Public Record of Meeting - February 23 - 24, 2006
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 February 23 and 24, 2006, 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, Richard Elliott, Dionne A. Falconer, Deborah Foster, Jacqueline C. Gahagan, Michael Grant, Marie Anésie Harérimana, Kenneth Monteith, Anita Rachlis. Ex-officio: Frank McGee, Provincial Co-Chair, Federal/Provincial/Territorial Advisory Committee on HIV/AIDS (FPT AIDS).

Regrets: Brian Huskins, David M. Nelson, Frank Plummer, Sheena Sargeant.

Public Health Agency of Canada (PHAC) : Grafton Spooner , Manager, Government and External Relations, HIV/AIDS Policy, Coordination and Programs Division.

Secretariat: Monica Thibault, Nina Elkin.

Recording and Facilitation Services : Wylie Thomas, Hajo Versteeg.

Presenters: Fernand Comeau , Government and External Relations, HIV/AIDS Policy, Coordination and Programs Division, Public Health Agency of Canada; Marsha Hay Snyder, Accountability and Evaluation Section, HIV/AIDS Policy, Coordination and Programs Division, Public Health Agency of Canada; Alan Li, Committee for Accessible AIDS Treatment, Toronto; Steven Sternthal, Knowledge and Awareness Section, HIV/AIDS Policy, Coordination and Programs Division, Public Health Agency of Canada.

Welcome and Approval of Agenda

The Co-Chairs of the Ministerial Council on HIV/AIDS opened the meeting with a few words of welcome. The agenda was approved with modifications.

Business Arising from the December 9-11, 2005, Meeting of Council

The Ministerial Council on HIV/AIDS reviewed the status of action items arising from its meeting in Ottawa on December 9-11, 2005. It asked the Secretariat to implement a number of improvements to the system for tracking the status of action items.

Approval of the December 2005 Record of Decision

The Ministerial Council on HIV/AIDS approved the Record of Decision from its meeting in Ottawa on December 9-11, 2005, subject to specified changes.

Preparation for Meeting with Representatives of the Canadian Association for HIV Research

The Ministerial Council on HIV/AIDS spent time preparing for its meeting with representatives of the Canadian Association for HIV/AIDS.

Meeting Representatives of the Canadian Association for HIV Research

Dr. Ted Myers and Dr. Liviana Calzavara of the Canadian Association for HIV Research (CAHR) joined the meeting by teleconference to update the Ministerial Council on HIV/AIDS on the association's activities. Among other things, they described activities that CAHR is undertaking in preparation for the XVI International AIDS Conference being held in Toronto in August 2006, including four projects:

• An inventory of funding sources, which will consist of a database of all sources of funding for HIV/AIDS research in Canada;
• A human resources assessment, which will assess HIV/AIDS research capacity in Canada in terms of who is doing what;
• A code of conduct for HIV/AIDS research involving civil society which will address cross-cutting research ethics issues;
• Informational material on CAHR, including its history and role as a research and advocacy body, and which will showcase the accomplishments of CAHR and Canadian HIV researchers.

The Ministerial Council offered its support in facilitating the work of CAHR and provided advice on ensuring that CAHR's work to develop a research inventory is coordinated with the work of others, including a federal government initiative to develop a pan-Canadian research plan. The Ministerial Council asked the presenters to forward their ideas on how it can support their work to the Secretariat for consideration by the Ministerial Council. It also said it would consider holding a half-day session on research at its June meeting in Montreal to which it would invite CAHR among others.

Following the departure of the presenters, the Ministerial Council discussed the details of follow-up action.

Update on Code of Conduct for HIV Research

The Ministerial Council on HIV/AIDS received a status update on work to develop a code of conduct for HIV/AIDS research involving civil society. It was noted that a number of partners were involved in the development of the code including the Human Sciences Research Council of South Africa, the Commonwealth Secretariat, and a number of universities and civil society partners in Canada and Sub-Saharan Africa. The Ministerial Council provided advice and comments and asked its Research Committee to take the issue under advisement and report back with recommendations for action.

Update from the Federal / Provincial / Territorial Advisory Committee on AIDS (FPT 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 the committee's 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 Ottawa on January 31 and February 1, where it had received presentations on the new Epi-Update: HIV in Canada Among Persons from Countries where HIV is Endemic, the Communicable Diseases Control Network being established under the rubric of the new Public Health Network, the framework on population-specific approaches that Public Health Agency of Canada (PHAC) is developing, point-of-care rapid HIV tests and efforts underway to update the guidelines for health care providers and the draft priorities for extramural research being developed by the Canadian Institutes for Health Research (CIHR).

