Debates of Feb. 7th, 2008

HIV-AIDS among Aboriginal People

[Peter Julian, NDP, Burnaby—New Westminster, BC]

Mr. Speaker, this is a non-partisan evening so I will compliment the government on the issue of hepatitis C. There is no doubt that that compensation was sorely long overdue. That tragedy is something that needed to be responded to many years before, so I certainly will say that the government acted appropriately there.

However, on the issue of housing, I am sorry but I simply cannot agree with the Parliamentary Secretary for the Minister of Health. I simply cannot agree.

The funding that was put forward by the government came out of the NDP budget from three years ago. Even at the time, when we forced the former Liberal government to provide some funding for housing, we knew that was only a first step in what was required in long term investments to re-establish social housing and a national housing program in this country. Some of that money has been taken by the current Conservative government and set aside.

It is very slowly flowing, but the reality is that it is far from what is required across this country to address a national tragedy, which is the growing homelessness in the streets of our city. There are hundreds of thousands of Canadians sleeping out tonight. We are not just talking about aboriginal victims of HIV-AIDS. We are talking about individuals in all corners of the country.

My grandmother used to tell me about the Great Depression. I could not imagine a country where there were thousands of people sleeping out in the streets. She used to tell me about the dirty thirties, and I thought, my goodness, it is wonderful that I am living in a country where we have resolved that problem. Yet now in 2008, it is right back to the same kind of horrible social conditions that people saw back in the 1930s.

I simply do not believe that the government is taking this issue seriously and making the massive investments that are required to provide social housing right across this country.

[The Acting Speaker, Conservative, Royal Galipeau]

The hon. member for Vancouver East will want to know that there is a minute for both the question and the answer. By 30 seconds, she will be cut off.

[Libby Davies, NDP, Vancouver East, BC]

Mr. Speaker, I will speak very quickly.

The member commented on the impact of drug prohibition itself. One of the serious issues here is that the criminalization of drug users is actually accelerating the HIV infection rate as people are basically operating outside of the mainstream of society.

I just wonder if he would comment on that as a contributing factor to the crisis we face.

[Peter Julian, NDP, Burnaby—New Westminster, BC]

Mr. Speaker, it is very clear that we have substantial difficulties in using enforcement as a tool for dealing with drug addictions when we know that that is not the solution.

The member for Vancouver East, the member for Burnaby—Douglas and the member for Nanaimo—Cowichan have offered up a whole array of solutions, including harm reduction. Very clearly, we have to change our approach to addiction.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I rise this evening to address the proactive action that is being taken to address HIV-AIDS in this country and around the world.

As our Minister of Health indicated, this government is committed to addressing HIV-AIDS issues in Canada, and specifically within first nations, Inuit and Métis communities.

The issue of HIV-AIDS is one that has probably touched virtually every community that is represented here in the House of Commons. In my dental practice I treated those infected with HIV and I saw first hand the devastation that this disease can cause.

I have travelled to many developing countries and I have witnessed the destructive effects of this disease, not just on those infected, but also on the families and the communities left to deal with the aftermath.

This past December in Kitchener, I had the privilege of walking through the One Life Experience, a 2,000 square foot interactive exhibit created by World Vision, which allows people to walk in the shoes of one of four children who have been affected by AIDS. This powerful display gave me a renewed sense of what it must be like to deal with the bad news that the blood tests have been returned and have confirmed a positive HIV diagnosis. How does one deal with that shattering news? My prayers go out to those who have been infected with HIV and to the families and communities that are left scrambling to cope.

Approximately 58,000 Canadians were estimated to be living with HIV infection in 2005. This unfortunately represents a 16% increase from 2002.

While new infections will unfortunately continue to occur, survival rates will improve due to treatments for HIV. As a result, requirements for treatment and care will also continue to increase in the future. An estimated 2,300 to 4,500 new HIV infections occurred in Canada in 2005, slightly higher than what was estimated for 2002. That is troubling to say the least.

We all have a collective responsibility to ensure that concerted action is taken. This government has taken concrete steps to address this disease, and hopefully one day, we will find a vaccine that will alleviate this worldwide epidemic.

In terms of who is most at risk in Canada, we can identify three groups. The main risk group for HIV in Canada is men who have sex with men. This group comprises 45% of new infections. Persons exposed to HIV through heterosexual contact comprise approximately 36% of new infections. Of the groups that are most at risk in Canada, persons who inject drugs make up 16% of new infections.

This last statistic is of particular importance to the aboriginal community as the proportion of new HIV infections among aboriginal Canadians due to injection drug use is much higher than among all Canadians. This highlights the uniqueness of the HIV epidemic among aboriginal persons and it underscores the complexity of Canada's HIV epidemic.

Aboriginal persons continue to be over-represented in the HIV epidemic in Canada. They represent 3.3% of the Canadian population, and yet in 2005 it was estimated that aboriginal persons accounted for 7.5% of all those living with HIV in Canada. That is an estimated 3,600 to 5,100 aboriginal persons living with HIV. Equally troubling is the fact that aboriginal persons also comprised 9% of the new HIV infections in 2005. These numbers give us an overall HIV infection rate among aboriginal persons about 2.8 times higher than among non-aboriginal persons.

