Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada - September 30 - October 2, 2009 - Ottawa, Ontario

Public Record of Meeting

 

Present:

Ministerial Advisory Council: Brian Conway (Co-Chair), John Plater (Co-Chair); Jonathan Angel, Monique Doolittle-Romas, Jacqueline Gahagan, Michelle George, Faye Katzman, Ken Monteith, Gerry Mugford, David M. Nelson, Anita Rachlis and Sheena Sargeant.

Regrets:

Frank McGee, Edith Wambayi

Public Health Agency of Canada (PHAC): Grafton Spooner, Manager, External and Government Relations; David Kerr, Program Consultant, External and Government Relations Section and Susan Maves, Committee Coordinator, HIV/AIDS Policy, Coordination and Programs Division, PHAC

Facilitation and Recording Services: Doug Bateson, Diane Finkle-Perazzo

Guests: Jacqueline Arthur, Population Section, HIV/AIDS Division, PHAC; Marc-André Gaudreau, Manager, Program Development and Evidence Based Interventions, PHAC; Clare Jackson, Population Section, HIV/AIDS Division, PHAC; and Tanya Lary, Senior Policy Advisor, External and Government Relations Section, HIV/AIDS Policy, Coordination and Programs Division, PHAC.

Welcome

John Plater, Co-Chair, welcomed Ministerial Advisory Council (Council) Members and extended regrets from Brian Conway, Co Chair who joined the meeting the following day.  John also expressed regrets on behalf of Frank McGee and Edith Wambayi.  The Meeting Agenda was approved with a minor modification.

Interdepartmental Policy Forum on the Determinants of Health and HIV/AIDS held September 14 – 15, 2009 in Ottawa

Grafton Spooner provided an overview of the Interdepartmental Policy Forum on the Determinants of Health and HIV/AIDS held in Ottawa, September 14-15, 2009.  Council members discussed the importance of the determinants of health and decided to review a number of background documents to prepare for their meeting with the Minister on this issue. 

Committee Review Findings: Presentation and Discussion

Tanya Lary, Senior Policy Advisor, HIV/AIDS Policy, Coordination and Programs Division Public Health Agency of Canada, provided an overview of the Summary Report of the Findings and Conclusions of the Review of Advisory and Coordinating Mechanisms under the Federal Initiative to Address HIV/AIDS in Canada.  Ms. Lary reviewed the general findings from the consultations with Council Members and Council agreed to review the report more fully and provide additional feedback. 

Ministerial Advisory Council Meeting with The Honourable Leona Aglukkaq, Minister of Health, Parliament Hill.

On October 1, 2009, Council proceeded to Parliament Hill for a meeting with The Honourable Leona Aglukkaq, Minister of Health.  Council members presented information and advice to the Minister on the following issues:

• Criminalization of HIV
• Determinants of Health and HIV/AIDS
• AIDS 2010 Conference and World AIDS Day
• Harm Reduction
• H1N1 Virus and HIV
• Federal Initiative Funding and Renewal

Population-Specific HIV/AIDS Status Report: Aboriginal Peoples

Jacqueline Arthur, A/Manager and Clare Jackson, Policy Analyst, of the Population Section, HIV/AIDS Division, Public Health Agency of Canada, joined the meeting to provide an update on the summary of findings of the Population-Specific HIV/AIDS Status Report: Aboriginal

Peoples. First Nations, Métis and Inuit peoples make up a unique segment of the HIV/AIDS picture in Canada.  Injection drug use is the main HIV exposure category.  Compared to the non-Aboriginal population, Aboriginal women and youth are particularly affected by HIV/AIDS.  HIV/AIDS among Aboriginal peoples is linked to a variety of broad factors and determinants of health, and HIV/AIDS approaches need to reflect the diversity of First Nations, Métis and Inuit populations.

Council members discussed how the Status Report could inform the Council’s future work in providing policy advice on key and emerging issues.  They agreed the Report was an invaluable tool and could be used by Council in a variety of ways.  Council members pointed out issues related to lack of accessibility to health care in remote communities and there is a general lack of awareness about the challenges of Aboriginal people especially related to on and off reserve issues.  They also pointed to the lack of information about sex workers and expressed concern about the difficulties inherent in providing consistent provincial data.

HIV Testing and Counselling Guidelines

Marc-André Gaudreau, Manager, Program Development and Evidence Based Interventions Section, HIV/AIDS Policy, Coordination and Programs Division, joined the meeting to provide an update on the HIV Testing and Counselling Guidelines for Canada.  Preliminary findings of the consultation have shown there is strong support for the importance of HIV testing and counselling; strong support for a routine testing approach; and support for pre-test information instead of counselling.

