Public Record of Meeting - December 9 - 11, 2005
Ottawa, Ontario

The Ministerial Council on HIV/AIDS was created to advise the Minister of Health on aspects of HIV/AIDS that have a national scope. The Minister of Health meets with the Ministerial Council at least once a year to receive its advice and recommendations, and reports annually to Canadians on the progress of the Federal Initiative to Address AIDS in Canada. Additionally, the Ministerial Council provides ongoing advice and communications to the Minister throughout the year.

The Public Record of Meeting (PROM) that follows provides an overview of the issues, information and recommendations discussed at the May 6-7, 2005, meeting of the Ministerial Council on HIV/AIDS. Where appropriate, discussion points and action items are reported to the public within the PROM. For a detailed summary of activities, please refer to the annual report which the Ministerial Council publishes every June for the preceding year ending March 31. Annual reports are available for download from the Ministerial Council's website:

http://www.phac-aspc.gc.ca/aids-sida/fi-if/minister-eng.php

Present:

Ministerial Council: Louise Binder and Lindy Samson (Co-Chairs); Mary Armstrong, Dionne A. Falconer, Deborah Foster, Jacqueline C. Gahagan, Marie Anésie Harérimana, Kenneth Monteith, David M. Nelson, Anita Rachlis, Sheena Sargeant. Ex-officio: Frank McGee, Provincial Co-Chair, Federal/Provincial/Territorial Advisory Committee on AIDS (FPT AIDS) .

Regrets: Michael Grant, Richard Elliott, Brian Huskins, Frank Plummer (ex-officio).

Public Health Agency of Canada (PHAC): Grafton Spooner, Manager (December 9 & 11), Government and External Relations, HIV/AIDS Policy, Coordination and Programs Division; Fernand Comeau (December 9 & 10), Government and External Relations, HIV/AIDS Policy, Coordination and Programs Division.

Secretariat : Monica Thibault, Nina Elkin (December 9).

Recording and Facilitation Services: Wylie Thomas, Hajo Versteeg.

Presenters: Catherine Bélanger, Portfolio Manager, Strategic Policy, Correctional Service Canada

Welcome and Approval of Agenda

The Co-Chairs welcomed members to the meeting. The agenda was approved with modifications.

Report from Health Canada and the Public Health Agency of Canada

Fernand Comeau and Grafton Spooner of the Government and External Relations Section of the HIV/AIDS Policy, Coordination and Programs Division of the Public Health Agency of Canada (PHAC), presented the Ministerial Council on HIV/AIDS with the Health Canada / PHAC report and highlighted the following:

• Government of Canada Position Statement on HIV/AIDS --They noted that copies of the latest draft were distributed to the Ministerial Council. The Government of Canada Assistant Deputy Ministers (ADM) Committee on HIV/AIDS will meet on January 12, 2006, at which time the Government of Canada Position Statement on HIV/AIDS will be endorsed.
• XVI International AIDS Conference --The HIV/AIDS Division has been busy with preparations for the conference. A number of government departments are participating through the federal AIDS2006 Secretariat. One of the benefits of the conference is that it has raised the profile of HIV/AIDS issues throughout the federal government.
• World AIDS Day Report --The report was released electronically, but because an election had been called, the message from the Ministers and from the Ministerial Council had been removed from the final document.
• Social Marketing --PHAC has been developing a social marketing campaign to address stigma and discrimination, which is scheduled to be launched in April 2006. The Ministerial Council asked the Secretariat to arrange for a presentation on the campaign at its next face-to-face meeting in February.
• Aboriginal Health --PHAC has joined a collaborative research project with academic and community researchers in Canada, Australia and New Zealand. The project, which will see $1.6 million allocated to Canadian researchers, supports complementary research toward the goal of improving the health of Aboriginal peoples in each of the three countries.
• Leading Together: Canada Takes Action on HIV/AIDS --Members of the Ministerial Council provided suggestions for increasing the visibility of Leading Together, championing its use and making it more user-friendly. It was noted that a website had been set up: www.leadingtogether.ca and that the interim steering committee for Leading Together was working on the terms of reference and a nomination process for a permanent steering committee which will be up and running in the Spring of 2006.
• Financial Report --It was noted that PHAC was in the middle of preparing the third quarter report and that the changes to the presentation of the data requested by the Ministerial Council were being addressed. A report will be presented at the Ministerial Council's February 2006 meeting.
• Community-Based Research --The Ministerial Council identified a number of follow-up actions related to the functioning of the Community-Based Research (CBR) Program at the Canadian Institutes of Health Research (CIHR). It was noted that CHARAC (CIHR HIV/AIDS Research Advisory Committee) had just completed a priority-setting exercise and that the Research Committee would be preparing a response to the report.
• HIV/AIDS Surveillance --The Ministerial Council discussed gaps in HIV/AIDS surveillance data and a number of initiatives to close those gaps. It directed its Research Committee to take the discussion under advisement and provide recommendations later in the meeting.
• Drug Formularies --The Ministerial Council discussed the difficulties created by the existence of multiple drug formularies across the country and identified a number of follow-up actions.

