Elections 2019

CAS AND THE 2019 ELECTION

In collaboration with the Ontario AIDS Network, the Coalition des organismes communautaires québécois de lutte contre le sida (COCQ-sida), the Pacific AIDS Network (PAN), the Alberta Community Council on HIV (ACCH), and the Ca nadian Aboriginal AIDS Network (CAAN), CAS is happy to provide this guide to Canada’s HIV organizations and allies on how to engage Canadian political parties on their role in ending HIV in Canada. We also have written directly to the parties, you will find our letters and answers and commitments here.

As you know, we are in the midst of a federal election that will conclude with voters making their choices on Monday, October 21, 2019. This is a crucial election and we have an opportunity to let all candidates, parties and voters know that the HIV/AIDS epidemic in Canada still requires a strong federal government response, and to seek their commitments to supporting the fight against HIV/AIDS in our community. We also require a strong government response to address criminalization, ensure a safe drug supply and meet commitments to harm reduction. So far, it seems to be a close election with no obvious outcome. This is the perfect opportunity to persuade the candidates and parties who need every vote.

Elections are important opportunities to make our collective voice heard and Canada needs a government that is committed to sustained and effective investments in our work. While most of us work in charitable organizations that must avoid partisan activities (exclusive criticism of only one party or endorsement of any one candidate or party) it is important that we raise issues with all candidates and with voters. It’s important that Canada’s HIV sector be a part of the conversation and there are a number of activities that CAS is coordinating on behalf of our members. We thank the Ontario AIDS Network (OAN) for their work in the development of this resource.

CAS has no political affiliation, but we feel an urgent need to make our members, affiliates and the people we serve aware of the political issues surrounding HIV in Canada. CAS’s members and partners have done and continue to do incredible work. With renewed commitment from political hopefuls as we move into the next term of federal leadership, we can ensure continued progress in the right direction!

Coordinating with our Regional Partners

CAS is collaborating with the OAN, Coalition des organismes communautaires québécois de lutte contre le sida (COCQ-sida), the Pacific AIDS Network (PAN), the Alberta Community Council on HIV (ACCH), and the Canadian Aboriginal AIDS Network (CAAN) to send each party leader a letter asking them to commit to the following:

Ensuring that people living with HIV, people with lived experience of hepatitis C and others with lived experiences are involved in significant roles in the Government of Canada’s response to HIV/AIDS and STBBIs in Canada and abroad.
Reaffirming the commitment of Canada to the UNAIDS objectives for the elimination of HIV by 2030 (95-95-95).
Ensuring the sustainability of the front-line, community-based response to HIV, HCV and STBBIs through the stability and growth of the Community Action Fund and other such funding initiatives (for more please refer to the Missing Millions document from the Canadian HIV/AIDS Legal Network found here).
Democratizing access to testing for HIV, HCV and other STBBIs by encouraging the development and market availability of testing technologies, including point-of-care tests, dried blood spot tests and self-tests, developed in Canada.
Ensuring that the Government of Canada does not create barriers to the provinces’ harm reduction public health interventions, including those aimed at preventing not only HIV but also overdoses and overdose deaths, in recognition of harm reduction as one of the four pillars of the Canadian Drugs and Substances Strategy.

Our goal is to host a signing of these commitments in each region of Canada in the coming weeks. As parties confirm their support, we will then report to our members on the progress of each party’s commitment. We recognize that this is not an exhaustive list and expect that the work of other partners will also be inclusive of issues such as the criminalization of HIV non-disclosure, treatment access and more.

It is also worth noting that other HIV and LGBTQ advocates, including at the national level, are engaging the parties during the election on many of these same issues; it is important that we collectively amplify the voices and influence of the HIV sector with multiple, complementary activities targeting the parties and candidates seeking public support. For instance, information about the Canadian HIV/AIDS Legal Network’s harm reduction advocacy can be found here or the national Proud to Vote Campaign focused on LGBTQ advocacy can be found here.

For your part, we ask that you engage with your immediate community to let them know the potential impacts of this election and the commitments each party has made to address HIV. Reach out to your local candidates and let them know that CAS has submitted a list of commitments to their party leaders.

Once the responses from the party leaders have been received by CAS and our partners, we will share them with everyone.

Suggested Questions for Candidates

Given the competition for attention during this period, we suggest that you focus your efforts on a small number of key issues.