Canada is in the middle of the range of developed countries with respect to rates of HIV infection. Our per capita rate of persons living with HIV infection is lower than that in the U.S.A., Italy and France, but it is higher than that in the U.K and Australia.

The rate of newly reported cases of HIV infection in B.C. is slightly higher than in Canada as a whole. In 2006, 8.4 new cases per 100,000 were reported in British Columbia. This compared to 7.8 cases per 100,000 across Canada. Again we see a disparity in the percentages. Overall, 20.3% of Canada's cumulative reported HIV cases are from B.C., whereas B.C. represents about 13% of Canada's population.

In 2005 and 2006 the proportion of reported HIV cases attributed to an injection drug use exposure in British Columbia was 25% as compared to 19.3% in the rest of Canada. Of the 4.3 million plus people living in British Columbia, 4.5% were estimated to be of aboriginal identity, this according to the latest 2006 census.

Among the HIV reports in B.C. with ethnicity information, aboriginal persons accounted for 15.1% of cases reported in 2005 and 15.8% of cases reported in 2006. The rate of new HIV infections among aboriginal injection drug users compared to non-aboriginal users has been observed for a number of years in Vancouver. While this in itself is not a new finding, it continues to be an issue of concern and is related to the overall higher rates of HIV infection in aboriginals in Canada in general.

Building on what the hon. minister said, I will to provide some concrete examples of what is being done by this government to address HIV-AIDS in aboriginal communities across Canada. This of course includes what is being done in Vancouver's downtown east side.

The government knows that many factors have increased the vulnerability of aboriginal Canadians to HIV. HIV-AIDS has a particularly significant impact on aboriginal women. Females represent nearly half of all positive HIV test reports among aboriginal peoples, approximately 47% as opposed to 20% of reports among non-aboriginal people. Aboriginal people are also infected with HIV at a younger age than their non-aboriginal counterparts.

As stated before, injection drug use is the main risk for HIV-AIDS among aboriginal people in Canada. Over half of the new HIV infections estimated among aboriginal people for 2005 were attributed to injection drug use compared with only 14% among all Canadians.

As noted by our hon. Minister of Health, the government is serious about addressing the issue of drug use among Canadians. The national anti-drug strategy offers a two track approach which is tough on crime and compassionate for victims, and provides $63.8 million over two years to tackle the drug trade. It includes three action plans: one, preventing illicit drug use among young Canadians; two, treating people with illicit drug dependencies; and three, combatting the production and distribution of illicit drugs.

Drug use is devastating to Canadians. It destroys individuals, tears families apart and carries life altering consequences, and the government is taking action.

Under the federal initiative to address HIV-AIDS in Canada, the Public Health Agency of Canada, in partnership with Health Canada, supports the work of the National Aboriginal Council on HIV-AIDS. This council acts as an advisory mechanism. It provides policy advice to Health Canada and the Public Health Agency of Canada and other relevant stakeholders about HIV-AIDS and related issues among all aboriginal peoples in Canada.

The council is a mechanism for the development and coordination of shared actions between the federal initiative to address HIV-AIDS in Canada and aboriginal communities working on HIV-AIDS issues. Its aim is to ensure that Health Canada and the Public Health Agency of Canada and its representatives have effective and efficient access to policy advice regarding aboriginal HIV-AIDS and related issues.

The Public Health Agency of Canada supports community based organizations as well as national NGOs to achieve a number of goals. These goals include: supporting a national voluntary sector response that plays a coordinating and leadership role in the response to HIV-AIDS; helping engage in direct meaningful involvement with people living with or at risk of HIV-AIDS; encouraging collaboration and partnership to address risk factors of the disease and achieve an integrated approach to disease prevention across sectors; enhancing the capacity of individuals, organizations and communities to respond to this epidemic; gathering and encouraging the exchange of HIV-AIDS information and knowledge; enabling the development of respective informed and innovative policies and program interventions that are relevant across Canada; and finally, enhancing a broader response to the HIV-AIDS epidemic and its underlying causes.

For example, the Public Health Agency supports specific projects in the Vancouver downtown east side: the Vancouver Native Health Society for a project that aims to reduce disparities in HIV treatment and care through community based initiatives; and the Western Aboriginal Harm Reduction Society to advance regional capacity building initiatives for non-reserve community based programing through workshops, training, outreach, community forums and discussions.

Also, the Positive Women Network is supported to increase access to integrated culturally relevant services by young HIV positive aboriginal women and other women in collaboration with other stakeholders. This will create a peer-driven, safe and supportive environment for young HIV positive women, particularly in the Vancouver downtown east side, and focus on a meaningful participation of these women in the direction of their own care, support and prevention initiatives.

The network is also supported in the development of innovative programing and resources for women, their families and service providers. It develops culturally appropriate services for aboriginal women who face multiple barriers to care, treatment and support.

The Persons with AIDS Society of British Columbia is being supported to assist its members on matters such as income security, will and estates, landlord and tenancy issues and human rights infringement. Staff and volunteers help clients prepare forms, understand procedures and, at times, accompany clients at tribunal hearings or appeals.

