Thank you, Madam Chair.
Let me first introduce my partner in this presentation, Dr. Thomas Kerr, from the B.C. Centre for Excellence. He's the director of the urban health program here at the centre at St. Paul's Hospital and the University of British Columbia.
The theme I would like to discuss for you relates to the efforts we have made over the last couple of decades to control HIV and AIDS in the province of British Columbia.
Here on the west coast, we have been affected by the worst HIV epidemic in the country. As Dr. Racette indicated, our health system is under significant stress, and sustainability of these efforts is a serious consideration. We agree wholeheartedly with Dr. Bohm's closing remarks that accurately monitoring our epidemic is essential for understanding what's happening. But at the end of the day, if we don't do something about it, monitoring is not going to cut it for us.
The B.C. Centre for Excellence is unique, in the sense that it's mandated not only to distribute antiretroviral therapies throughout the province to all eligible individuals, fully free of charge, but to also support laboratory monitoring. And we have a mandate to monitor health outcomes related to HIV.
Back in 1995, research conducted at the centre and elsewhere showed that by using three-drug combination therapy, we could arrest the course of the disease. What happens is that it shuts down the replication of the virus, and in a matter of weeks, the amount of virus circulating in blood goes to undetectable levels. As a result, immunity recovers, the patient doesn't get sick, and we restore the person's normal life. Today, a 20-year-old individual who starts on this regimen will expect five decades of normal life. We have really changed the outcome of HIV from a rapidly lethal disease to a disease that can be completely managed as a long-term, chronic management proposition.
As a result of that, morbidity and mortality in the province of British Columbia have decreased by greater than 90%, which goes a great deal to contributing to decreasing the burden on our hospitals and our health care system. Treatment has been deemed to be highly cost-effective for this reason, and as a result, the province continues to support free treatment for all in need.
During the years 1996 to 2000, we briskly rolled out antiretroviral therapy in the province. As a result of our monitoring efforts, we saw unexpectedly that the number of new HIV infections in the province decreased by approximately 40%. This was an unexpected event at the time, but it was a tip for us that the treatment not only prevents disease progression, but, in addition, and most importantly, it can stop HIV transmission.
We looked then at this phenomenon in the mother-to-child transmission setting. We found that by treating the mothers, we could stop transmission to the babies by nearly 100%. In more recent work we've done, in collaboration with others, we have shown that the same principle applies when you treat an injection drug user or when you treat a member of an HIV-discordant couple, in which one member of the couple is HIV-positive and the other is HIV-negative.
The province of British Columbia, therefore, has embarked, for a number of years now, on a new strategy, which we call seek and treat. We're seeking out individuals by facilitating and normalizing HIV testing, and we are screening the population for HIV so that we can chip away at the recurrent statistic that 25% of people infected with HIV are unaware of the infection. The Public Health Agency of Canada, year after year, reports the same number, yet we have not changed our guidelines regarding HIV testing.
We are advocating a national strategy on HIV testing such that the testing can be generalized so that we can identify those individuals and do the best for them, and in doing so, stop HIV transmission. By approaching the problem in this way, British Columbia, in addition to decreasing morbidity and mortality by greater than 90%, has now decreased new HIV infections by greater than 66%.
Let me emphasize that we are the only jurisdiction in the country that has seen a meaningful decrease in the number of new HIV diagnoses per year in the last two decades, at a time when Saskatchewan has seen a fivefold increase in the number of cases and Manitoba has a threefold increase in the number of cases. There is also a rising number of cases in Newfoundland and in your own great city of Ottawa. First nations individuals are five times overrepresented in this epidemic.
Madam Chair, we think we have a solution at the Canadian level. The United States has actually formally embraced this approach. We would like to recommend that HIV treatment and prevention be made a national priority for this country immediately.
I will let Dr. Kerr discuss how this should be enforced among injection drug users.
Thank you.