'AN EMBARRASSMENT.' Health Minister Tony Clement hurt Canada's reputation by denouncing Vancouver's safe injection site, says the executive director off the Canadian HIV/AIDS Legal Network.

(tonyclement.ca)

Federal health minister Tony Clement was completely out of step with the rest of the world at the recent International AIDS Conference, say delegates from Canadian AIDS organizations.

Richard Elliott, the executive director of the Canadian HIV/AIDS Legal Network, says Clement's public condemnation of a safe injection site in Vancouver at the Mexico City conference was a major blow to Canada's prestige.

"It's an embarrassment for Canada," he says. "It's become very clear that we have a health minister, and presumably a government behind him, who are denialists. It's similar to the condemnation the South African government received for denying that HIV causes AIDS.

"I didn't have the sense that there was anyone else from other countries, medical or government representatives, speaking out against harm reduction. The current Canadian government is out of step with any rational response and out of step with the rest of the world."

The conference, which ran from Aug 3 to 8, also focused on the increasing criminalization of HIV, funding issues and the access to HIV medication in developing countries.

"I think it's safe to say the issue of criminalizing HIV had more exposure than it's ever had before," says Elliott. "The tenor of the discussion was this is generally a bad idea. One of the things that was highlighted repeatedly was criminalization in Africa, mostly in the context of these countries adopting omnibus AIDS bills. They actually go to the extremes, some of them criminalizing instances where transmission takes place even with safer sex.

"In Sierra Leone legislation explicitly criminalized transmission from mother to child. Sometimes they just want to be seen to be doing something to respond to the epidemic. It's an unwillingness to address the underlying social determinants, most of which are human rights and social justice issues."

Elliott says criminalization is not restricted to Africa.

"There was a recent decision by the Swiss Supreme Court that was breathtaking in its stupidity," he says. "It found that a man could be convicted of HIV transmission even though he was not aware he was HIV-positive."

Elliott says that although the United Nations opposes criminalization it's supporting a policy to make HIV testing automatic in countries with an HIV epidemic.

"Every time you go to your health provider you're given an HIV test unless you opt out," he says. "This in environments where people face stigmatization and violence and criminal prosecution for not disclosing their HIV status."

Canadian delegates say that listening to the realities from other countries reinforced the need to fight for funding in Canada.

"It showed the importance that we not rest on our laurels, that we continue to have dedicated funding," says Monique Doolittle-Romas, the executive director of the Canadian AIDS Society.

Canadian delegates met with Clement during the conference. Doolittle-Romas says they told the minister that federal funding for AIDS service organizations (ASOs) in Canada was almost $12 million short annually of what had been promised in the national AIDS strategy implemented in 2006.

"It's disappointing that we were talking about shortfalls in funding at an international conference," says Doolittle-Romas. "I'm hoping the minister heard the same message asking him to put the money back into community organizations. Our message was that leadership begins at home.

"I think the minister listened but there was no commitment."

Elliott says Clement denied there was a shortfall, saying that the money had been directed to the government's HIV Vaccine Initiative.

"There's a united front between scientists and community groups," says Elliott. "We made it very clear that the community supports having money for the HIV vaccine initiative... but not at the expense of community groups.

"The minister said he would be initiating a funding review."

The conference also focused on the need for cooperation among ASOs and groups working in other areas.

"We need to have organizations that focus on different areas working together," says Hazelle Palmer, the executive director of Planned Parenthood Toronto. "For organizations like Planned Parenthood that focus on sexual reproductive health there was a real recognition that we need to work together.

"There's been ASOs and there's been sexual health clinics and they've been separate. We want to look at what we bring to the table, encourage people to be tested and be aware of how HIV is transmitted."

Palmer says she was inspired by a trip she took with a mobile health unit in Mexico City.

"They're out in a plaza doing demonstrations, talking about how to use a female condom, how to put on a condom, these wonderful drag queens doing the work," she says.

"We're trying to launch a mobile health unit in Toronto. We would love to be able to talk about HIV prevention as well."

Canada's role in providing HIV drugs for developing countries also came under discussion. Elliott says that since Canada adopted new legislation about generic manufacturers providing drugs, there's only been one case where a deal was struck. Generic manufacturer Apotex recently agreed to provide a triple combination AIDS drug to Rwanda.

Although Elliott admits that still puts Canada above most other countries, he says the legislation is far too restrictive on amounts that can be sold and for how long.

"Why not just give a general licence to a generic company that they could sell to as many countries as they could and just report on the sales and pay a fee to the pharmaceutical company?" asks Elliott.

Elliott says the conference also examined how human rights issues surrounding men who have sex with men affect the spread and prevention of HIV.