The Public Health Agency of Canada also supports five national projects, specifically targeting aboriginal communities and HIV-AIDS.

The first is the Canadian Aboriginal AIDS Network's culturally appropriate harm reduction program development. The project objective is to develop national and regional capacity building initiatives from non-reserve aboriginal community based programing. This will be achieved by developing a harm reduction model targeting vulnerable populations, including at risk women and youth, inmates and two-spirited men developing training on using the model in creating a national aboriginal task force on injection drug use.

The second is the Red Road HIV/AIDS Network Society's bloodlines project. This project objective is to provide an accurate, culturally relevant publication that includes meaningful educational information for aboriginal people living with HIV-AIDS and their family and friends, front line workers, health providers, program planners and policy-makers. The project objective will be achieved through launching Bloodlines Magazine nationally, which represents the voice of marginalized populations.

The third is the Canadian Aboriginal AIDS Network's Fostering Community Leadership to End HIV-AIDS Stigma and Discrimination Social Marketing campaign. The project objective is to increase levels of awareness and knowledge about HIV-AIDS among aboriginal leadership by at least 10% through social marketing principles.

The project intends to end stigma and discrimination and create community environments that may become more responsive and conducive to establishing needed education, prevention, testing, diagnostic care, treatment and support programs. The project objective will be achieved through an initial social marketing campaign that is intended to speak to the basic principles of human rights.

The fourth is the Pauktuutit Inuit Women of Canada's project titled, “Addressing the HIV Needs of Inuit in Urban Centres”. This project's objective is to improve the quality of life of Inuit infected with or affected by HIV by improving access to Inuit-centred prevention, diagnosis, care, treatment and support provided by AIDS service organizations, aboriginal and non-aboriginal-specific organizations, as well as other health, medical or social service providers.

The project objective will be achieved through the formation of an advisory committee, a literature review of HIV prevention, testing and diagnosis, care and support services currently available, interviews with Inuit men and women and through the identification of gaps and strategies to develop a best practice document and/or audiovisual teaching tool.

The fifth is a further Canadian Aboriginal AIDS Network project. Its objective is to develop national and regional capacity building initiatives for a non-reserve aboriginal community based program. This will be achieved by developing a harm reduction model targeting vulnerable populations, developing training on using the model and creating a national aboriginal task force on injection drug use.

As we can see, the government is working closely with aboriginal communities to support efforts that are and will continue to make a difference.

[Libby Davies, NDP, Vancouver East, BC]

Mr. Speaker, I listened with interest to the member's comments. Obviously he is reading from a long list of projects that have had some funding or will get some funding. I do not think anyone is disputing the fact that funding exists. Part of the debate we have had tonight is the fact that there is completely inadequate funding. Over the years, cuts have been made to the HIV-AIDS programs. Our organizations are struggling, whether it is within the aboriginal community, and I named some in my riding of Vancouver East, or elsewhere across the country. It also includes national organizations.

The member tries to give us the illusion that his government is taking the right action and is providing the necessary supports and resources, and it is an illusion. If it were something that was having the right kind of impact, we would not be seeing the kinds of reports that have sparked this emergency debate. We would not see the four year study that Evan Wood did for the B.C. Centre for Excellence in HIV/AIDS in British Columbia. We would not see other studies come forward, showing an alarming increase in the rate of HIV-AIDS among injection drug users.

I ask the member to think about that and share with us whether the government has the commitment to realistically address those needs, whether it is through the health care system or through the provision of housing.

To come back to the question of Insite, the safe injection facility is a program that has worked. It has saved lives and helped people gain access to treatment . Yet it is operating with a great sense of insecurity about its future. It only has a temporary exemption from the Controlled Drugs and Substances Act to operate until the end of June.

The very reason there is an emergency is because public policy has failed. It has failed on many different levels. Therefore, I find the member's comments tonight to be very far from where we are in terms of reality.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, the fact that we are here addressing this issue indicates the urgency with which we all see this issue. We certainly want to take action on it.

I trust that during the comments I made my colleagues picked up on the number of times that I referred to community based. What is key is that we look to aboriginal groups, working in cooperation and collaboration with government, to provide programs that are culturally relevant and that have been recommended by aboriginal groups for aboriginal groups and then we will have a much greater chance of success.

To say that we have not had success in dealing with these issues and putting it on this government is somewhat unreasonable. We have been working at this for the last two years but this problem has not been with us for only two years. With the examples I have given, we are certainly taking it seriously and, as I said, working in collaboration.

The other point I would like to address is on the question that was raised about the Insite model. A number of my colleagues in the NDP have referred to this and have implied that there is unanimous support for this model. , I do not take anything away from the democratic right of my colleagues in the NDP to recommend this as an effective model, that is what democracy is about, but it is very important that Canadians understand that there is not unanimous support for this type of treatment. In fact, I recall very vividly last year when a number of people from the Canadian Police Association visited my office and shared with me a number of concerns they had regarding the justice system in our country. One of the issues that is of concern to the Canadian Police Association is this very practice.

I want to read word for word from Canadian Police Association's journal so it is on the record. It states:

While Canada’s existing laws have been successful in limiting the harm caused by illicit drug use, there needs to be a sustained effort to educate Canadians, particularly vulnerable young people, about the adverse effects of illicit drug use. Young people are receiving conflicting and often confusing messages about the harms associated with marijuana use.

