Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada - Meeting of March 16 - 18, 2008 - Toronto, Ontario
Public Record of Meeting

Present:

Ministerial Advisory Council: Brian Conway (March 17 & 18) and John Charles Plater (Co-Chairs); Jonathan B. Angel, Michelle George, Monique Doolittle-Romas, Faye Katzman, Gerry Mugford, Jacqueline Gahagan (March 16 & 17), Kenneth Monteith, Anita Rachlis, Sheena Sargeant, Jacobet Edith Wambayi; Ex-officio: Frank McGee.

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

Secretariat: Fardosa Loyan, Susan Maves.

Facilitation and Recording Services: Janet Dunbrack, Wylie Thomas and Hajo Versteeg.

Guests: Nina Arron, HIV/AIDS Division, PHAC; Tracey Donaldson, Community Acquired Infections Division, PHAC; Marc-André Gaudreau, HIV/AIDS Division, PHAC; Marsha Hay-Snyder, HIV/AIDS Division, PHAC; Cathy Parker, Centre for Policy and Regulatory Affairs, Health Canada; Paul Sandstrom, National HIV and Retrovirus Laboratories, PHAC.

Welcome

John Plater, Co-Chair, Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada opened the meeting with a few words of welcome. He noted that the Ministerial Advisory Council would be renewing its strategic plan, and briefly reviewed the agenda.

Strategic Planning

The Ministerial Advisory Committee on the Federal Initiative spent the evening of March 16 and the morning of March 17 renewing its five-year strategic plan. Janet Dunbrack, who facilitated the meeting, presented a broad outline of a new strategic plan developed by the working group established at the Ministerial Advisory Council’s last meeting in December, 2007. The Ministerial Advisory spent time reviewing and discussing the proposed strategic priorities, and settled on the following five:

• Broker partnerships for collaborative action in response to HIV/AIDS.
• Ensure comprehensive approaches to prevention, care, treatment and support for all communities.
• Ensure effective, well-resourced and responsive structures and strategies to fight the epidemic.
• Support all streams of HIV/AIDS-related research.
• Ensure that Canada’s global response to HIV/AIDS meets its international commitments.

Once the five strategic priorities were agreed to, the Ministerial Advisory Council broke into three groups to assign activities to each of the priorities from a list of action items identified in interviews with key informants, including former members, over the course of the winter. The facilitator then worked to consolidate and analyze the results from the breakout groups, which she presented to back to the Ministerial Advisory Council the next day.

The following day, the Ministerial Advisory Council discussed the outcome of the breakout group discussions and agreed to a path forward for finalizing the strategic plan. It then spent some time discussing an appropriate committee structure to carry out the work of the strategic plan. It agreed on five standing committees, one for each of the strategic priorities, plus an executive committee composed of the Co-Chairs and the chairs of each committee. Council members were given 24 hours to think about which committees to join before signing up.

Approval of the Annual Report

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada approved its annual report for the fiscal year 2006-2007, subject to changes identified. It asked the Secretariat to proceed with posting the annual report on the website.

Report from the Public Health Agency of Canada

Nina Arron, Director of the HIV/AIDS Policy, Coordination and Programs Division of the Public Health Agency of Canada (PHAC), joined the meeting by teleconference to deliver PHAC’s report to the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada. Specifically, she provided updates on the Canadian HIV Vaccine Initiative, the National Framework for Research Planning and Knowledge Exchange, the new National HIV/AIDS Knowledge Broker and Canada’s biennial report to the United Nations General Assembly Special Session on HIV/AIDS (UNGASS). The Ministerial Advisory Council reiterated its advice that the developers of the national research framework work in close consultation with the Canadian Association of HIV Research.

Following the departure of the presenter, the Ministerial Advisory Council asked its Research Committee to consider Ms. Arron’s request for advice on the proposed experts panel that is being established to guide the development of the national HIV research framework. It also asked the Secretariat to follow up with Ms. Arron about providing an update on the environmental scan of research priorities undertaken in 2005 as part of the work to develop the framework. (See June 2006 Public Record of Meeting).

Addressing Sexually Transmitted and Blood-Borne Infections, Tuberculosis and Related Co-Infections

Tracey Donaldson, Manager, Operations, Management and Strategic Planning, Community Acquired Infections Division (CAID), PHAC, joined the meeting to introduce the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada to the work of CAID. She described the key activities and priorities of CAID and reviewed surveillance data for hepatitis C, tuberculosis, chlamydia, gonorrhoea and syphilis.

