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| : HIV/AIDS : Reports and Publications : HIV/AIDS Communiqué |
HIV/AIDS Communiqué - Volume 1 Number 1 - Fall 2002Table of content
In this issue:Introducing the Public Health Agency of Canada's HIV/AIDS Communiqué Welcome to the first edition of the Public Health Agency of Canada's HIV/AIDS Communiqué, a new communications tool designed to keep CSHA partners and others informed about new initiatives and ongoing work by all responsibility areas of the Public Health Agency of Canada involved in addressing the HIV/AIDS epidemic. The Public Health Agency of Canada's HIV/AIDS Communiqué will be published three to four times a year on this web site in order to make it more accessible to CSHA partners and all Canadians, as well as HIV/AIDS policy makers and front-line workers around the world. The HIV/AIDS Communiqué is produced by the HIV/AIDS Policy, Coordination and Programs Division in the Centre for Infectious Disease Prevention and Control (CIDPC) at the Public Health Agency of Canada. We hope you find the first edition useful and informative. Please do not hesitate to contact us with feedback and suggestions for future items - we welcome your input.  Funding Calls:Capacity Building Fund Issues Call for Proposals The Public Health Agency of Canada has issued the first call for proposals under its new National HIV/AIDS Capacity Building Fund. Given the increasingly complex requirements of HIV/AIDS prevention, care, treatment and support, Canada needs to continually renew and enhance the knowledge, skills and abilities of those working in the community. With this in mind, the overall objectives of the fund are to:
Funds will be allocated to initiatives that are national in scope and focussed on developing the capacity of staff and volunteers (and thus the capacity of communities across Canada) to strengthen their responses to the HIV/AIDS epidemic. Projects focussed on building organizational capacity are not eligible for the funds. The call for proposals was issued on September 1, 2002, with a submission deadline of October 15, 2002. A Funding Guidelines document has been developed to explain the fund and provide information on who can apply for funding, the types of projects that will be supported, what costs will be eligible, funding levels and project duration. Information is also provided on the review process and criteria, administrative and reporting requirements and application details. For a copy of the Funding Guidelines or to submit a proposal contact: Shane Rhodes Tel: (613) 946-3636 Issues:Syphilis Resurgence Raises Concerns About HIV TransmissionSyphilis rates are on the rise in Canada, and health officials are concerned about the potential impact on HIV transmission. The Centre for Infectious Disease Prevention and Control (CIDPC) notes that syphilis is a serious sexually transmitted infection that was rare in Canada only five years ago. In 2001, however, the rate of syphilis infections was more than double the 1997 rate. Outbreaks have been noted across the country - among sex trade workers in downtown Vancouver, among heterosexuals in Yukon, and among men who have sex with men in Calgary, Ottawa and Montréal. The interaction between syphilis and HIV makes this jump in infection rates even more troubling. Syphilis infection increases the risk of being infected with HIV by three to five times. As well, people who are already HIV-positive and also have syphilis infection are at greater risk of transmitting HIV to someone else. Syphilis can also progress more quickly and be more difficult to treat in people who are HIV-positive. Symptoms of syphilis infection include a painless open sore in the genital area, throat or anus; patchy hair loss; a rash anywhere on the body; fever, swollen glands and muscle and joint pain. If syphilis is left untreated, it may progress to tertiary syphilis and affect the brain, the blood vessels, the heart or the bones. Diagnosis of syphilis infection can be done through a blood test or by examining fluid from the sore under a microscope. Most cases of syphilis can be treated with injectable penicillin. In January 2002, Wyeth-Ayerst Canada Inc. formally notified their stakeholders of a decision to discontinue the distribution of Bicillin L-A (injectable benzathine penicillin G) in Canada. The Public Health Agency of Canada has been able to obtain information on alternative worldwide distributors of Bicillin to address availability in the short-term. CIDPC will continue to work with all involved parties to identify a long-term solution to the problem. Click here for more information on syphilis transmission, signs, symptoms, diagnosis and management. Multi-drug-resistant HIV is adding another layer of complexity to the HIV/AIDS epidemic in Canada and around the world but does not currently require extraordinary responses, according to a working group of experts that recently studied the issue. The working group, established in late 2001, is comprised of experts from the Public Health Agency of Canada (epidemiology, laboratory science, drug surveillance and policy); the HIV testing and counselling communities; the legal, ethical and human rights field; HIV/AIDS clinical care; and community HIV prevention and care. Among the issues examined was the need for counselling and phenotype and genotype testing to determine the presence and nature of drug resistance. Preliminary findings from this working group suggest that this added complexity requires all sectors and jurisdictions involved in responding to the epidemic to consider