Update on Blueprint for Action on Women's Issues Coalition

The Ministerial Council on HIV/AIDS received an update on the Blueprint for Action on Women's Issues Coalition, which recently launched its manifesto at World AIDS Day events across the country. The Coalition was established 1½ years ago and has since grown to include 70 to 80 national members and six international members. The Coalition's principle goals are: 1) complete equality for women at AIDS2006; and 2) the development of a blueprint for action on women and HIV/AIDS. The Coalition will be launching its "measurable outcomes" on International Women's Day ( March 8, 2006) which will be used to develop a "report card" against which it will grade countries' progress on each of its demands. It was noted that the organizers of the XVI International AIDS Conference were working hard to integrate women into the conference agenda and that women had been asked to be a pilot for the population-specific approaches under the FI. Following the presentation, the Ministerial Council provided feedback on the Blueprint and discussed its linkages to other initiatives to address HIV/AIDS in Canada.

Preparation for Meeting with Correctional Service Canada

The Ministerial Council on HIV/AIDS spent time preparing for its meeting with Catherine Bélanger, Strategic Policy, Knowledge Management and Policy Development, Correctional Service Canada (CSC). Ms. Bélanger had been asked to present on the organizational structure of CSC to give the Ministerial Council a better understanding of how it can work with the agency on issues related to HIV/AIDS. The Ministerial Council identified supplemental topics to raise with Ms. Bélanger, which it asked the Secretariat to convey to Ms. Bélanger before she arrived at the meeting.

Committee Meetings of the Ministerial Council on HIV/AIDS

The committees of the Ministerial Council on HIV/AIDS held working meetings at different times over the course of the afternoon.

Presentation by Correctional Service Canada

The Co-Chairs of the Ministerial Council on HIV/AIDS welcomed Catherine Bélanger, Portfolio Manager, Strategic Policy, Knowledge Management and Policy Development, Correctional Service Canada (CSC). They expressed the Ministerial Council's wishes to develop a strong working relationship with CSC to address HIV/AIDS in prisons.

Ms. Bélanger presented an overview of the organizational structure of CSC. She described the roles and responsibilities of its various divisions, highlighting those whose mandates in some way affect the delivery of prevention, treatment, care and support for HIV/AIDS in prisons. She noted that CSC's policy is to provide "essential health care," which the agency defines based on provincial standards. In practice, this means that if a treatment is offered in one province, CSC will make the treatment available to all prisoners, regardless of whether it is offered in the province of incarceration. This allows treatment to follow prisoners when they are transferred between federal institutions located in different provinces. She noted that challenges related to continuity of care occur when prisoners leave federal custody and enter the health care system of the province of residence. Ms. Bélanger offered to forward to the Ministerial Council further details on continuity of treatment for prisoners as they are transferred within the federal system and between the federal system and the provinces.

