Thank you, Chair and members of this committee, for the opportunity to appear before you today. The issue of the criminalization of HIV non-disclosure is a serious one, and I'm very pleased that the Standing Committee on Justice and Human Rights is studying the matter.
My name is Robin Montgomery. I'm the Executive Director of the Interagency Coalition on AIDS and Development. I do not have a law degree, nor do I have a medical degree. However, I am a human rights defender and a public health advocate on issues of HIV here at home in Canada and within the global community. It's from this perspective that I will ground my comments today.
In our work at the Interagency Coalition on AIDS and Development, a Canadian coalition that bridges domestic and global responses and connects the worlds of HIV and international development, we continue to observe the negative impact of HIV criminalization on individuals, on communities and on countries and regions in Canada and around the world. We see the negative impact on women, on LGBT2QI communities and on black and indigenous communities, to name but a few.
We also see its detrimental implications for our collective progress in ending HIV as a global public health threat as part of our 2030 agenda for sustainable development, an international commitment to which Canada has been an enthusiastic signatory.
We know that HIV does not discriminate. It's rooted in complex social and structural issues. It's largely both a cause and a consequence of poverty, where isolation, marginalization, vulnerability, stigma and discrimination are its closest friends.
One key global strategy in meeting our 2030 targets and goals, leaving no one behind, is called the 90-90-90 fast-track strategy, laid out by UNAIDS and endorsed by Canada. The tenets of this strategy are grounded in targets for HIV prevention and treatment, with the understanding that if we are able to reach the goal of having 90% of people living with HIV knowing their status, 90% of people who know their status on antiretroviral therapy and 90% of people on antiretroviral therapy achieving viral suppression, then we will effectively see success in getting to zero new infections, zero AIDS-related deaths and zero stigma and discrimination.
Singling out HIV with specific laws or prosecutions runs directly counter to this UN-led global public health strategy. There is no body of evidence that criminalization of HIV non-disclosure exposure or transmission has a public health benefit. There is, however, as we've heard today, a growing body of research that illustrates how such prosecutions undermine public health interventions and messaging by further stigmatizing people living with and at risk of HIV, placing them at risk of violence and driving them further away from learning their status and accessing essential and life-saving services and treatment. As we know, HIV-related stigma is the greatest barrier to testing, treatment uptake and timely access to prevention, treatment, care and support services.
As we've heard today, HIV epidemics are driven by undiagnosed HIV infections, not by people who know their HIV-positive status. It is now well established that the possibility of HIV transmission from an HIV-positive person with an undetectable viral load as the result of early and effective treatment is zero. HIV-positive people with a suppressed viral load cannot transmit the virus. I refer you to the “Expert consensus statement on the science of HIV in the context of criminal law”, which is a statement that was circulated in July 2018 from 20 of the world's leading HIV scientists. I have copies here for you today, but only in English. I will follow up with a hard copy following today's session.
The 2012 Oslo Declaration on HIV Criminalisation, which is the second document that I have shared with you today, points to the growing body of evidence that illustrates how criminalization of HIV non-disclosure is actually doing more harm than good in terms of its impact on public health and human rights. Due to the high number of undiagnosed infections, relying on disclosure to protect oneself and prosecuting people for non-disclosure can and does lead to a false sense of security.
As we've heard today from our esteemed colleagues at CATIE, if our goal is to encourage people to disclose their HIV status to partners and to access services early, using the blunt tool of sexual assault law to achieve this is counterproductive. Rather, an evidence-informed and rights-based alternative includes measures that create an environment that enables people to seek and realize the benefits of testing, support and timely treatment, and to safely disclose their HIV status.
While there may be a limited role for criminal law in rare cases in which people transmit HIV knowingly and with malicious intent, we echo experts, advocates and leaders at the Global Commission on HIV and the Law, UNAIDS, the UN special rapporteur on the right to health, the World Health Organization and the Canadian Coalition to Reform HIV Criminalization. We prefer to see people who are living with and at risk of HIV supported and empowered from the moment of diagnosis, so that even these rare cases can be prevented. This requires a non-punitive, non-criminal HIV prevention approach that is centred within communities where expertise about and understanding of issues of HIV are best found.
Where to go from here? We are very encouraged by the 2018 federal prosecutorial directive as a firm step forward, but more needs to be done. The acceleration of work with provincial attorneys general to endorse and follow the federal government directive is absolutely paramount. Reforms to the Criminal Code are also warranted in order to further limit the currently broad scope of HIV criminalization in Canada.
These reforms should achieve two things: first, put an end to the use of sexual assault law as the means of criminalizing HIV non-disclosure; and second, limit any use of the Criminal Code to cases of intentional and actual transmission of HIV to another person.
To help move forward this important work that has already been undertaken with the federal directive, broad multi-stakeholder consultations and cross-sector co-operation will be essential to ensure that legal reforms are steeped in the most up-to-date, leading scientific and medical evidence, and that all concerned stakeholders are meaningfully engaged. These include experts in human rights and law; public health, medical and scientific experts; experts from civil society and the community; and first and foremost, experts with lived first-hand experience—people living with HIV.
Canada has demonstrated tremendous global leadership and political will in responding to issues of HIV, human rights, gender diversity and gender equality. It is unfortunate, as well as very inconsistent and very confusing, to also have the distinction of being one of the most aggressive countries in the world in terms of the criminalization of HIV non-disclosure. It is fourth only to Russia, the United States and Belarus.
Canada's leadership here is absolutely critical. It will send an important signal to other countries that are either in the process of legal reform or that have yet to begin. Removing HIV non-disclosure prosecutions entirely from the reach of sexual assault laws will, first, be catalytic in Canada's ability to meet its own 90-90-90 targets. Second, it will be catalytic in its commitment to the sustainable development goal to leave no one behind. Third, it will align with Canada's commitment to human rights and evidence-informed public health approaches.
Thank you.