the impact of multi-drug-resistant HIV on policies and programs. The Public Health Agency of Canada will continue to monitor drug-resistant HIV through the Canadian HIV Strain and Drug Resistance Surveillance Program (CHSDRSP). CMEC Studies Determinants of Youth Sexual Health An investigation of the determinants of youth sexual health in Canada, especially with regard to HIV prevention, is nearing completion and work has begun on the final report. The Canadian Youth, Sexual Health and HIV/AIDS Study is being administered by the Council of Ministers of Education Canada (CMEC) with funding from the CSHA. More than 10 000 youth across Canada in grades 7, 9 and 11 were surveyed in the 2001-2002 school year by a consortium of researchers from four Canadian universities. The results of this research will inform program and policy development for many levels of government and communities in Canada. The Public Health Agency of Canada working group led by the HIV/AIDS Policy, Coordination and Programs Division is working with the researchers to guide the project though its final stages, including the development of the study final report, which should be available by March 2003, and a dissemination plan. top The Government of Canada's first progress report on implementation of the Declaration of Commitment adopted at the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) was submitted to UNAIDS in the spring of 2002. UNGASS grew out of debates in the UN Security Council in the fall of 2000, where member states expressed alarm at the growing impact of HIV/AIDS on human health and society. As a result, the UN General Assembly agreed to convene its first ever special session on a health issue. Held in June 2001, UNGASS brought together 189 member states and representatives of civil society to consider the international community's response to the HIV/AIDS epidemic. The main output of the Special Session was a Declaration of Commitment on HIV/AIDS, a practical blueprint for action that is providing fundamental guidance for global HIV/AIDS initiatives. Entitled Global Crisis - Global Action, the Declaration addresses such issues as leadership; prevention; care, treatment and support; human rights; reducing the vulnerability of children; alleviating social and economic impacts; and HIV/AIDS in conflict areas. The Declaration of Commitment includes a requirement for governments to report regularly on its implementation, with the first report due in 2003. However, due to the ongoing urgency of the global epidemic, in March 2002 the UN General Assembly passed a resolution requesting a progress report on implementation of the Declaration at the 57th General Assembly in September 2002. To meet this deadline, all countries were asked to report by the end of April 2002. Health Canada's International Affairs Directorate (IAD) coordinated the development of the Government of Canada's "country report." based on input from federal government partners involved in implementing the CSHA and other HIV/AIDS-related efforts including the Canadian International Development Agency. The report was also reviewed by FPT AIDS and representatives of Health Canada's Working Group on International Issues (the Canadian AIDS Society, the Interagency Coalition on AIDS and Development, the International Coalition of AIDS Service Organizations, the Canadian HIV/AIDS Legal Network and the Canadian Public Health Association). Despite the time restrictions, Canada was one of only a few countries to solicit input from the voluntary sector. The Government of Canada's Report on the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS is available on the IAD web site. New Resource for Private Sector A new document that appeals to the Canadian corporate sector's sense of social responsibility and examines how and why businesses must become engaged in the global response to HIV/AIDS - both for their own good and that of society as a whole - was launched by Health Canada at the XIV International AIDS Conference in Barcelona. Entitled Enhancing Canadian Business Involvement in the Global Response to HIV/AIDS, the report was developed by the International Affairs Directorate at Health Canada. Its goal is to help stimulate a dialogue and encourage the involvement of Canada's private sector in responding to HIV/AIDS at the international level. The report, which is essentially an information resource, explains the growing threat of HIV/AIDS in today's highly complex and interdependent world economy. It addresses the actual and potential business impact of HIV/AIDS, and makes the case that no business or organization is immune to the HIV/AIDS epidemic. Enhancing Canadian Business Involvement in the Global Response to HIV/AIDS is available in CD-Rom or print format from the Canadian HIV/AIDS Clearinghouse of the Canadian Public Health Association or in electronic format. Work in Progress:Policy Initiatives Update The Policy Unit of the HIV/AIDS Policy, Coordination and Programs Division is pursing a number of strategic initiatives to further implementation of the CSHA. The following is a snapshot of some areas currently being addressed by the Policy Unit.
The HIV/AIDS Policy, Coordination and Programs Division is working with the Natural Health Products Division of Health Canada to identify key policy issues that need to be addressed to improve the effective use of and access to complementary and alternative practices and therapies. The two divisions are also exploring ways to strengthen Health Canada's internal coordination of policies and activities in this field.
