Mr. Speaker, I speak in support of the motion to regulate testing of all applicants for immigration for HIV-AIDS.
Today I would like to talk about a potentially massive health care problem which could be easily averted if we as parliamentarians take action. The problem is the entrance into Canada of HIV or AIDS infected immigrants. We are talking about immigrants, not visitors.
AIDS is a relatively new phenomenon in comparison with other diseases. The term has only entered the vocabulary of most Canadians over the past decade. Public awareness of the disease is still far less than it should be. Consequently there has often been a lag in the response of governments and institutions in dealing with the problem. We are aware that AIDS is only communicated in certain instances, not by casual contact. This is a situation which we must rectify today.
What is proposed is mandatory HIV-AIDS testing for all new immigrants to Canada. There is a great deal of logic and common sense to the proposal. I believe the action would be supported by a substantial majority of the Canadian public.
The facts are simple. The treatment of patients infected with the HIV virus and AIDS is an enormously expensive undertaking. Despite the millions of dollars spent on research, at this time there appears to be very little hope for a cure or even an effective vaccine. Those who study AIDS continue to advocate prevention as the best line of defence.
The motion could play a key role in reducing the number of Canadians who would otherwise be infected by the disease. HIV and AIDS infection is spreading rapidly across the world. These are the current numbers: by mid-1994 approximately 986,000 cases of aids have been reported. However, as the World Health Organization has noted, several factors suggest this is only a small part of a larger total. Many countries were slow to admit they have an AIDS problem and to move to set up systematic surveillance and reporting.
In areas where expertise and blood testing facilities are lacking it may be difficult to differentiate AIDS from other common diseases. In remote parts of the developing world many people fall ill and die without ever coming into contact with modern health services. Given these factors the World Health Organization believes the number of people to be infected with AIDS is much higher. The WHO estimates that by early 1994 more than three million cases of aids have actually occurred, including over 500,000 infants born to HIV infected women.
Some may argue that three million cases in a world population of over five billion does not represent a major health crisis, but the number of AIDS cases is actually a small part of a much larger problem. AIDS is the late stage of infection by a virus that can take more than a decade to cause illness.
The real measure of the scope of the epidemic is the number of people infected with HIV. The World Health Organization estimates there are more than 15 million people worldwide, including more than a million children infected with the virus. By the year 2000 if conservative forecasts prove correct, the cumulative total of HIV infections may reach 30 million to 40 million and the number of AIDS cases, more than 10 million.
A World Health Organization publication entitled "AIDS, Images of the Epidemic" notes the need for proper surveillance for better understanding of the disease. It notes that the most convenient approach to surveillance is to locate it in the health care system and test people who come in for care.
I believe the motion being put forward today is very much in the spirit of that recommendation. Canada already has in place the means to impose HIV-AIDS testing on immigrant applicants. These powers are contained in subsection 19(1) of the Immigration Act.
Canada has a long history of facing the challenge of infectious and lethal diseases brought to our country by immigrants and newcomers. For example, the forced quarantine of European immigrants for cholera and typhoid on the Quebec island of Grosse-Île is well documented. The island is now considered to be part of Canadian history and was recently visited by Irish President Mary Robinson because of its significance. Although Grosse-Île was at times a place of death and great suffering, it served the purpose of protecting the Canadian population as a whole from infection by these terrible diseases. It was the guiding principle then and it must remain the guiding principle for our immigration officials today.
Members of Parliament are accountable to the people they were elected to serve. Too often as members we hear stories of how the system failed. Sometimes it is a case of a criminal being paroled to offend a second time. Other times it is a case of a deportation order not being followed through and a policeman being murdered as a result.
If we do not follow through on the motion being discussed today, I believe one day the government will have to account to victims and friends and families of victims who contracted the disease through government inaction.
Why must we allow this to happen? Why is it that so often the government and governments like it must wait to be confronted by the victims before they make changes to policies? It is not unduly cruel to deny HIV and AIDS sufferers entrance to the country if it will prevent even one Canadian from contracting the disease. Persons infected with HIV and AIDS clearly, in the words of the Immigration Act, are or are likely to be a danger to public health or public safety. Something must be done.
Protection of the public is not the only criterion for denying individuals infected with AIDS or HIV the right to immigrate to Canada. The second part of the act takes into consideration another important component of any discussion of health care and that issue is cost. The act recognizes it should not be a priority of government to admit to the country those who will be a burden on the Canadian health care system.
Clearly immigrants infected with HIV or AIDS would be a source of excessive demand on the Canadian health care system. The disease is as expensive to treat as it is inexpensive to prevent. Recent figures from the United States show the average cost of treating a person with AIDS was $32,000 a year and the annual cost of treating a person with HIV but not AIDS was estimated at $5,150 a year. In 1991 the cost of HIV and AIDS care in the United States was estimated at $5.8 billion, including $4.4 billion for people with AIDS and $1.4 billion for HIV infected persons without AIDS.
In Canada some figures have shown the cost per year for persons infected with AIDS is $33,900. Our health care system is already overburdened and many Canadians have been forced on to waiting lists because of funding cutbacks. I call on the government not to aggravate the problem further by allowing immigrants with a terminal contagious disease into the country.
There are other factors to consider. Canada's taxpayer funded health care system is available to all citizens who want to use it. This is not the case for most other countries. It is conceivable that individuals knowingly infected with this virus could come to Canada because we have a publicly funded and accessible health care system. Our system may even be desirable to U.S. residents suffering from the disease, millions of whom have no health care insurance.
I would also like to note at this point that the United States already tests applicants for legal immigration to that country for AIDS and HIV.
In conclusion, a battery of blood tests is already part of the standard medical examination that is mandatory for all immigrants. Adding HIV will not substantially increase the cost of examinations, most of which are user pay. The cost of an HIV-AIDS test is $12, approximately one-third the cost of a test for tuberculosis. There is no good reason not to test for and exclude immigrant applicants with HIV since those with other untreatable or serious communicable diseases are already subject to exclusion.