Council members stressed the perception of counselling often varies between physicians and clients and Quebec is also involved in a parallel process on optimizing testing among immigrants and refugees.  They also discussed the issue of consent for testing and testing opportunities when managing another disease or as part of regular medical check ups. 

Evidence-Based Decision Making Report

Monique Doolittle-Romas, Chair of the Strategies Committee, provided background on the development of the Evidence-Based Decision Making report prepared for Council by Huskins and Associates Consulting Inc. Council agreed to accept the document with minor modifications.

Foresight Document

Council Members examined the Foresight Document Conceptual Framework Draft.  This document was developed to address the changing nature of HIV/AIDS in Canada and to meet the future challenges and issues.  It was agreed that a preamble would be written and the document stress Canada’s role within the global pandemic.  Council also considered the possibility of including a series of possible scenarios to illustrate what may happen in the future such as the development of a vaccine for HIV/AIDS. It was also suggested that issues related to youth be strengthened in the document and the impact of web-based communication approaches (e.g. Facebook, Twitter, etc.) be considered. 

AIDS Strategies: Comparative Analysis of Selected National Strategies

Gerry Mugford, Chair of the International Committee reviewed the AIDS Strategies: Comparative Analysis of Selected National Strategies report.  Council agreed to finalize the report, and to have an executive summary written.  The document will be utilized by Council to address best practices on policy and programs and provide the Minister with advice.  Council also agreed to use this document in conjunction with their work on the Foresight Document. 
Council nominated two of its members to sit on the Global HIV/AIDS Consultative Group.  Jacqueline Gahagan and Gerry Mugford will represent Council.

H1N1 Virus: Considerations for Individuals Living with HIV

Council Members considered the document Guidance on H1N1 Vaccine Sequencing. These guidelines recognize the individuals or groups which are at higher risk of severe illness or hospitalization due to exposure to the H1N1 virus.  Individuals living with HIV would be included on the list of “persons with chronic conditions” and would therefore be covered by these guidelines. Council agreed these guidelines were appropriate and AIDS Service Organizations in the field are working hard to ensure that HIV positive individuals are able to obtain access to the medicines and the treatment they require.  Council also supported the approach that is being taken by the Chief Public Health Officer, Dr. David Butler-Jones, to combat the H1N1 virus.  They agreed that if conditions changed, an emergency meeting via teleconference would be held to discuss the situation.

UNGASS Report

Tanya Lary, Senior Policy Advisor, HIV/AIDS Policy, Coordination and Programs Division joined the meeting to provide an update on the Government of Canada’s Report to the Secretary General of the United Nations on the United Nations General Assembly Special Session Declaration of Commitment of HIV/AIDS (The UNGASS Report) 2010. The UNGASS Report is a biannual report on the domestic implementation of the Declaration of Commitment on HIV/AIDS.  It covers the period January 2008 – December 2010 and is prepared by the Public Health Agency of Canada. Council provided advice on which best practices should be highlighted in the 2010 Report; what major challenges should be identified; and how the Report could be better utilized by stakeholders.

Renewal of Leading Together: Canada Takes Action on HIV/AIDS (2005 – 2010) Document: 2010 and Beyond

Tanya Lary remained at the meeting and jointly presented with Jacqueline Gahagan of Council, information about the renewal of Leading Together Strategy. Leading Together is a blueprint for action on HIV/AIDS for all of Canada.  It calls for improved coordination, integration, accountability and responsiveness to the epidemic and is grounded in the values of social justice,

human rights, diversity, participation and empowerment, global responsibility, and mutual accountability. Council Members provided some examples of how Leading Together has been used in the field and stressed the important synergy between the Federal Initiative and its commitment to Leading Together.

Criminalization of HIV: Discussion and Letter of Advice to the Minister

Council discussed the issue of criminalization of HIV, building on a previous discussion held in preparation for the meeting with the Minister.  Council agreed there is a need for more detailed background information on criminalization and decided to consider this issue further at their next meeting.

XVII International AIDS Conference (AIDS 2010)

Council discussed possible involvement in these events.

Report from the Partnership Committee

Council supported the need to increase its linkages with other National Stakeholder Groups and the National Aboriginal Council on HIV/AIDS (NACHA) in particular. 

Review of Business Items Arising from June 2009 Meeting

Council considered the Record of Decision (ROD) and the Public Record of Meeting (PROM) from its meeting of June 4 - 5, 2009 and identified a number of minor changes.  Council approved the June 2009 ROD and PROM subject to the changes identified.  The Secretariat reviewed the Action Summary from the June 2009 meeting as well as Council’s Correspondence since the June 2009 meeting.

Closing Remarks

John Plater and Brian Conway, the Co-Chairs, thanked Council Members and the Secretariat for their hard work and dedication.  They reminded Members the next meeting is scheduled for January 28–29, 2010 in Toronto.