Following her presentation, the Ministerial Council provided Ms. Bélanger with an overview of its mandate, membership and roles advising the Minister of Health and FI partners on issues related to HIV/AIDS in Canada. The Ministerial Council offered its support to CSC addressing HIV/AIDS in prisons, and in this regard, raised a number of issues, including: observed gaps between policy and implementation, which have been noted by community groups who work on HIV/AIDS in prisons; a possible role for the Ministerial Council in helping CSC implement the advice from PHAC on needle exchange in prisons; regional differences in the HIV/AIDS epidemic and their implications for prison HIV/AIDS programming; the challenges of conducting research in a prison environment and opportunities for addressing these; and, opportunities for CSC to showcase its HIV/AIDS programming at the XVI International AIDS Conference.

Following Ms. Bélanger's departure, the Ministerial Council identified a number of follow-up actions, which it agreed to include in its thank-you letter to Ms. Bélanger. A small ad hoc working group was established to pull together questions from Council to include in its letter to Ms. Bélanger. It was agreed that a copy of Leading Together: Canada Takes Action on HIV/AIDS should accompany the letter. It asked the Secretariat to follow up with Ms. Bélanger about opportunities for the Ministerial Council to participate in the consultative processes that she identified.

Approval of the October 2005 Record of Decision

The Ministerial Council on HIV/AIDS approved the Record of Decision from its last face-to-face meeting held on October 20 and 21, 2005, in Ottawa, subject to a number of changes. It asked the Secretariat to ensure that the approved Records of Decision from the October and May 2005 meetings are sent to Ministerial Council members.

Review of Actions Summary and Business Arising From the October 2005 Meeting

The Ministerial Council on HIV/AIDS reviewed the status of action items arising from its meeting in Ottawa on October 20 and 21, 2005. Because of the short time since the last meeting, a number of items were still in progress and so the Ministerial Council asked the Executive Committee to identify outstanding items and report back with recommendations later in the meeting.

Committee Reports of the Ministerial Council on HIV/AIDS

Research Committee

The Research Committee provided its report to the Ministerial Council on HIV/AIDS. It noted that the CIHR HIV/AIDS Research Advisory Committee (CHARAC) had conducted a priority-setting exercise at its October 7, 2005, meeting, and had arrived at seven draft priority areas to guide the spending of research funds that CIHR receives through the FI: 1) Health Systems, Services and Policy; 2) Resilience and Determinants of Health; 3) Health of Populations and Population-Specific Research; 4) Prevention Technologies and Interventions; 5) Drug Toxicities and Resistance; 6) Biomedical Research; and, 7) Issues of Co-Infection. The Ministerial Council considered the draft research priorities report from CHARAC and provided comments and feedback to the Research Committee for inclusion in its official response to the draft priorities.

The committee reported that CHARAC had recently received a presentation by CIHR on the preliminary findings from an environmental "scan" of HIV/AIDS research in Canada. The scan is part of a series of studies being conducted by CIHR and PHAC to provide the foundation for developing a pan-Canadian HIV/AIDS research plan. The Ministerial Council's representative to CHARAC noted that there were concerns over whether the research plan would be ready in time for the XVI International AIDS Conference being held in Toronto in August 2006. It was noted as well that there were a number of ongoing initiatives with which the research plan must eventually align and that these risked being overlooked by rushing the process. After some discussion, the Ministerial Council agreed to recommend to the developers of the research plan that they focus on establishing a sound and inclusive process for developing the research plan, and that the process could be showcased at the conference.

Other issues that the Ministerial Council discussed were : HIV/AIDS research funding processes at CIHR; the definition of HIV/AIDS research for the purposes of research accounting; HIV/AIDS surveillance needs; success rate for community-based research proposals; processing fees charged against HIV/AIDS research grants; efforts underway to develop a code of conduct to guide HIV research conducted in the South. After some discussion, it was agreed that the Research Committee should take the FPT AIDS surveillance strategy under advisement and report back to the Ministerial Council. It was also agreed that the Research Committee would take the lead in developing the agenda for the next face-to-face meeting on February 23 and 24, 2006.

International Affairs Committee

The International Affairs Committee provided its report to the Ministerial Council on HIV/AIDS. It informed the Ministerial Council that it planned to follow up with Foreign Affairs Canada regarding the department's HIV/AIDS strategy. It reported that it would be following up with the Canadian International Development Agency (CIDA) regarding the status of its plan for a new agency strategy on HIV/AIDS to replace its action plan, which is now expired. As well, the committee is monitoring Canada's commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria. It noted that it was planning to review the FI and Leading Together with an "international lens" and would provide recommendations for action at the next meeting on February 23 and 24, 2006. It noted that members of the Consultative Group on Global HIV/AIDS Issues had expressed concern about the need to review the committee's accountability mechanism and terms of reference. The Ministerial Council agreed that the committee would offer its help in optimizing the process and identified possible follow-up actions.

