'We need a response:' Sask. doctors call on province to address high rates of HIV

A group of Saskatchewan doctors have called for the province’s high rates of HIV to be declared a public health emergency.

Thirty physicians, who treat people living with HIV in the province, released a public letter to the Sask. government Monday asking the epidemic be recognized and for action to be taken. 

“Recognizing this is an infectious disease, we need to put no barriers in the way of people getting treatment,” said Dr. Ryan Meili, one of the family physicians who signed the letter.

Currently, Saskatchewan has the highest rates of HIV in Canada.

Meili said while the number of cases in the province dipped in 2014 to 114, that number is still about double the national average. The following year it spiked to 150 cases.

“We’re over twice—nearly triple—the national average,” Meili said. “Alongside those increased cases, we also see some of the worst results.”

Meili said Saskatchewan has the highest rates of people dying from HIV in Canada.

Right now, however, there are no channels to formally declare a public health emergency under the existing public health act in Saskatchewan.

The province did implement an HIV strategy from 2010-2014, and continues to provide annual funding of $4 million to support HIV prevention, testing and treatment.

“As new HIV cases are diagnosed, resources are mobilized to connect each and every person to care,” said Dr. Denise Werker, the deputy chief medical health officer for the province.

Werker noted the increase in HIV patients should be expected because people are becoming more aware of the disease, how to get tested and treatments. 

“People are acknowledging they may have the disease, and are accessing that testing and more people are connecting to care,” she said.

‘We need a response’

Meili said the group behind the letter has met several times with the health minister since the HIV strategy ended in order to create a new plan, with no success.

Additionally, the province has yet to respond to the group’s calls to formally adopt the UNAIDS 90-90-90 goals to eradicate the disease by 2020.

“We’re asking the government to accept that goal and that’s something we’ve put in front of them several times before and haven’t had a response—that’s why we’re bringing it to the public,” Meili said.

That goal would see 90 per cent of all people living with the disease knowing their HIV status by 2020.

Of those diagnosed, the target would be to get 90 per cent on sustained antiretroviral therapy with 90 per cent of all people receiving the treatment to have viral suppression—meaning the disease levels are so low, they can’t pass HIV on to anyone else. 

While Meili said the letter was made public due to frustration over the mounting crisis, it was also timely as the federal government recently committed $800 million toward the global fund to treat HIV, Malaria and TB.

“We heard Bono say, a couple days ago, ‘The world needs more Canada.’ Well right now, Saskatchewan needs more Canada. We need a response from the provincial, federal governments as well as First Nations leadership to really deal with this problem,” he said.

According to the physician, Saskatchewan’s high HIV rates are connected to drug abuse patterns in the province. Meili said intravenous drug use is the most common cause of infection, bolstered recently by higher rates of sexual transmission.

“Very much related to poverty, marginalization, and the substance abuse that emerges from that,” he said.

Meili said any and all treatment plans or goals should include measures aimed at helping people living with addiction and dealing with the root causes of poverty.

Canada’s HIV Rates

Rate, per 100,000 population, of positive HIV test reports all ages by province/territory—Canada: 2012

Saskatchewan: 17.0
Alberta: 6.2
Ontario: 6.2
Quebec: 5.6
Manitoba: 5.8
British Columbia: 5.1
Yukon: 2.8
N.W.T.: 2.3
Nfld. & Labrador: 1.8
P.E.I & Nova Scotia: 1.7
New Brunswick: 0.5