Following her presentation, the Ministerial Advisory Council had an opportunity to ask questions of clarification and to discuss some of the implications of the surveillance data presented. It indicated its interest in learning more about the results of the 2007 Inmate Study conducted by Correctional Service Canada. Ms. Donaldson agreed to follow up with managers within PHAC to obtain additional information on the surveillance data and definitions as requested by the Ministerial Advisory Council.

Following the departure of Ms. Donaldson, the Ministerial Advisory Council debriefed on her presentation. It highlighted the importance of ensuring that the various divisions of PHAC responsible for different diseases and infections communicate with each other. It asked the Secretariat to draft a letter on its behalf to Ms. Donaldson thanking her for her presentation and asking her to consider how the work of the CAID contributes to the goals of the Federal Initiative. It asked the Secretariat to ensure that all future thank-you letters include a sentence asking presenters to think about how their work contributes to the Federal Initiative.

National HIV and Retrovirus Laboratories

Paul Sandstrom, Director of the National HIV and Retrovirus Laboratories (NHRL), joined the meeting by teleconference to present the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada with an overview of his organization’s mandate, activities and reporting relationship within PHAC. His presentation reviewed specific projects and programs in the NHRL’s core activity areas:

• Reference testing, specialized screening and diagnostic testing;
• HIV surveillance, prevention and control;
• Integrated HIV data management;
• HIV laboratory improvement and quality assurance;
• Training and education of health care and public health workers
• Public health-related research and development.

A short discussion was held following Dr. Sandstrom’s presentation. Following his departure from the meeting, the Ministerial Advisory Council asked the Secretariat to prepare a letter to Dr. Sandstrom thanking him for his presentation and advising him that it would be in touch for further dialogue and information exchange.

In Camera Discussion on the Need for Facilitation and Report-Writing Services in Support of Meetings

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada held an in camera session to decide whether it continued to need facilitation and report-writing service in support of its meetings. The meeting facilitator and recorder were asked to leave the room for the duration of the discussion.

When the meeting reconvened, the Co-Chairs reported that the Ministerial Advisory Council had agreed to continue with outside facilitation and report-writing services in support of its face-to-face meetings. They asked the Secretariat to proceed with requests for proposals for facilitation and recording services along the same lines as in the past.

Safety of Human Cells, Tissues and Organs for Transplantation

Cathy Parker, Acting Director of the Centre for Policy and Regulatory Affairs of Health Canada, joined the meeting to provide the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada with an update on the Safety of Human Cells, Tissues and Organs for Transplantation Regulations (CTO Regulations), which came into effect on December 7, 2007. She described in detail the scope of the regulations, the gaps in regulatory oversight that they are intended to address and the process and timelines involved in their development.

Ms. Parker noted that Health Canada was caught off guard last February, when controversy hit the press over the regulations’ criteria for donor screening, which exclude people considered at high risk for HIV, HCV or HBV from donating, including men who have had sex men in the last 5 years.

Following her presentation, Ms. Parker had time to take questions from the Ministerial Advisory Council. Several members expressed their concern that the exclusion of men who have had sex with men contributes to stigma and discrimination. Ms. Parker said that she understood the concerns completely, but that the purpose of the regulations was to minimize the potential health risks of transplantation to recipients. She described the rationale for the restriction, noting that it was not a ban, and said that the regulations attempted to strike a balance between safety and ensuring the availability of CTO for transplant. She noted that Section 40 of the regulations allowed transplanting physicians to override these restrictions with the informed consent of the recipient.

Following Ms. Parker’s departure, the Ministerial Advisory Council discussed follow-up action. It asked the Secretariat and designated members of the Council to draft a letter to Ms. Parker thanking her for her presentation and reiterating its concerns that the screening for risk factors contributes to stigma and discrimination. It asked that the draft letter be circulated to full Council for comment before being finalized and sent.

Scholarships for AIDS 2008

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada discussed the level of funding for scholarships to attend the XVII International AIDS Conference being held in Mexico City in August. It was noted that while the federal government would maintain the same level of support it provided for the XVI AIDS Conference in Toronto, other sources of funding from Ontario and pharmaceutical companies would be much reduced. The Ministerial Advisory Council asked that information on scholarships be provided in a timely manner.