Executive Committee Report

The Executive Committee provided its report to the Ministerial Council on HIV/AIDS and identified three issues for discussion: the types of expertise and experience needed on the Ministerial Council; financial reports from PHAC on the Federal Initiative to Address HIV/AIDS (FI) in Canada; and transition planning for the new federal government. The Ministerial Council provided advice to PHAC on broadening the scope of expertise represented on the Ministerial Council and for invigorating the calls for nominations. It also identified a number of follow-up actions to ensure that it receives financial reports in a timely fashion.

Transition Planning

The Ministerial Council on HIV/AIDS spent time preparing for the change in government including a letter introducing the Ministerial Council to the Honourable Tony Clement, Minister of Health and materials for an eventual briefing of the new minister and his staff.

Ad Hoc Committee on AIDS 2006 Report

The Ministerial Council on HIV/AIDS received an update from the Ad Hoc Committee for AIDS2006 on preparations for the XVI International AIDS Conference being held in Toronto on August 13 to 18, 2006. At its last meeting in December 2005, the Ministerial Council identified a number of roles for itself including co-hosting a session on HIV/AIDS advisory models and welcoming delegates. The committee reported that it had submitted two abstracts to the conference: one on the Ministerial Council on HIV/AIDS: Facilitating Inter-Departmental and Inter-Ministerial Policy Development; and another submitted jointly with the Ukrainian National Coordinating Council on HIV/AIDS on the Role of Government Advisory Bodies in Informing Public Policy on HIV/AIDS: A Review of International Models . The Ministerial Council considered a number of options for hosting events in relation to the conference and instructed the committee to work out the details and report back with options.

Update on the Canadian Exhibition Space at the XVI International AIDS Conference

The Ministerial Council on HIV/AIDS received an update on preparations for the Canadian exhibition space at the XVI International AIDS Conference. The space will bring together provincial, territorial and federal governments and non-governmental organizations to provide a single Canadian presence at the International AIDS Conference. The Ministerial Council agreed to participate in the working group that is guiding preparations for the booth and directed the Secretariat to obtain a more detailed job description for the working group and circulate it to Ministerial Council members along with a request for expression of interest.

Update on National Pharmaceuticals Strategy

The Ministerial Council on HIV/AIDS received an update on an initiative to develop a national pharmaceuticals strategy. Health Canada has been tasked with preparing recommendations in five priority areas for consideration by the federal, provincial and territorial ministers responsible for health at their meeting in June of 2006. British Columbia's National Pharmaceutical Strategy Secretariat is also taking an active role. After a brief discussion, the Ministerial Council asked the Championing Committee to take the strategy under advisement and report back with options for action at a future meeting.

Communications and Liaison Committee Report

The Communications and Liaison Committee provided its report to the Ministerial Council on HIV/AIDS. A brief discussion was held on increasing communications with the National Aboriginal Council on HIV/AIDS (NACHA). The Ministerial Council asked the Communications and Liaison Committee to look into this further and report back with recommendations.

International Affairs Committee Report

The International Affairs Committee gave its report to the Ministerial Council on HIV/AIDS including a debriefing on the February 6 th meeting of the Consultative Group on Global HIV/AIDS Issues. This was accompanied by a wide-ranging discussion on the international dimensions of Canada's response to the HIV/AIDS epidemic. The Ministerial Council identified additional agenda items for its June meeting in Montreal, including a presentation from Foreign Affairs Canada and the Global Health Research Initiative.

Research Committee Report

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 held its most recent face-to-face meeting in Ottawa on February 20, 2006. The Ministerial Council's representative to CHARAC provided a detailed summary of the meeting. She noted that CHARAC had reviewed feedback it received in response to the draft priorities for extramural research it is developing to guide the spending that CIHR receives through the FI. CIHR is in the process of establishing the working groups that will flesh out the details of the priority areas. The Ministerial Council asked the Research Committee to provide further details on the working groups and the process for establishing their membership.

Other topics that were discussed included the pan-Canadian HIV/AIDS research plan, the strategic plan being developed for CIHR's HIV/AIDS Research Initiative, and the results of CIHR's 2005 strategic and open competitions. The Ministerial Council identified further agenda items for the Research Committee to consider as it develops the half-day session on research at the June meeting.

Presentation on Immigration and HIV/AIDS

Dr. Alan Li, a physician with the Regent Park Community Health Centre, presented the Ministerial Council on HIV/AIDS with an overview of the barriers faced by immigrants, refugees and people without status in Canada. Dr. Li is a member of the Committee for Accessible AIDS Treatment (CAAT), a coalition of about 25 health, legal and social service organizations in Toronto, which was formed in response to barriers faced by immigrants, refugees and people without status who are living with HIV/AIDS. Dr. Li previously presented to the Ministerial Council at its January meeting in 2005.