It goes on to state:

The CPA [Canadian Police Association] is concerned that the permissive approach to drug use has failed Canadians. At our Annual General Meeting in August 2006, CPA delegates voted unanimously to urge the government to cease all financing of the supervised injection site program and invest in a national drug strategy to combat drug addiction which, in addition to enforcement, includes education, prevention and treatment.

It further states:

In Vancouver, police officers and citizens are seeing a rise in drug related activities around the supervised injection sites, other than those that use the facility. These types of programs are delivering the wrong message to our children and youth on drug use. It trivializes the use of illicit drugs when the focus should be on treating the people who need help, not encouraging them to keep using drugs. The supervised injection site program has had no impact on reducing public disorder and has, in fact, created a safe haven for traffickers and fosters a sense of entitlement among drug users.

I wanted that on the record because there is not unanimous approval of that kind of treatment objective.

[Rod Bruinooge, Conservative, Parliamentary Secretary to the Minister of Indian Affairs and Northern Development and Federal Interlocutor for Métis and Non-Status Indians]

Mr. Speaker, clearly the member has a deep appreciation for this area of concern.

The urban aboriginal strategy actually extends to Vancouver. He spent a lot of time on the aboriginal affairs committee and has seen this government do a number of great things. Perhaps he could speak a bit to the things that our government is in fact doing in this important area.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I appreciate the opportunity to respond to that question. Earlier this evening a colleague opposite made the comment that members on this side of the House do not care about first nations communities or aboriginal people. I take exception to that.

When I came to Parliament two years ago I requested the opportunity to serve on the aboriginal affairs and northern development committee. It was not out of any sense of expertise or anything like that, but out of a desire to serve and work alongside my colleagues here to address the issues that have plagued our aboriginal communities for years.

I am pleased that at different times the aboriginal affairs committee has had the opportunity to hear witnesses from communities where they have succeeded in amazing ways in terms of economic development and educational opportunities. They have improved the lives of the people either on first nations reserves or in urban centres.

We have much to celebrate in terms of the progress we have made. I for one am very optimistic about the fact that our aboriginal communities have the ideas and we need to listen to them and work with them, as I said in my speech, collaboratively and cooperatively to address these issues.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, it is a sad evening that we have had to come together to speak in this year about this huge failing report card, the study that the member for Vancouver East highlighted in asking for the emergency debate.

I thank my colleagues from Vancouver Centre and Winnipeg South Centre for their thoughtful remarks. I hope tonight we can speak to all of this as a huge symptom and a report card on what we just are not doing.

As Nellie Cournoyea said in 1975 in the Status of Women report, speaking together, paternalism has been a total failure. It is again the treatment of our aboriginal people that has allowed us to show this growing gap in terms of health outcomes between average Canadians and our aboriginal peoples that puts our aboriginal peoples down at 67% and 62%, which would be in keeping with third world status.

When I was minister, I had the privilege of attending the launch of the Commission on Social Determinants of Health and I was proud to be there with Monique Bégin, Stephen Lewis and Sir Michael Marmot. As the minister, I had to speak to the embarrassment of the gap in health status between our aboriginal peoples. Health status must show total equality and not leave anybody behind.

Last summer, we had to beg the Commission on Social Determinants of Health to come to Canada because it thought everything was okay here. When I spoke in Santiago about this embarrassing gap in health status for our aboriginal people, the commission could not believe what it saw in the downtown east side nor what it saw among our aboriginal peoples who have been through way too much in terms of paternalism.

I guess we on this side do believe that the Kelowna accord was an opportunity to turn this upside down. The accord was an 18 month process that was going to deal with health, housing and economic development, as well as education and accountability. This process involved aboriginal peoples and ended up with the signing of aboriginal leadership and of all the provinces and territories in order to really turn around this paternalism once and for all, and to begin the new beginning that was indeed the hope.

We know that it is impossible for people to stay well and to make healthy choices in their lives without a secure, personal and cultural identity. Our identity is what brings self-esteem and resilience, that in the determinants of health, poverty, violence, environment, shelter, equity and education, it takes the ground of a secure personal identity to help people make good decisions in terms of how they see themselves in eating well, exercising , gambling and using drugs and alcohol. It is that background that leads to the life in which a lot of the people in the downtown east side have found themselves.

I was in the downtown east side one Sunday morning at 7:30. I walked around and talked to a few of the people there and looked into their faces. I guess I can never think, as a mother, that this could be my child or that this could be anybody's child. However, we know that they must have the same baby photos as our children have and that it just does not seem fair that something happened in terms of their upbringing.

We know that 85% of the women in downtown Toronto, with Women's Own Detox Centre, have had some sort of child or sexual abuse. In terms of shopping bag ladies, it is probably well over 100% because that has happened to these people way more than once.

It means that they had to numb themselves and sometimes become addicted and ended up turning tricks in order to be able to sustain their habit. These people could never trust authority because the people who were supposed to be looking after them ended up abusing them. It ends up being that they have trouble with teachers, police and all kinds of people of authority, and that is where this begins.

