Today, on World AIDS Day, it is time to reflect on the history of this pandemic and to assess our progress and our failures. We are at a defining moment in the fight against HIV and AIDS. We can say with some certainty that an HIV- and AIDS-free generation is within our grasp. Much of the credit must go to Canadian research and innovation, or more specifically British Columbian research and innovation.
Great strides have been made in the treatment and prevention of HIV/AIDS by Dr. Julio Montaner and his team at the B.C. Centre for Excellence in HIV/AIDS (BC-CfE), who developed the highly-active anti-retroviral therapy (HAART), making it possible to foresee an eradication of this disease. The benefits of this treatment program are twofold: sustained HAART treatment decreases the amount of HIV virus in the blood and sexual fluids to undetectable levels, thus preventing morbidity and mortality, and equally as important, dramatically reducing the likelihood of HIV transmission by more than 95 per cent, making B.C. the only jurisdiction in North America where new HIV cases are declining. Elsewhere, HIV transmission rates continue to increase.
With the unwavering support of the British Columbia government, the BC-CfE has been an exemplary case study of how far TasP can go to change the face of HIV & AIDS. In B.C., in 1992, at the peak of the epidemic, more than 800 new people per year were diagnosed with HIV and at least one person was dying every day from AIDS. Since then, the number of new AIDS diagnoses have decreased by over 90 per cent and new HIV diagnoses has fallen by over 70 per cent. Pregnant women, who are HIV-positive, have had nearly 100 per cent success in not passing on the virus to their babies. Furthermore, vertical HIV transmission has been nearly eliminated and HIV new infections among injection drug users have declined by over 95 per cent.
Evidence is so overwhelming with regard to the efficacy of TasP that the World Health Organisation recently endorsed its use. China, was the first country to adopt the BC-CfE's TasP strategy as a national HIV/AIDS policy, and formalized its commitment and implementation in partnership with the BC-CfE and the province of B.C. Indeed, this week, in Beijing, B.C. Premier Christy Clark signed a Memorandum Of Understanding (MoU) between the National Center for AIDS/STD Control and Prevention, the Chinese Center for Disease Control and Prevention (NCAIDS/China CDC), and the BC-CfE that will facilitate the continued sharing of expertise regarding TasP. The MOU will establish a Fellowship program to allow six senior China CDC scientists to spend three months each, over three years, at the BC-CfE to gain expertise in the implementation, monitoring and evaluation of TasP, and to develop a strategy to expand the reach of TasP to other related therapeutic areas, including viral hepatitis (hepatitis B and hepatitis C infections).
The U.S. formally embraced TasP as a public health policy to control HIV/AIDS in 2011. This October, the U.K., France and Brazil joined them.
Earlier this past week, Desmond Tutu, Archbishop Emeritus of Cape Town and Honorary Chairman of Endgame, a global campaign to defeat AIDS, tuberculosis and malaria, urged President Obama to double the number of people receiving antiretroviral treatment through PEPFAR, which recognizes the benefit of HAART, especially in treating pregnant women. In response, the United States Senate approved an extension of PEPFAR to fight AIDS worldwide.
This begs the question -- given B.C.'s unprecedented success against HIV and AIDS; given WHO's endorsement of TasP; given the fact there are currently, an estimated 71,300 Canadians now living with HIV, with 3,175 new cases each year; given China's very active implementation and that of other nations including the U.S. and PEPFAR who acknowledge the extraordinary benefits of HAART; why hasn't Canada and our federal government embraced TasP?
Development of a vaccine is still a dream for the future. We have a Canadian strategy that's proven that it can act now to decrease transmission and lower the number of new cases -- a strategy that is internationally heralded and implemented and provides a real opportunity to end the HIV pandemic in our lifetime.
Canada should be proud. However, as is sadly the case with the current federal government that has been slow to embrace or accept any Canadian scientific innovation, the rest of Canada will be deprived of the opportunity to benefit from a treatment program that only British Columbians can access.
It is medically, ethically and morally wrong to ignore evidence. Science must triumph over ideology. Alleviation of human suffering deserves that much.
The Hon. Dr. Hedy Fry, P.C., is the M.P. for Vancouver Centre and is the Federal Liberal Health Critic. Before entering politics she practiced family medicine in Vancouver for 20 years and was President of the British Columbia Medical Association.
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