Communications and Liaison Committee

The Communications and Liaison Committee provided its report to the Ministerial Council on HIV/AIDS. It advised that the current chair of the committee would be stepping down and that new co-chairs had been identified.

The committee reported that it was working on developing guidelines for writing the Record of Decision and Annual Report, for which it would eventually be seeking Ministerial Council's approval. It noted that it had already developed a draft model Public Record of Meeting (PROM) and guidelines, copies of which were distributed to members in the meeting binders. The Ministerial Council approved the model PROM and guidelines and asked the Secretariat to prepare all PROMs dating back to November 2004.

The committee presented draft Frequently Asked Questions (FAQs) for posting on the Ministerial Council's website. The Ministerial Council provided detailed comments which it asked the committee to incorporate in the final draft of the FAQs.

Championing Committee

The Championing Committee provided its report to the Ministerial Council on HIV/AIDS. It noted that it had reviewed the responses to the questionnaire sent out to community groups working on HIV/AIDS and prisons. The Ministerial Council discussed the findings and asked the committee to prepare a summary report which could be sent out to respondents.

The committee briefly reviewed work carried out by the Ministerial Council and others last year which resulted in Citizenship and Immigration Canada (CIC) making changes to the visa application form for temporary visitors to Canada so that HIV-positive visitors to Canada are no longer required to reveal their HIV status. It noted as well that CIC had, on its own initiative, decided to waive the $75 visa application fee for people attending the XVI International AIDS Conference. The committee identified a number of issues to follow up with CIC regarding the changes to the visa form and in relation to immigration and HIV more generally. The Ministerial Council considered the committee's recommendations and agreed to ask CIC for an update at its next face-to-face meeting in Toronto. It also agreed to invite Dr. Alan Li of the Ontario Advisory Committee on HIV/AIDS to present on issues related to immigration HIV testing and barriers to accessing HIV/AIDS services experienced by immigrants in Canada.

The committee reported that it had reviewed the Blueprint for Action on Women and HIV/AIDS, which it felt could serve as a useful process model for PHAC and other population groups as they develop population-specific approaches.

The committee advised the Ministerial Council that the current regulatory policy of the Government of Canada was being updated and revised in an initiative led by the Privy Council Office. It reported that it had reviewed the draft Government Directive on Regulating and recommended that the Ministerial Council submit a formal written response. After a brief discussion, the Ministerial Council directed the Championing Committee to prepare a formal response on the draft directive and circulate to full council for comment before being finalized.

The committee informed the Ministerial Council that it had been monitoring the development of the National Pharmaceuticals Strategy (NPS). It briefly reviewed the background of the initiative and the nine areas for action identified by the First Ministers (Prime Minister Martin and the leaders of the provinces and territories). It noted that Health Canada had been tasked with preparing recommendations in five focus areas for consideration by the Ministers of Health at their meeting in June of 2006. After a brief discussion, the Ministerial Council asked the committee to take the strategy under advisement and present it with options for action at the February meeting. The Ministerial Council also established a new subcommittee to work on treatment issues.

The committee reported that the Common Drug Review had recently undergone a program evaluation for which it received good marks. However, this evaluation did not align with the views held by consumer groups regarding the functioning of the program. The Ministerial Council discussed follow-up and directed the Subcommittee on Treatment Issues to take the Common Drug Review program evaluation under advisement and present recommendations for action at the Ministerial Council's February meeting.

Executive Committee

The Executive Committee provided its report to the Ministerial Council on HIV/AIDS. It noted that it had a number of recommendations for improving the efficiency of the work of the Ministerial Council. It expressed concerns about delays in receiving the financial reports on the FI. The Ministerial Council agreed with the committee's recommendation to offer its help to the HIV/AIDS Division in obtaining the financial reports. The Ministerial Council directed the Secretariat to organize a teleconference for full council after the election to discuss transition, if any.