Housekeeping Items

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS reviewed the day’s agenda and a number of housekeeping items, including the conflict of interest policy and forms.

Review of Business Arising

Approval of Record of Decision from the December 2007 Meeting

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada considered the draft Record of Decision from it meeting on December 3 and 4, 2007, which it approved subject to changes identified by members.

Approval of Public Record of Meeting from the December 2007 Meeting

The Ministerial Advisory Council considered the draft Public Record of Meeting from it meeting on December 3 and 4, 2007, which it approved subject to changes identified by members.

Review of Actions Summary

The Secretariat reviewed the status of action items identified at the last meeting and outstanding items from earlier meetings. The Ministerial Advisory Council considered the outstanding action items from previous meetings and assigned them to the new committees.

Correspondence

The Secretariat briefly reviewed correspondence sent to and from Council since the last meeting.

Federal Initiative Funding

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada discussed responding to the $10 million reduction to the Federal Initiative as a result of government-wide cuts to grants and contributions and reallocations to help fund the Canadian HIV Vaccine Initiative (CHVI). It noted the impact the cuts were already having on the ability of community-based organizations to deliver frontline services in the fight against HIV/AIDS, and agreed that it would continue to monitor the situation closely. It asked designated members to prepare a letter to the Minister of Health to raise its serious concerns about the loss in funding for community groups involved in the response to HIV/AIDS. It also asked the Secretariat to organize a teleconference to fully brief members on the CHVI.

Committee Work Planning

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada broke into committees to agree to a time for their first teleconferences and plan the work ahead. When the meeting reconvened, committees reported the times and dates for their meetings and asked the Secretariat to set up teleconferences accordingly.

Council Meeting Dates

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada scheduled its meetings for 2008/2009:

• June 19-21, 2008 (Vancouver);
• October 23 & 24, 2008 (Ottawa);
• February 19 & 20, 2009 (Toronto).

Financial Report on the Federal Initiative

Marsha Hay-Snyder, Manager of the Accountability and Evaluation Section, HIV/AIDS Division, PHAC, joined the meeting to report on Federal Initiative expenditures in fiscal year 2007-2008 and review information about known reallocations and reductions that affect the Federal Initiative. She provided a two-page financial summary reporting expenditures against Treasury Board allocations as of December 31, 2007 for the four federal departments and agencies who receive funds from the Federal Initiative, including a more detailed breakdown in spending by each of the 11 responsibilities centres. Ms. Hay-Snyder also handed out a list of all planned activities using Federal Initiative funds in 2007-2008. She noted that financial data from Correctional Service Canada (CSC) was not ready at the time her financial report was prepared, but would be available by year-end.

Ms. Hay-Snyder stayed on after her presentation to answer questions from the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada. Several members repeated earlier requests to report expenditures against the programmatic areas (“Areas of Action”) of the Federal Initiative and to cost out the individual activities listed in the document she circulated. Ms. Hay-Snyder offered to look into questions about how decisions were made regarding where to make the cuts, and report back to the Ministerial Advisory Council.
Following her departure, the Ministerial Advisory Council agreed to write to Marsha Hay-Snyder thanking her for her presentation and the significant improvement in the financial report over previous iterations, and to reiterate its request for additional information, including the 2008/2009 financial figures as soon as these are known, with an indication of how the cuts will impact the Treasury Board allocations.

HIV Testing and Counselling Policy Framework

Marc-André Gaudreau, Manager, Program Development and Evidence-Based Interventions, HIV/AIDS Division, PHAC, joined the meeting to provide the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada with an update on the development of the HIV Testing Policy Framework, which is on track for completion by the winter of 2009. He described the context and need for a comprehensive policy framework that provides guidance on testing and counselling in a variety of settings and in light of emerging technologies. He reviewed work that has been completed to-date and outlined the work ahead. He described in some detail the consultation process that is being set up to guide the development of the framework and component guidance documents.

Following the presentation, the Ministerial Advisory Council provided Mr. Gaudreau with feedback and suggestions on the consultation process, including groups to consult.

Following the presenter’s departure, the Ministerial Advisory Council agreed to write to Mr. Gaudreau thanking him for his presentation and offering its help as the framework is developed.

Closing Remarks

The Co-Chairs thanked members of the Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada for their participation and the Secretariat and members of the HIV/AIDS Division for their hard work organizing the meeting. Everyone in the room was given an opportunity to share her or his reflections on the meeting.