I hope that we continue this debate and we have this hugely important conversation tonight about how the country is still failing in actually getting the fundamentals right so that people can have secure childhoods.

Tonight, I want to say that I had great hope that when Dr. Kellie Leitch had been appointed by the health minister to do a report on children, that her report would be the kind of comprehensive report that we knew was coming, that would deal with poverty, violence and all of the things affecting children that she knew so well.

That report was supposed to be due in July 2007. I believe, because she did decide to put poverty and these other things that are not in the exact purview of a health minister in her report, that we are watching this report being suppressed and suppressed, and that this is again how the government just does not get it.

It is not as if tonight's debate should be a surprise. Speaking about the general population, we could be talking about heart disease, type 2 diabetes, TB infection rates, smoking rates or suicide rates. Then we note that the proportion of AIDS is still climbing. This again speaks to this gap in terms of how the paternalism has not worked and having top down solutions and well intentioned colonials tell these people what to do and how to run their lives has got them and us into huge problems.

Over the last number of years the kind of data that the member for Vancouver East pointed out to us has been there. The Epi update from the Public Health Agency last year and probably the year before and the year before that indicated that aboriginal people remain overrepresented in the HIV-AIDS epidemic in Canada. Among aboriginal Canadians the proportion of new HIV infections in 2005 was attributed to intravenous drug use. At 53% it was much higher than Canadians at 14%.

HIV-AIDS has a significant impact on aboriginal women. During 1998 to 2006 women represented 48.1% of all positive HIV test reports among aboriginal people as compared to 20.7% of reports among non-aboriginal people.

Aboriginal people with a diagnosis of HIV tend to be younger than non-aboriginal people. Almost one-third, 32.4%, of the positive HIV tests of aboriginal people from 1998 to the end of 2006 were younger than 30 years as opposed to only 21% of these infected in non-aboriginal people.

In the “Burden of HIV Infection Among Aboriginal Injection Drug Users in Canada”, a report published in the American Journal of Public Health, it raised the attention of many people including the member for Vancouver East and my colleagues. I think it is very important that we go to the conclusions of that report which called for culturally sensitive and an evidence-based response. I am afraid it is where our government has sorely let these people down.

There is a denial that harm reduction works and therefore, yet again, the government is choosing ideology over evidence. This is unbelievably irresponsible. The fact that Dr. Wood and Dr. Julio Montaner have said that the other need is for evidence-based response just compounds this error again and again.

The idea that harm reduction would be taken out of the drug strategy was appalling to every member of the Canadian Medical Association last August. It was appalling and there are some tough questions for the minister, but the minister and the Prime Minister still will not budge on this.

The $100 million that was included in the first ministers accord in 2004 and was to be used directly for health human resources for aboriginal people seems to be missing. I have asked the Minister of Health about it. I have asked the Minister of Indian Affairs about it. The money is not there.

Just think how many more nurses and physicians that money would have paid for, not to mention cultural sensitivity training for people in the health profession. That money would have helped to achieve the kind of care that Dr. Wood and many others have said time and time again just does not exist.

Liz Evans, the head of Insite, gave a speech on Wednesday morning at the Canadian Federation of Nurses Unions. She was clear when she said that aboriginal women are the toughest people to deal with in terms of needing cultural sensitivity. They are not able to separate themselves from a power differential in terms of a male going with them to treatment. This requires extraordinary training and extraordinary sensitivity.

The organization that she runs, which includes Insite, North America's only supervised injection site, is at risk. The community service program aims at providing support to people in Vancouver's downtown eastside. It offers support in hotels and houses as well as a range of programs and services, including a low income community bank, dental clinic, community cafe, laundromat, drug user's life skills centre, and a needle exchange program. These are successful.

Some of my patients are still on the street. It takes time to build a relationship with them to make them feel safe. It takes time before they finally ask for help.

I would like to focus my remarks on the government's track record on HIV-AIDS and its total inability to comprehend the social determinants of health.

The theme for this year's world AIDS conference was “Stop AIDS: Keep the Promise”. Stopping AIDS in this country is going to take us stopping Steve. Stopping AIDS requires education, prevention, a vaccine, and hopefully, some day a cure. However, it is clear that this year's theme was lost on the Conservative government. I only see broken promises about creating an effective and accountable HIV prevention program in the coming years. Yet again, ideology is trumping evidence.

The government's track record on HIV-AIDS is abysmal. From the Prime Minister's refusal to attend the international AIDS conference, to the elimination of harm reduction strategies, to the slashing of community support programs, the Conservative government has preferred ideology over sound public health policy based on evidence.

These decisions are especially offensive because they have come at a time when HIV rates are rising and our most vulnerable populations, such as aboriginal groups, need our help the most, and yet the government cannot help but cut programs.

The Centre for Infectious Disease Prevention and Control at the Public Health Agency of Canada tells us that more Canadians are living with HIV-AIDS, an estimated 58,000 at the end of 2005 compared with 50,000 at the end of 2002. An estimated 2,300 to 4,500 new HIV infections occurred in 2005 compared to 2,100 to 4,000 in 2002, and yet the government is cutting the programs that prevent it. People would rather not get AIDS.

