Friday and Saturday, Montreal will play host to the Fifth Replenishment Conference of the Global Fund to Fight AIDS, Tuberculosis and Malaria. While much of the discussion will be focused on developing countries (the Global South), where the fund has played a crucial role since is creation in 2002, this is also an appropriate time to take stock of Canadian realities.
At a time when the global effort is suffering from precarious funding, Canada has stepped up to the plate by increasing its contribution by 20 per cent, to a total of $785 million over the next three years. This commitment is to be applauded. It proves that there is a willingness on the part of government to make Canada a leader once again on the international scene. It is also a promising reminder that increased donations will get us closer to beating these diseases once and for all.
But good leadership also puts the spotlight on Canada’s own responsibility to address human-rights issues that are impediments to the improvement of public health and fair access to health services.
In the HIV sector, we know that gender inequality, racism and homophobia are the breeding grounds for the epidemic. Poverty and discrimination are further barriers to access and care. As was recently pointed out by Canada’s Minister of International Development and La Francophonie, Marie-Claude Bibeau, HIV has a particularly heavy impact on young women.
In order to continue to play its part as an international leader, Canada has to make good on commitments to end these epidemics here at home. We have work to do in our own backyard in order to align the fight against HIV/AIDS with human-rights advocacy.
Canada in 2016 is a country that still imposes criminal penalties on people living with HIV: they still risk prison sentences for having sexual relations without disclosing their HIV status to their partners when they have taken the necessary precautions to avoid transmission (use of a condom or undetectable viral load), and when there has been no transmission. This increases stigma, goes against science and UNAIDS recommendations, and should not be the case in a country that otherwise is helping lead the way.
Leadership comes from inspiring the best public policy, especially when it is supported by scientific data. In this regard, Canada must go farther and support the opening of supervised-injection sites. Such harm-reduction approaches are proven to reduce rates of infection.
Furthermore, we must work to create social and legal frameworks that help sex workers, as recommended by such NGOs as Amnesty International. It is crucial that we repeal Bill C-36, the so-called “Protection of Communities and Exploited Persons Act” that criminalizes sex work in Canada.
This major international event will also be an opportunity to highlight how these epidemics affect migrants. Mandatory testing by immigration authorities contradicts recommendations by Canadian health experts. Rejecting migrants on the basis of their HIV or health status continues to foster prejudice in this regard. Economic arguments for refusing them entry only serve to exacerbate such inequalities. It is high time to look at universal access to treatment and the real cost of its being denied to certain people.
The Global Fund Replenishment Conference is a fitting time to demonstrate Canada’s financial support for countries most affected by HIV, TB, and malaria. Canada’s commitment to international aid is a solid foundation for global action on these issues.
But now is also the time for us to lead by example in our own country. There is much work to be done before we can truly “End it. For Good.” We need concrete measures that show Canadians stand with and support HIV-positive people.
Gabriel Girard is a post-doctoral researcher in sociology at Université de Montréal. Pierre-Henri Minot is executive director of Portail VIH/sida du Québec in Montreal. This article is based on an open letter that has been co-signed by more than 150 others. The full list is available at pvsq.org/globalfunds2016.
