I reached out to Gary Lacasse, executive director of the Canadian AIDS Society, to find out where things stand in Canada in terms of funding and programming, and the news, unfortunately, was not encouraging. “We haven’t had any increase in funding since 2008, specifically for HIV,” says Lecasse. “We’re still stunned, after so many closures, after so many redirections of funds, that haven’t committed to the experience that when you fund programs that are holistic, that take care of the whole problem and not just specific parts of it, you see reductions in cases HIV as we have seen continuously until [2014]when the rates started going up.” In 2019, the federal government aligned its programs with a prevention-only model under the pan-Canadian Sexually Transmitted and Bloodborne Infections (STBBI) framework, but did not attach new funding to that framework. The framework aims to reduce infections by 2030 at a time when some sexually transmitted infections are on the rise, notably syphilis, but also gonorrhea and chlamydia. Lacasse says support mechanisms for people living with HIV have been “annihilated” under the new framework, which has led to the closure of some grassroots groups. While Lacasse says a focus on prevention and harm reduction is necessary, it should have been done over and above existing programs rather than replacing them. Subscribe to Xtra Weekly Every Friday, a collection of LGBTQ2S+ news and culture stories. You can unsubscribe at any time. Our newsletters may contain advertising messages, please see our Privacy Policy. “When COVID hit, we were asked to do more work, and now with monkeypox, that’s an added workload for our organizations across Canada.” “You can’t keep putting extra work on top of people who are already stretched to their limits,” says Lacasse. Lacasse notes that the decline in reported HIV cases over the past two years is largely due to a decrease in testing due to COVID. “When COVID hit, we were asked to do more work, and now with monkeypox, that’s an additional workload for our organizations across Canada,” Lacasse says, noting that this additional work is not covered by additional resources from the federal government. “We have to use our limited funding from other sources to do work for the government, which is not recognized at the local level,” says Lacasse. “They are reducing nickel and sector. There is a lot of research that is pointless because we have the answers to a lot of things like testing. We know how to do the testing there and we are very good at it. We don’t need to do any more research on how to get the tests when we have programs that don’t even fund it.” I also asked Lacasse about the role of the provinces, because health care and public health are under their jurisdiction, and they have a proven tendency to shift the blame to the federal government for their own failures or for not funding programs. Lacasse notes that it varies from province to province—Ontario and B.C. are fairly well placed, but even in B.C. have seen the closure of groups like Positive Living BC and the Pacific Women’s Network after their funding was cut. “In Quebec, funding is extremely low,” says Lacasse. “Manitoba has some good funding, but it seems to be the same organizations that are there, but developing new programming. And in Saskatchewan, it’s like the Sahara desert — there’s almost no funding.” Lacasse also points out that Saskatchewan has one of the highest rates of HIV transmission in Canada and that its morbidity rate is high. While some, such as Jody Jollimore, executive director of the Center for Community-Based Research in Vancouver, have called for the federal government to “force” the provinces to take steps like making PrEP more widely available for free, there is actually no mechanism by which they can to achieve this. It is difficult enough for the federal government to try to tie up future health care transfers so that they are actually spent on health care and not to cover a provincial surplus (Alberta and New Brunswick) or to send vote-buying checks before an election (Ontario and Quebec). There’s simply no lever to pull that could force provinces to do anything about things like making PrEP available. In the feds’ bid to join the provinces in a national pharmacare program that could see PrEP and other drugs immediately available for free, so far PEI is the only province to agree. Lacasse disputes the government’s claim that they are meeting the United Nations’ 90-90-90 targets (90 percent of people with HIV know their status, 90 percent of those diagnosed on antiretroviral therapy, 90 percent of those on treatment achieve viral suppression) by 2020 , aiming to eliminate HIV as a public health threat by 2030, saying they are not even collecting the right data. Canada’s HIV funding lags behind other G7 countries, and estimates by HIV and AIDS groups across the country put a figure of $123 million in funds that have been promised and not delivered. Furthermore, the House of Commons health committee recommended in 2019 that funding be increased by $100 million a year to tackle HIV, and the government has not acted on that either, despite not being shy about spending on other areas of public policy. This is funding that saves money in the long term, as each new HIV infection represents $1.3 million in direct and indirect costs over a person’s lifetime. “This government is all about the message – there’s no substance behind it,” Lacasse says. “Empty dollars are announced, but they’re never where they’re supposed to go.” Lacasse is right—this administration likes to talk a good game, but has obvious problems living up to its lofty rhetoric. The International AIDS Conference is an opportunity for them to show that they are listening to these organizations and to ensure that they are adequately funded to rise to the challenge and truly meet their goals. We will see if there really is the political will to do this.