I do not understand how, in spite of rising numbers, the government decides to cut programs. It is not that we are doing well. The government is cutting when we are doing terribly with respect to our most vulnerable people, our aboriginal population, and the people that tonight's debate is about.

It is astounding to me that in the main estimates for 2006-07, under public health agencies, it says there has been a steep increase in sexually transmitted infections over the last decade and rising co-infections of HIV with diseases such as tuberculosis, hepatitis C, and syphilis. Yet, the government is cutting programs.

For the 58,000 Canadians now living with the illness and the thousands of Canadians who will become infected every year, we cannot stop the clock on AIDS. Prevention and support services matter more than ever and yet the government is cutting $15 million out of the program.

Last fall, the United Nations announced that AIDS rates in developed countries will spike if governments drop their guard. This government has dropped its guard and it has dropped $15 million out of a program that was promised in the base budget. Shockingly, the minister has admitted this in terms of borrowing the money to be able to match the Gates money. Surely this is completely different than what the Gates foundation presumed in its promise of the money.

I just cannot believe that the government can think that the people of Canada are so stupid as to think that it is okay to take cut money from community prevention programs and the supports and services to people living with AIDS at a time when the numbers are going up.

In Ontario, our community AIDS programs have been cut by 60%. In British Columbia, we do not even know, and yet its money is going to run out at the end of next month. We have been told that this disproportionate cut was just because Ontario came to the plate first. Just coming to the plate first does not mean that these people in British Columbia and in all the other provinces are going to take their hits too because $15 million is missing from the program.

It is the silence from the Minister of Health that shocks me. After the minister had promised that the new funding levels would be announced early in the new year, how can the government continue to cut? How can these community organizations go on? They have to lay off people. They have no idea how much money they will be receiving at the end of the month. They have no idea where this $15 million will be coming from. It is not surprising that the members for Vancouver East and Vancouver Centre are worried.

Let me be very clear. AIDS service organizations have never received a reduction in AIDS funding under any prior government or administration. The member for Yellowhead who spoke tonight was part of the health committee that said that the funding had to go up, and yet he is quiet when his government is cutting $15 million out of the community funds.

These are untimely, irresponsible cuts and are unprecedented firsts.

The surge in HIV-AIDS rates among Vancouver's aboriginal drug users is especially distressing. It is the big F on our report card in terms of how we are doing. We know our aboriginal people are at higher risk for HIV-AIDS infections and we know that IV drug users are also at greater risk. This is a compounded problem and now we are seeing the increasing gap in terms of aboriginal and non-aboriginal drug users.

We know HIV is a preventable disease. It is preventable and we know that the countries that have instituted harm reduction are doing better than we are, regardless of how many pennies the member for Yellowhead was trying to say that we were spending per capita. When will we stop, in this country, boasting about how much we are spending on things instead of being accountable for the results?

As the researcher in the paper said, this is a tragedy. Many people in the aboriginal community are reaching out for care and the care just is not there.

I am concerned that the government is turning a blind eye. It is because of ideology instead of evidence. The government is insisting on saying this is about law enforcement. I am proud to say that we, as the previous Liberal government, gave $1.5 million to support the evaluation of the three year pilot for Insite. I am pleased that there have been a series of reports that show that it works and that the government has had to be backed into making little tiny extensions, and accepts that this is a program that needs to be there, but it needs to be all across this country, not just in Vancouver. It is astounding that these people will not listen.

I want to conclude my remarks by inviting the Conservative government to provide a better future for Canadians who want to win the battle against AIDS and for those who need to live in dignity with it.

[The Acting Speaker, Conservative, Royal Galipeau]

I must interrupt the hon. member. I had given her a two minute warning and a one minute warning.

We are now going to have questions and comments. The hon. Parliamentary Secretary for Health has the floor.

[Steven Fletcher, Conservative, Parliamentary Secretary for Health]

Mr. Speaker, the member for St. Paul's needs to look in the mirror to see where many of the problems in first nations communities stem from. We had 13 years of inaction by the previous Liberal government. The member for St. Paul's was a member of the cabinet. Kelowna was a press release. There was no money, not one single dime booked. Again, this shows a lack of commitment.

On the residential schools, it was this Conservative government that got it done. It was this Conservative government that signed $1 billion to mitigate the suffering that first nations people went through.

We inherited a disastrous situation on first nation reserves after 13 years of Liberal government. And let us be honest, the Liberals were in power for most of the 20th century, so the Liberals certainly carry most of the blame for that.

We have the Canadian Human Rights Act where first nations people on reserve are denied the same human rights that Canadians anywhere else enjoy. It is the opposition Liberal Party that has blocked that.

In fact, it was the Liberal budget of 2005 that cut millions of dollars from AIDS funding.

Actions always speak louder than words. I would like to remind the member that when she talks of compassion, when she talks about doing the right thing, when she was sitting around the cabinet table, she had the opportunity to compensate hepatitis C victims from tainted blood from pre-1986 and post-1990. In a confidence vote, those people were denied compensation. She was a member of the cabinet and was involved in that vote.

