Public Safety Committee on April 1st, 2010

[Sandra Ka Hon Chu]

We don't actually have information in terms of the cost of the different programs that exist in the world.

When we've spoken to the Spanish wardens, there is the cost of the needles and syringes themselves, and in many cases where the staff deliver the program, there's marginal time spent. There are discussions with prisoners about referrals--

[Mark Holland, Liberal, Ajax—Pickering, ON]

And what is the annualized cost of treating hepatitis C and HIV/AIDS for prisons?

[Sandra Ka Hon Chu]

For someone in prison, it's $22,000 for hepatitis C, and $29,000 a year.

[Mark Holland, Liberal, Ajax—Pickering, ON]

And for HIV/AIDS?

[Sandra Ka Hon Chu]

That's $29,000 a year.

[Mark Holland, Liberal, Ajax—Pickering, ON]

Thank you, Mr. Chair.

[Sandra Ka Hon Chu]

That's a lifetime cost.

[The Chair, Conservative, Garry Breitkreuz]

Thank you very much.

Ms. Mourani, please.

[Maria Mourani, Bloc, Ahuntsic, QC]

Thank you, Mr. Chair.

Thank you for being here, Madam. I have a few quick questions. You said that 30% of offenders currently have hepatitis C. Is that right?

[Sandra Ka Hon Chu]

I think 27.6% was the figure I saw. That was from 2006, and I believe those rates are probably higher.

[Maria Mourani, Bloc, Ahuntsic, QC]

You were not talking about the present, but about 2006.

In the data that you brought, do you have the breakdown of offenders who became infected in prison versus those who had already been infected?

[Sandra Ka Hon Chu]

We don't have a breakdown. I think in some cases it's very hard to determine when exactly they're infected and how. We don't have that data. The 2007 survey--

[Maria Mourani, Bloc, Ahuntsic, QC]

So we cannot say that these people became infected in prison. We can only say that they are infected.

[Sandra Ka Hon Chu]

Yes, but there is data that indicates upon admission when people test, the rates of HIV and hepatitis C, and the problems within the prison system. Those are significantly different, and I can share those with you.

[Maria Mourani, Bloc, Ahuntsic, QC]

Before or after what? I do not understand.

[Sandra Ka Hon Chu]

When people are tested upon admission--when they're about to enter prison--the rates of HIV and hepatitis C are significantly lower than the prevalence overall in the federal prison system. You can draw some conclusions from that, although you can't say definitively when they're infected.

[Maria Mourani, Bloc, Ahuntsic, QC]

What conclusions can we draw?

[Sandra Ka Hon Chu]

Some people are getting infected inside.

[Maria Mourani, Bloc, Ahuntsic, QC]

That they got infected in prison?

[Sandra Ka Hon Chu]

Yes.

[Maria Mourani, Bloc, Ahuntsic, QC]

Let us look at it from the perspective of the Correctional Service Canada. The mandate of the Correctional Service is to offer programs to combat drug addiction, to help people overcome a drug addiction.

What do you think about the disconnect between our giving needles and everything to people in prison so that they can take drugs, and banning drugs from prison and offering programs that teach people how to work on themselves to beat the addiction and stop taking drugs?

[Sandra Ka Hon Chu]

I don't think it's ambivalence. I think it's a recognition of the reality that people use drugs. In the community, we ban drugs, and we provide needle and syringe programs based on the public health and cost evidence. So I think it would be a recognition of the reality that people are suffering from addictions. They don't necessarily access treatment for whatever reason, and we want to prevent disease from being transmitted.

[Maria Mourani, Bloc, Ahuntsic, QC]

How do you see the management of this needle program? Should the needles be provided to offenders in their cells, letting them figure it out? Is that how you see it?

[Sandra Ka Hon Chu]

It depends on how you decide to deliver the program. There have been different models. There have been automated dispensing machines and peer health workers. In most of the cases where this program has existed, there has always been an increasing number of people who use the program being referred to addiction treatment programs. So there's always a conversation to be had about drug use, and the dangers of drug use.

[Maria Mourani, Bloc, Ahuntsic, QC]

There is something I do not understand; when you talk about the program, you talk about the program outside the prison and not inside.