The Public Health Agency of Canada continues to work with Strategy partners to develop a social justice framework for the CSHA, based on four guiding principles identified by participants at the direction-setting follow-up meeting in Montréal. Those guiding principles are that the social justice framework:
Participants at the Montréal meeting expressed that, while some flexibility is necessary, the social justice framework should be a common tool for the development and implementation of policies and programs and should include research and evaluation conducted under the CSHA.
The Public Health Agency of Canada has struck an internal working group on HIV Vaccine Development and Equitable Distribution. This follows the release of a report on HIV vaccines by the Canadian HIV/AIDS Legal Network and the significant attention focussed on this issue at the XIV International AIDS Conference in Barcelona. Once its terms of reference have been established, the working group will develop a mechanism for consultation and collaboration with external partners.
A study to identify new and emerging areas for clinical trials in Canada, including an assessment of the current capacity for conducting trials, is nearing completion. The study results will be shared with Canadian Institutes of Health Research (CIHR) to inform their planning process for 2003-04.
A study on the feasibility of providing controlled substances to HIV-positive injection drug users in care settings is nearing completion and will provide the evidence needed to support policies and programs that ensure ethical, effective and accountable care for injection drug users. The study gathers the best available research and anecdotal evidence from Canada and other jurisdictions on initiatives such as heroin prescription, methadone maintenance and stimulant replacement therapies, as well as supervised consumption facilities. top Work is continuing on the redesign and relocation to a new administrative structure for the Community-Based Research (CBR) Program of the Canadian Strategy on HIV/AIDS (CSHA). Initiatives under the CBR Program include General CBR, Aboriginal CBR, CBR Capacity-Building and Aboriginal CBR Capacity-Building. A transition team working in the HIV/AIDS Policy, Coordination and Programs Division has administered them since April 2001, when the former administrator - the National Health Research and Development Program - ceased to exist. Among recent developments:
Work is well advanced on the annual World AIDS Day report produced by the HIV/AIDS Policy, Coordination and Programs Division of the Public Health Agency of Canada in collaboration with CSHA partners. In 1997, the Minister of Health committed to report annually to Canadians on the progress being made in addressing the HIV/AIDS epidemic in Canada. Past reports have been released on World AIDS Day (December 1st) of each year. This year, interviewees have been asked to identify challenges they face in addressing the epidemic and priorities for the coming year. As well, the report will contain information on Canada's engagement in the global response to HIV/AIDS, and a few short feature articles will draw attention to people directly affected by HIV/AIDS as well as those who are working in the HIV/AIDS field. As in previous years, drafts of the report will be circulated to partner organizations for comment and an editorial board comprising government and NGO representatives will be assisting with the development of the report. For more information on the World AIDS Day report, contact Shannon Brunton Stephens of the HIV/AIDS Policy, Coordination and Programs Division at shannon_brunton_stephens@hc-sc.gc.ca. Direction-Setting Follow-Up Meeting in Montreal, April 14-16, 2002 The CSHA's collaborative direction-setting process took an important step forward in April 2002 when 180 people representing the spectrum of Canada's HIV/AIDS community met in Montréal to consider next steps in implementing the Strategy and ensuring it remains credible, relevant and responsive. Organized by the HIV/AIDS Policy, Coordination and Programs Division in collaboration with the CSHA Direction-Setting Process Task Group (composed of representatives of CSHA partners), the Montréal meeting was a follow-up to the inaugural direction-setting meeting held at the Gray Rocks Inn in the fall of 2000. The goals of the Montréal meeting were to:
Key outcomes of the meeting included the development of over 20 actions to move forward the first nine directions as well as a recommended process for the development of a five year strategic/operational plan to address HIV/AIDS in Canada. Click here for Record of Proceedings: Montreal Direction-Setting Follow-up Meeting Since April, the Public Health Agency of Canada has been working with the Direction-Setting Process Task Group to develop and implement a comprehensive follow-up and communications strategy that will enable partners to move forward together on the outcomes of the Montréal meeting. Among recent developments:
CSHA Resource Allocation Process Moves Forward Work is proceeding on the review of how federal resources ($42.2M) under the CSHA are allocated. The current resource allocations were developed in late 1997 based on recommendations from national partners and others involved in the consultation process. In June 2001, Health Canada completed a framework to guide ongoing reviews of federal resource allocations under the CSHA. In late 2001, HIV/AIDS Policy, Coordination and Programs Division developed an action plan to guide the first review. The use of an independent consultant and an advisory task group are key elements of the action plan. The information gathering/analysis stage is underway. Martin Spigelman and Associates is currently reviewing information about CSHA expenditures and other key documents in the literature. The first meeting of the review task group is expected to be held in mid-October 2002. In addition, Health Canada is exploring ways of integrating the review with the ongoing development of the five year strategic/operational plan to ensure that federal resources are allocated in line with the overall strategic/operational plan to address HIV/AIDS in Canada for the next five years. Events:Canada at BarcelonaMore than 15 000 delegates from around the world attended the XIV International AIDS Conference in Barcelona, Spain, from July 7 - 14, 2002, including a strong Canadian delegation that was proactive, vocal and engaged throughout the five-day event. Scientists, health care workers, heads of state, policy makers, NGOs, people living with HIV/AIDS and the media were all in attendance at the Barcelona conference, which focussed on transforming knowledge and political will into commitment and action. Significant attention was also given to gender issues, harm reduction and possibilities for HIV/AIDS treatment in low-income countries. Political commitment to address the global HIV/AIDS epidemic was seen to be higher than ever at the biennial conference, which was attended by more than 20 current and former heads of state. Nevertheless, the outlook continues to be disturbing: the United Nations Joint Programme on HIV/AIDS (UNAIDS) released new data indicating that the HIV/AIDS epidemic is still in its early stages. UNAIDS predicts 45 million new HIV infections worldwide by 2010. Such a scenario would see an estimated 25 million children orphaned, reduced global economic output, and the disintegration of some societies due to the immense scale of the devastation. The conference confirmed that HIV/AIDS prevention and treatment are not mutually exclusive and should be pursued in tandem, and that treatment should be made widely available throughout the world. Also at the conference, Africa's First Ladies agreed to pursue united action to address the HIV/AIDS epidemic, and a "Barcelona Women's Bill of Rights" was produced and disseminated. From a Canadian perspective, the XIV International AIDS Conference was a tremendous opportunity to learn from colleagues and partners in other countries while also sharing information on Canada's domestic and international response to the epidemic. More than 250 Canadians attended the conference and were involved in some 120 oral and poster presentations. Health Canada's International Affairs Directorate (IAD) coordinated a cohesive federal government presence in Barcelona through an inter-departmental planning process that began several months before the conference. The Government of Canada's delegation at the conference included officials of Health Canada, the Canadian International Development Agency (CIDA), the Canadian Institutes for Health Research, Correctional Service Canada (CSC) and the Department of Foreign Affairs and International Trade (DFAIT). The Hon. Susan Whelan, Minister for International Cooperation, was head of the Government of Canada delegation. Dr. Paul Gully, Senior Director General, Population and Public Health Branch at Health Canada, served as alternate head. Ontario's Minister of Health and Long-Term Care, the Hon. Tony Clement, also attended the conference. The CSHA's non-government partners were also well-represented in Barcelona. Canadian government and non-government organizations had a unified presence at the conference through the "Canada Booth," which was coordinated by the Canadian HIV/AIDS Clearinghouse under contract to the HIV/AIDS Policy, Coordination and Programs Division of Health Canada. The booth was both a distribution point for information about Canada's response to the HIV/AIDS epidemic as well as a meeting place for Canadian delegates in Barcelona. Among the publications distributed to delegates by Health Canada was a CD-ROM containing over 350 resources from CSHA partners (to order copies of this CD-ROM, contact the HIV/AIDS Clearinghouse of the Canadian Public Health Association As a Cooperating Institute of the conference, Health Canada co-sponsored satellite sessions on legal, ethical and human rights issues; vaccines; the Global Research Network on HIV Prevention in Drug-Using Populations; gender; and citizen-engaged policy. Officials of the department also made 10 oral and poster presentations. CIDA, also a Cooperating Institute, announced $53.3 million in grants for HIV/AIDS projects in Kenya, China, Pakistan, the Caribbean and southern Africa. As a follow-up to the XIV International AIDS Conference, IAD hosted a "lunch and learn" session at Health Canada headquarters in Ottawa on August 14, 2002. About 80 people attended this informal debriefing session, including NGO representatives and staff of Health Canada and other federal departments and agencies such as CIDA, CSC, DFAIT and the Patented Medicine Prices Review Board.
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), a Calendar of Canadian Participation in Barcelona that highlighted Canadian involvement in conference workshops, poster presentations, skills-building activities and satellite sessions.