Strengthening Federal Action in the Canadian Response to HIV/AIDS

The Federal Initiative to Address HIV/AIDS in Canada

The launch of the Federal Initiative to Address HIV/AIDS in Canada signals a renewed and strengthened federal role in the Canadian response to HIV/AIDS over the next five years. The Federal Initiative - a partnership of the Public Health Agency of Canada, Health Canada, the Canadian Institutes of Health Research and Correctional Service Canada - will work toward a Canada free from HIV and AIDS and the underlying conditions that make Canadians vulnerable to the epidemic.

To achieve this vision, federal action will focus on providing leadership to enhance strategic relationships, better align the efforts of key players (with clear roles and responsibilities) and improve ongoing evaluation and ensure that people living with and vulnerable to HIV/AIDS are partners in shaping policies and practices affecting their lives. By maximizing the use of its own resources and collaborating with others, the federal government will make a larger and more effective contribution to addressing the complex social, human rights, biological and community barriers that continue to fuel the epidemic.

The Federal Initiative embraces elements of both the social justice and determinants of health approaches. It builds on the lessons learned from past strategies^{Footnote 1} and moves toward the development of a fully integrated Government of Canada approach to HIV/AIDS.

The Federal Initiative also responds to a study by the Standing Committee on Health in 2003 that recommended a strengthened federal role, including more effective interventions and improved HIV/AIDS prevention and treatment initiatives for at-risk populations that fall under federal jurisdiction.^{Footnote 2}

Shifts in the Federal Response

The CSHA was successful in many ways, and those successes will be built upon in the new Federal Initiative through:

• a strong community-based and non-governmental response
• a solid research foundation with greater community involvement
• use of evidence to inform programs and policies
• intergovernmental collaboration on policy and program development
• a multi-sectoral, partnership approach to planning
• a human rights approach to addressing HIV/AIDS
• the direct involvement of people living with and vulnerable to HIV/AIDS
• increased public accountability
• greater Canadian leadership in responding to the global epidemic

These achievements, together with recommendations from program reviews, evaluations and other consultative exercises, have signalled the need for the federal government to:

• develop discrete approaches to addressing the epidemic for people living with HIV/AIDS, gay men, injection drug users, Aboriginal people, prison inmates, youth and women at risk for HIV infection, and people from countries where HIV is endemic
• increase government collaboration at all levels - federal, provincial, territorial and municipal
• support the use of social marketing initiatives to increase public awareness of HIV/AIDS and encourage those who may be part of the hidden epidemic to access HIV/AIDS programs
• encourage greater integration of HIV/AIDS prevention, care and treatment interventions with those of other diseases, as appropriate
• more broadly engage federal departments and agencies in the response, such as Citizenship and Immigration Canada, and those that have mandates related to housing, disability, social justice, employment and other determinants of health
• increase its engagement in the global response to the epidemic
• improve the communication of outcomes achieved from federal investments in HIV/AIDS

Goals

As part of their commitment to improve the health of Canadians and contribute to the implementation of Leading Together, the Public Health Agency of Canada, Health Canada, the Canadian Institutes of Health Research and Correctional Service Canada will work with other key federal government departments and agencies, provincial and territorial governments, non-governmental organizations and other stakeholders, toward the following goals:

Goal #1: Prevent the acquisition and transmission of new infections.
Goal #2: Slow the progression of the disease and improve quality of life.
Goal #3: Reduce the social and economic impact of HIV/AIDS.
Goal #4: Contribute to the global effort to reduce the spread of HIV and mitigate the impact of the disease.

Policy Directions

Three policy directions will guide federal decision making and relationships under the Federal Initiative.

• Partnership and Engagement
  Coherent action-locally, nationally and globally-by people, organizations and systems involved in the HIV/AIDS response is critical to reaching the ambitious goals of the Federal Initiative. To this end, federal, provincial, territorial and municipal partnerships will be enhanced while ensuring respect for jurisdictional mandates. An aligned inter- and intradepartmental approach will be put in place. It will focus on determinants of health and will have clearly defined roles and responsibilities. As well, increased engagement will be sought with the voluntary, professional and private sectors, international partners and people living with and vulnerable to HIV/AIDS.
  Continued strong relationships with non-governmental organizations and community partners will be paramount.
• Integration
  Many people living with and vulnerable to HIV/AIDS have complex health needs and may be vulnerable to other infectious diseases, such as those transmitted sexually or by injection drug use. Federal HIV/AIDS programs will be linked with other health and social programs, as appropriate, to ensure an integrated approach to program implementation. Programs will address barriers to services for people living with or vulnerable to multiple infections and conditions that have an impact on their health. Those affected will play a key role in overcoming these barriers.
• Accountability
  The federal government will foster mutual accountability among its delivery partners and will make public their achievements and challenges on an annual basis through the World AIDS Day report (published each year on December 1).