Update on World AIDS Day

The Ministerial Council on HIV/AIDS received an update on the 2005 World AIDS Day Report from its representative on the editorial board for the report. He noted that the World AIDS Day Report had not included the usual letter from the Ministerial Council, which, along with the message from the Minister of Health, had been withdrawn when the election was called. The Ministerial Council identified a number of actions in follow up, including writing letters of thank you. The Ministerial Council noted that there have been issues in relation to tight turnaround for commenting on drafts of the report for a number of years and agreed to begin its preparations for the WAD Report at its June 2006 meeting in Montreal.

Update From the Federal/Provincial/Territorial Advisory Committee on AIDS

Frank McGee, Provincial Co-Chair of the Federal/Provincial/Territorial Advisory Committee on AIDS (FPT AIDS), gave the Ministerial Council on HIV/AIDS an update on FPT AIDS activities since the last meeting. He reported that the committee was continuing its work to develop the FPT Consensus Statement on HIV/AIDS which it plans to have completed in time for the XVI International AIDS Conference. He noted that the committee last met in Edmonton on October 25 and 26, 2005, where Alberta had provided extensive presentations on its activities to address HIV/AIDS. In addition to the presentations from Alberta Health and Wellness and the regional office of PHAC, the committee heard presentations from CSC and received a tour of the prisons for men and women. He noted that the FPT AIDS was developing terms of reference for working with CSC through the Heads of Corrections Working Group on Health.

Transition Planning

The Ministerial Council discussed preparations for a possible change of ministers or a change in government. It directed the Secretariat to prepare letters of introduction to be sent out immediately following the election and identified background documentation to accompany the letters.

Preparations for the XVI International AIDS Conference

The Ministerial Council on HIV/AIDS discussed preparations for the XVI International AIDS Conference being held in Toronto in August 2006 and identified possible roles for itself in relation to the conference. It discussed the possibility of hosting or co-hosting a satellite session on HIV/AIDS advisory committees and identified a number of actions for follow up with potential partners. It asked the Ad Hoc Committee on AIDS2006 to meet by teleconference with representatives from PHAC to brief them on the Ministerial Council's plans.

Government of Canada Position Paper on HIV/AIDS

The Ministerial Council on HIV/AIDS considered a draft of the Government of Canada Position Statement on HV/AIDS and provided detailed comments for inclusion in a formal response to the draft. A small ad hoc working group was established to prepare and submit the formal response by the start of business on Monday, December 12, 2005.

HIV/AIDS Research Ethics Board

The Ministerial Council on HIV/AIDS held a brief discussion on the relative advantages of HIV/AIDS-specific research ethics boards, particularly as they relate to protecting the rights of HIV-positive people who take part in clinical studies. It was noted that the University of Toronto has had an HIV/AIDS-specific research ethics board in place for a number of years but that efforts were underway to disband it. The Ministerial Council had been approached for its support for the University of Toronto's HIV/AIDS Research Ethics Board. After considering the request, the Ministerial Council decided that, given its local focus, it would not be possible to formally endorse the process, as it falls outside the Ministerial Council's mandate. However, it agreed that it provided a model which could be relevant to HIV research across the country. The Ministerial Council asked the Secretariat, with help from the Research Committee to draft a letter to the Institute of Infection and Immunity regarding the advantages of the HIV-specific research ethics review board model for research across the institutes of CIHR. It also directed the Research Committee to raise the issue when it meets with representatives from PHAC to discuss the pan-Canadian research plan and at the next meeting of CHARAC.

Next Face-to-Face of the Ministerial Council of HIV/AIDS

The Ministerial Council on HIV/AIDS agreed to extend its Montreal meeting by a day to allow for committee work. The dates of the Montreal meeting were confirmed as June 1 - 3, 2006.

UNGASS Update

The Ministerial Council discussed its input into the UNGASS process and identified representatives to participate in the process.

Closing Remarks

The Co-Chairs closed the meeting by thanking members of the Ministerial Council on HIV/AIDS for their work during the meeting and the Secretariat and PHAC for their support.