Federal Funding

While we are thankful for the government’s recent investment of $930 million in the Global Fund – a 16% increase over last year – the national HIV response is chronically underfunded. Recent governments have underfunded and diverted funds earmarked for the national HIV response to the tune of $100 million between 2004 and 2016. This is at a time when rates of HIV have increased by 17% over the past five years, in sharp contrast to the significant decrease in new HIV transmissions seen in many other countries with comparable health care systems to Canada’s. What is your commitment to deepening the Federal government’s investment in the HIV epidemic in Canada and will your party keep this commitment? If elected, what will you do personally to ensure it is kept?
Will you commit to increasing the funding allocated for addressing HIV in Canada to $100 million, as recommended by the Standing Committee on Health in 2003 and now again in 2019, and proportionately increase funding for all activities funded under the Federal Initiative including direct HIV program funding to community organizations. Would you also review the funding model to include mission-based sustained funding?

Universal Treatment Access – Several parties have announced their commitment to a national pharmacare program. A significant number of Canadians living with HIV do not have access to effective treatments, free of significant deductables and co-pays. In addition, many Canadians do not have access to effective prevention tools such as Pre-Exposure Prophylaxis (PrEP) for the same reason. What are your thoughts about ensuring that universal HIV treatment and PrEP are included in such planning?

HIV Testing – About 14% of Canadians living with HIV have not yet been diagnosed (that’s about 9,000 people) and once diagnosed many experience barriers to accessing effective treatment. These issues are compounded for newcomer and Indigenous communities, as well as for people who use substances. How does your party plan to address this reality?

Harm Reduction – Canada’s overdose epidemic is a national crisis and more than 11,000 Canadians have died of overdose since 2016. What is your commitment to ensuring that supervised consumption and harm reduction services, are available in every community?

HIV Stigma – HIV continues to be a very stigmatized disease. In all instances the stigma and discrimination associated with HIV has a direct and negative impact of the health and wellbeing of all those living with and affected by HIV. This stigma also affects people’s willingness to be tested and (if needed) to seek treatment and support. Fear of criminalization for failure to disclose HIV prior to any sexual contact prevents people from coming forward to test and drives the epidemic underground. Stigma can also affect public policy and support for HIV prevention initiatives, particularly harm reduction services. How can your government address HIV-related stigma and discrimination in meaningful ways?

Our success – Would you say that Canada is making meaningful progress to address the HIV epidemic on every level? Including the quality of life of those living with HIV? If not, what else in your mind needs to be done to make meaningful progress and what are you going to do to get us there?

Social Media

If you are active on social media, making a post on Facebook, Twitter, Instagram, etc. helps to build momentum and reach a larger audience.

It is crucial to create a sense of urgency amongst community members. While it is important to share policy “talking points” like those we’ve provided, personal stories (and photos) are much more effective in moving votes. Encourage voters who are comfortable doing so to explain why they are personally voting in support of HIV-supportive candidates and parties, as well as asking their networks to do the same. Presenting individual narratives can foster conversations about the election, issues related to HIV, as well as engagement in the political process.

We’re also asking that you consider sharing some of the following hashtags as you post: #CDNpoli #elxn2019 #HIVAdvocacy #HIVote

In addition, we’ve developed some sample posts:

Will Canada end the HIV/AIDS Epidemic by 2030? We already have the tools, we just need the political support!
For the first time in history Canada can declare victory against the HIV epidemic – if we continue to support community-based organizations!
Complacency is our real danger: 6 to 7 people are still diagnosed with HIV in Canada every day.
Complacency is our real danger: about 14% of people in this country who have HIV have not been diagnosed.
To end the HIV epidemic in Canada, we need to make investments in 100% coverage of drugs for treatment and prevention of HIV.
To end the HIV epidemic in Canada, we need to make investments in expanded prevention and early diagnosis programs.
When will we ensure universal coverage? Not all provinces in Canada fully cover HIV prevention and treatment medications.
To end the HIV epidemic in Canada, we need to make investments in continuation of proven harm reduction programs.
To end the HIV epidemic in Canada, we must invest in supportive housing for the significant numbers of Canadians with HIV who are homeless or insecurely housed.
Funding community-based programs and AIDS Service Organizations (ASOs) provides a return on investment of $5 savings for every dollar spent.
Canada can do more to ensure that the lives of those living with HIV stay on the political radar, especially when success is in sight.