It was this government that provided the billion dollars in compensation after years of denial by the previous Liberal government. Will the member ever understand why people believe the Liberal Party is disingenuous when it comes to these types of issues? It is because of their record. Will the member ever accept that?

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, the Conservative government continues to try and take credit for the kinds of things that take a long time to negotiate. The residential schools agreement was signed by Irwin Cotler and Andy Scott. The day I was sworn into cabinet we made sure that we put the hepatitis C agreement on the road and that those negotiations took place.

I am so saddened by the government's approach. In some of our prisons 50% of the inmates have hepatitis C. If the parliamentary secretary cared about people with hepatitis C you would be pushing to have needle exchanges in those prisons.

It is extraordinary that--

[The Acting Speaker, Conservative, Royal Galipeau]

Could I please have the attention of the hon. member for St. Paul's. If the hon. member for St. Paul's could please take her seat. When the Speaker stands, she sits.

I know it is late, but we are trying to have some decorum. We do not name members of the House by name, which she did for the hon. member for Mount Royal. We do not refer to other members in the second person but in the third person. By using these rules we try to depersonalize the debate and we get to a better result.

The hon. member for St. Paul's has the floor.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, I would ask the parliamentary secretary to look forward. There are nice perfect models, such as Nine Circles in Winnipeg that is looking at aboriginal people with HIV-AIDS in and out of prison.

There are some positive examples that are important. I am concerned that yet again paternalism is trumping actually bottom-up solutions that include our aboriginal people. I hope the member opposite will understand that in terms of blaming, it would be much better to go forward and show his record for once, instead of this blame game that no one believes anymore.

[Libby Davies, NDP, Vancouver East, BC]

Mr. Speaker, the member for St. Paul's mentioned some of the truly remarkable people who have been involved in producing information about the HIV-AIDS crisis in the downtown eastside and elsewhere.

She mentioned Liz Evans for one, who did speak, on Tuesday I believe, here on Parliament Hill, from the Portland Hotel Society, who is very involved in the operation of Insite, a very remarkable organization. She also mentioned people like Dr. Montaner, Dr. Wood, who did the study that we referred to tonight, Dr. Thomas Kerr, who has done many of the studies around Insite, and Dr. Martin Schechter. There are remarkable individuals in the academic and scientific communities, as well as community leaders who have kept the faith in terms of pressing the issue, in terms of the need to abide by workable public policy to look at evidence based results.

At the close of this debate, it is really important to recognize that we should be focusing on sound public policy. If we did that, we could be addressing many of the issues in the downtown eastside.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, the member opposite mentioned a few of the amazing people who are focusing on how we can be successful in this really big fight against HIV-AIDS and the unfair burden that our aboriginal people are carrying.

Dr. Wood's paper, as the member has said, speaks in terms of the availability of culturally sensitive supports and services and care as well as evidence based results. This speaks again to the problems we are facing when there is a top-down paternalistic attitude and people think they know better than the people who need our help, but there is also the failure to deal with evidence.

Liz Evans was able to tell us that not one death in all of those visits to Insite is an extraordinary success. People can live long enough to have a bit of hope and maybe get some help, but they are still alive, thanks to the Insite program.

I hope that over the next little while we will start to see all of us coming together on evidence rather than ideology and the idea that harm reduction must be part of any drug control program.

I thank the member for the debate tonight. I thank my colleagues from Winnipeg South Centre and Vancouver Centre for their thoughtful interventions.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I was troubled by four things from the previous speaker.

One was the disrespectful way in which she spoke about our Prime Minister by referring to him by his first name in the chamber. She also chastised us for boasting about how much we spend on HIV-AIDS in one breath and in the next breath she said we were not spending enough. Then she accused us of paternalism, when I clearly pointed out in my speech the multitude of examples of collaboration and community based initiatives.

Finally, how does she respond to the unanimous report of the Canadian Police Association in saying that the Insite program does not work, that it is a safe haven for traffickers, and fosters a sense of entitlement among drug users?

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, I will start with the last question, which is that I will take the view of scientists and health care providers such as Nurse Evans as the kind of evidence that I want of the efficacy of Insite.

It is not good enough to boast about the amount one spends. One has to be accountable for the results. If harm reduction is taken out, we will spend more money and get less results. That is what everybody is concerned about. The $15 million, I want it--

[The Acting Speaker, Conservative, Royal Galipeau]

The hon. Parliamentary Secretary for Health.

[Steven Fletcher, Conservative, Parliamentary Secretary for Health]

Mr. Speaker, HIV-AIDS is a global disease that knows no boundaries and affects all populations from all parts of the world. Men, women and children of all ages and socio-economic backgrounds can be impacted by HIV-AIDS.

The epidemic is most entrenched, however, among vulnerable populations, including aboriginal people. In fact, aboriginal people are among the most HIV vulnerable groups in Canada and are over-represented in this epidemic. Although they represented only 3.3% of the population in Canada, aboriginal persons comprised approximately 7.5% of the prevalent infections and 9% of new HIV infections in Canada in 2005. Injection drug use continues to be a key mode of HIV transmission in the aboriginal community. HIV-AIDS has a significant impact on aboriginal women. Aboriginal people are being infected with HIV at a younger age compared to non-aboriginal people. In 2005, the overall HIV infection rate among aboriginal persons was estimated to be 2.8 times higher than those of non-aboriginal persons.

