Good morning again.
My name is Frank Plummer. I'm the scientific director of the National Microbiology Laboratory in Winnipeg and the chief scientific officer with the Public Health Agency of Canada. I'm also a distinguished professor at the University of Manitoba and a physician scientist who has spent his career working on HIV and AIDS in Africa. It is in those latter capacities that I'm appearing before the committee today.
I would like to thank the committee for soliciting my input and giving me the opportunity to talk about some of my work and, moreover, allowing me to appear from Seattle. I'm attending an important meeting of the Gates grand challenges in global health program, which I couldn't afford to miss.
I'd also be remiss if I didn't thank the Gates Foundation for the gracious loan of their video conferencing facilities.
I know the committee is reviewing legislation to make Canadian-made generic drugs still under patent by non-generic pharmaceutical companies more accessible and affordable for developing countries, and that the original legislation was targeted largely to antiretroviral therapy for HIV.
First I'd like to tell the committee about some of the amazing work Canada has done related to the HIV epidemic in Africa. I lived in Nairobi for 17 years, directing a highly acclaimed collaboration between the universities of Nairobi and Manitoba. The research done through this collaboration was among the first to recognize that HIV was widespread in East Africa and did pioneering work to understand the epidemic and how to prevent the transmission of HIV.
As committee members will know, HIV is transmitted primarily through heterosexual relationships in Africa, and it also spreads from mother to newborn child. Through research funded largely by the Government of Canada, we learned that commercial sex is a key driver of the HIV epidemic. Ordinary sexually transmitted diseases such as gonorrhea and chlamydia promote HIV transmission. Circumcision of men reduces their susceptibility to HIV, and breast feeding is an important risk factor for transmission of HIV from mother to child.
Each of these understandings was translated into effective interventions by our group and ultimately changed global health policy. They make up the core of effective HIV prevention in Africa and elsewhere. Many tens of thousands of people don't get HIV infected each year because of this foundation work done by the universities of Manitoba and Nairobi and funded by the Government of Canada.
This long-standing collaboration and my involvement in it continue. This year we celebrated our 30th anniversary. In recent years the research work of the collaboration has focused on understanding natural immunity to HIV. This work, which may discover how to make an HIV vaccine, is funded by the Government of Canada and the Bill and Melinda Gates Foundation, which is why I'm here in Seattle today.
The work is carried out in a state-of-the-art laboratory complex built and equipped with a grant from the Government of Canada through the Canada Foundation for Innovation. So Canada has done and continues to do a lot in the fight against HIV and AIDS in Africa.
Now to Bill C-393. It is beyond my competence to comment on whether the current legislation and proposed amendments to it are problematic or not. I know there's been criticism of the effectiveness of the current program and only one country has yet accessed it. However, I doubt that the structure of the Canadian program has anything to do with why it's not being used. I think most likely the original, well-intentioned program was overtaken by events. The global fund to fight HIV, tuberculosis, and malaria, the U.S. PEPFAR program, the President's emergency plan for AIDS relief, the availability of high-quality antiretrovirals from generic manufacturers elsewhere, and drops in the price of non-generic drugs all contribute to a lack of interest in the Canadian program, and that's seen with other programs of a similar nature around the world.
Unfortunately, you were unable to hear from my colleague, Dr. Kimani from Nairobi, but it's his experience that availability of antiretroviral drugs is not the real problem. The ability to deliver high-quality treatment programs with qualified personnel is more of a problem.
While I'm certainly supportive of making antiretroviral drugs available to those who need them, I would also remind the committee that the current antiretroviral drugs are not cures. Importantly, they prolong life; however, it's my belief we will not solve the HIV pandemic by treating AIDS. People are becoming newly infected with HIV at a far greater rate than they are being put on treatment. Furthermore, treating AIDS is many times more expensive than preventing an HIV infection. We know how to prevent new infections effectively and inexpensively, and in my view, far too little emphasis and investment has been put into simple preventive strategies that we know work. We also need to focus research on technologies to prevent HIV transmission such as a vaccine or a microbicide.
I'll close there with a thank you for asking me to speak to you today, and for your attention. I look forward to your questions.