vancouver and the B.C. government on an Urban
Development Agreement that would yield more money for other programs.

Some have described the response as inadequate.

"It's a drop in the bucket," said eastside spokesman John Turvey, head of
the Downtown Eastside Youth Activities Society.

But a May 1999 update from Sutherland's department provides a blunt reason
for all Canadians to care about infected addicts in Vancouver and elsewhere.

The report notes that the virus that causes AIDS can creep beyond addicts
because drug users travel, socialize with non-addicts and have sex with
them.

It's a situation "that ultimately affects all of Canadian society," says the
report.

"It's certainly going to part of the insidious way in which this virus
spreads," said Sutherland.

"People should be aware that the edges of the epidemic are not always so
easy to detect."