Immigrants and refugees in Canada face a number of challenges that prevent them for seeking or receiving services related to prevention, treatment, care and support for HIV/AIDS. Dr. Li described these barriers which he grouped into three broad categories: challenges related to the migration and settlement process itself (upheaval, trauma, loss, etc.); challenges related to the social determinants of health (such as basic struggles for housing, food and employment); and, challenges related the lack of culturally appropriate services and other structural barriers created by public policies. Dr. Li described in detail some of the contradictions that are created by existing policies and programs that affect migrants to Canada and some of the actions that have been taken to address them. Dr. Li advocated for the urgent development of a pan-Canadian strategy to address HIV/AIDS among immigrants and refugees.

The Ministerial Council agreed that further urgent action was needed to address the HIV/AIDS epidemic among immigrant and refugees in Canada. It offered to assist Dr. Li's group in setting up a meeting with the appropriate people within the federal government and agreed to participate as an observer on a think tank dealing with HIV and immigration. The Ministerial Council asked the Secretariat to draft a number of letters to officials within the federal government recommending that work begin on developing a strategy on immigration and HIV/AIDS and identified for further consideration the possibility of preparing a position paper on immigration and HIV/AIDS.

Report from the Public Health Agency and Health Canada

The Ministerial Council on HIV/AIDS was presented with an update on the activities of the Public Health Agency and Health Canada under the FI. Marsha Hay Snyder and Fernand Comeau of the HIV/AIDS Division of PHAC joined the meeting by teleconference to provide the Ministerial Council with the financial report on the FI for fiscal year 2005/2006, including a breakdown of spending by the four partners (Correctional Service Canada, Canadian Institutes of Health Research, Health Canada and PHAC) in each of the programmatic areas of the FI. The Ministerial Council identified a number of improvements to the presentation of the data and requested that in the future the data be accompanied by a narrative report explaining any variance. The Ministerial Council asked the Secretariat to obtain further information on the results-based responsibility and accountability framework for the FI and circulate it to members. It asked its Executive Committee to consider a presentation on the framework at its June meeting in Montreal

Update on Leading Together: Canada Takes Action on HIV/AIDS

Fernand Comeau provided the Ministerial Council on HIV/AIDS with an update on the roll-out of Leading Together: Canada Takes Action on HIV/AIDS: 2005-2010. He noted that the interim championing committee for Leading Together, set up shortly after the Ottawa stakeholder dialogue held on April 14 and 15, 2005, was working to complete the terms of reference for a permanent championing committee for Leading Together. The permanent committee will be made up of 15 people: 10 representatives from the community and 5 ex officio government members. Mr. Comeau informed the Ministerial Council that he had hired a contractor to develop a nominations process and communications plan, which will be ready by the end of March 2006. Mr. Comeau reported that PHAC was preparing a short version of Leading Together and considering a satellite session on Leading Together in connection with the XVI International AIDS Conference. Several members of the Ministerial Council expressed frustration with the slow speed in rolling out Leading Together and offered a number of suggestions for improving the process, including greater involvement of provincial, territorial, municipal and Aboriginal governments in the championing committee.

Update on Communications and Social Marketing

The Ministerial Council on HIV/AIDS heard an update on communications and social marketing activities under the FI presented by Steven Sternthal of the Knowledge and Awareness Section, HIV/AIDS Division, PHAC. Communications and social marketing refer to activities directed toward improving knowledge of HIV/AIDS among Canadians, addressing community and societal attitudes, and reducing the stigma and discrimination that fuel the epidemic. Under the FI, funding for communications and social marketing activities will increase to $4.7 million annually by 2008-2009. Mr. Sternthal described the five-year communications strategy that is being developed and the reasons for its focus on stigma and discrimination. The Ministerial Council provided Mr. Sternthal with advice on the elements of the strategy.

Following Mr. Sternthal's departure, the Ministerial Council asked the Secretariat to prepare a letter to Mr. Sternthal thanking him for his presentation and advising him to establish an advisory group which would provide guidance on the communications strategy and the development of social marketing messages.

Letter to the Minister of Health

The Ministerial Council on HIV/AIDS reviewed and approved the draft letter of introduction to the Minister of Health prepared over night by one of its members.

Approval of the Public Records of Meeting

The Ministerial Council on HIV/AIDS considered the Public Records of Meeting (PROMs) of the four meetings held in 2005: December 9-11, 2005; October 20-21, 2005; May 6-7, 2005; and, January 21-22, 2005. It provided comments on each of these and then approved the four PROMs subject to the changes identified.

Close of Meeting

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