Getting out the Vote

There are a number of opportunities we urge you to consider in raising HIV issues during this election:

If you are unsure who your local candidates are, go here to find out.
If you are a newcomer to Canada or work with newcomers go here to learn more from settlement.org.
Urge community members to ask candidates about their commitments to the fight against HIV/AIDS (some suggested questions follow). You could use newsletters, emails, meetings or social media to spread the word.
Write letters to the editor urging voters to consider candidate’s commitment to the fight against HIV/AIDS.
Have a Board member or supporter attend all-candidates debates to ask questions (note that in most formats people are only allowed one question each). You may want to write several questions down in advance so that you are ready. Be strategic, sit in the front of the room or next to a microphone. If you don’t get a chance to speak, wait until the end of the meeting and ask each candidate their position and give them a copy of the questions you would like answered. Some sample questions are included below.
If you are unsure when candidate debates will take place reach out to you local candidate’s office for details. Once you have confirmed debate dates share the time and location with your members. Consider meeting up with members at debates and coordinating your response.
Write or email candidates in your area asking their response in writing to the questions (in this case you should feel free to add background information).
Drop by your candidates’ campaign offices in person to drop off material and ask questions. A friendly exchange can make an impact on campaign workers and the candidates themselves.
Ask community members if they are registered with Elections Canada and encourage them to vote early.
If you haven’t already done so, consider contacting community members on election day (or leading up to it) to ask if they have voted.
1. If not, remind them how important it is to do so.
2. If they need assistance (getting to the polls, for example), offer it if you have the resources.
Remind, remind, remind. Then remind again. It often takes several reminders before people actually vote. Create a schedule for social media posts and emails with a building narrative to encourage action. (“Only 10 days until the election”, etc.)

Spokespeople

Determine your agency’s spokesperson in advance of any media outreach. If you need someone to offer comment on national issues, feel free to recommend the following:

Gerry Croteau
Board Chair
gerryc@cdnaids.ca

Gary Lacasse
Executive Director
gary.lacasse@cdnaids.ca

If you have questions or comments related to our election package please let us know by sending an email to gary.lacasse@cdnaids.ca.

A Background on the Issues

The need for a federal response to HIV/AIDS is as crucial as ever. Consider:

There are more than 65,000 persons living with HIV currently in Canada; however, about 9,000 are unaware of their diagnoses. In addition, there are approximately 14,000 people who are undiagnosed and are not currently accessing effective treatment.
Looking at the latest national epidemiological data available, a total of 2,402 new HIV diagnoses were reported in 2017 in Canada; an increase of 3% compared with 2016 and an increase of 17.1% since 2014.
Hepatitis C (HCV): There are approximately 250,000 people living with HCV in Canada and an estimated 40% of these people are unaware of their infection.
As with HIV in Canada, it seems that HCV infection rates are slightly increasing, with 11,592 cases reported in 2017 (for a rate of 31.7 per 100,000 people). This represents an increase of 301 cases from 2016, when the rate was 31.3 per 100,000 people.
Each of these infections was entirely preventable. Each HIV infection is estimated to cost approximately $1.6 million.

This illustrates the continued urgent need for a national HIV/AIDS response with dedicated funding for community-based services, and also for public policy responses to the social determinants of health that can drive the epidemic.

While the need for federal investments is clear, the Government of Canada has steadily eroded its investments in the work of our sector. By 2008/2009 the Federal Government was supposed to have increased annual investments to $84.4 million. Due to funding cuts we’ve experienced a cumulative funding loss of more than $100 million between 2004 and 2016.

We are making progress; now is the time to deepen Federal investments in HIV related work and for our federal government to meet its commitments to funding. Despite the realities presented above, we are making progress in responding to HIV/AIDS in Canada.

Community engagement is crucial. Canada’s response to HIV/AIDS has been driven by community organizations and by people living with HIV/AIDS. They bring a depth of knowledge about the epidemic that cannot be matched by bureaucrats or academics. Their view from the front lines allows them to spot emerging trends, successes and failures in program responses, and critical gaps that require responses. They are nimble in adapting programs to respond to new needs. They also bring a crucial voice to the public policy table to help illuminate how public policy can either fuel or reduce the epidemic.

As we move forward to the next phase of the response to HIV, it remains crucial that those community voices be heard loud and clear in the development, implementation and monitoring of the national AIDS strategy.

Funding processes matter: expectations about the new Federal Action Plan on STBBI and the importance of investments through the Community Action Fund and the role community plays in setting priorities and indicators of success. As we engage the Public Health Agency of Canada in these and other questions, we hope we can count on the support of our elected officials.