These facts cry out for all concerned in government and health organizations. We need to take action.

Our government recognizes that HIV-AIDS in aboriginal communities remains an ongoing problem and we are taking action to deal with it.

The Government of Canada will invest more than $84 million toward HIV-AIDS in 2008-09, more than has ever been spent in our nation's history. These investments will support both the federal initiative to address HIV-AIDS in Canada and the Canadian HIV vaccine initiative, investments that will continue to grow over time.

Under our federal initiative, our government has identified HIV-AIDS in aboriginal communities as a key priority. Our government's federal initiative has two aboriginal specific funding programs supporting community effort. Hardly paternal, as was the allegation from the opposition.

The non-reserve first nation, Inuit and Métis communities HIV-AIDS project fund is working toward the reduction of HIV incidents and facilitates access to diagnosis, treatment and social support for aboriginal people living with HIV-AIDS in urban areas across Canada.

The specific populations HIV-AIDS initiative fund is addressing national policy and program priorities for people living with HIV-AIDS.

In addition, for first nations living on reserve and some Inuit communities, this fiscal year Health Canada is investing $5.8 million, representing an increase of $400,000 over the previous fiscal year.

The mandate of the on reserve HIV-AIDS program is to provide HIV-AIDS education, prevention and related health services to first nations on reserve and some Inuit communities. The overall goal of this program is to work in partnership with first nations and Inuit communities to prevent HIV-AIDS transmission and support the care of those impacted by HIV-AIDS.

And that is not all. In August 2006, Health Canada provided support to help plan and implement the international indigenous peoples satellite conference, an affiliated event of the 16th international AIDS conference.

We also provided support for the attendance of up to 51 on reserve first nations people living with HIV-AIDS.

We continue to support Aboriginal AIDS Awareness Week and the ongoing work of the Canadian Aboriginal AIDS Network, the Canadian Inuit HIV/AIDS Network, the National Aboriginal Committee on HIV/AIDS and other similar community level organizations. Hardly paternal, as was the previous government's approach.

As I mentioned earlier, HIV-AIDS knows no boundaries. HIV is having a significant impact on aboriginal women and aboriginal youth. Aboriginal people are being infected at a younger age than non-aboriginal people.

Almost half of the reported HIV cases among aboriginal people are among women. HIV infection appears to occur at a younger age in aboriginal women than the rest of the Canadian population, and young women under the age of 30 constitute a large proportion of the reported HIV-AIDS cases in the aboriginal community.

Under the federal initiative to address HIV-AIDS in Canada, youth have been identified as a priority. The Government of Canada supports national partner organizations such as the Canadian Aboriginal AIDS Network and the Assembly of First Nations.

Educational resources targeting women have been developed by our partner organizations. We are doing this to keep aboriginal families safe. This also means protecting the communities in which they live.

We know that certain factors such as poverty, sexually transmitted diseases, limited access to health services, and of course substance abuse, including injection drug use, have increased the vulnerability of many aboriginal Canadians to HIV. In fact, injection drug use has accounted for approximately half of AIDS cases in aboriginal peoples since 1998.

According to Dr. Evan Wood, a research scientist at the B.C. Centre for Excellence in HIV/AIDS, aboriginal drug users living in Vancouver's downtown eastside are contracting HIV-AIDS at twice the rate of non-aboriginal users. Dr. Wood's research shows that 18.5% of aboriginal men and women who inject cocaine and heroin become HIV positive. That compares with 9.5% of non-aboriginal intravenous drug users.

To adequately address this problem, it is critical that all levels of government work together to improve living conditions for aboriginal people living in the Vancouver downtown eastside. Under the Public Health Agency of Canada's non-reserve first nation, Inuit and Métis communities HIV and AIDS project fund, two projects have targeted this district specifically.

The first is the Vancouver Native Health Society's project, which aims to enhance sexual health, reduce drug use and create social support for those infected with HIV-AIDS. The second is the Western Aboriginal Harm Reduction Society, which also aims to enhance sexual health, reduce injection drug use and advance regional capacity building initiatives for non-reserve aboriginal community-based programing.

Nationally, our government is working to ensure that communities are safe, clean and of course drug free. This is done through our country's national anti-drug strategy. Last October, the Prime Minister of Canada announced the launch of the national anti-drug strategy, a strategy that places emphasis on educating Canadians, especially young people and their parents, about the negative effects of drug use.

An anti-drug strategy like this one has long been overdue in Canada. Our government is serious about implementing effective change to keep our communities safe from illegal drug use. We are concerned about the damage and pain these drugs cause families. We intend to reverse that trend.

This is why our government has committed to a strategy that will prevent illegal drug use from corrupting our youth, affecting our families and communities, and fueling organized crime and gangs. I am proud to say that we are delivering on our plan and achieving great results.

The Government of Canada is working hard to address HIV-AIDS in aboriginal populations across the country. We know that the issue continues to be a prominent one, one that requires a great deal of attention from governments at all levels.

Our government is delivering on its commitments to keep all Canadians safe and healthy no matter where they reside in Canada.

This also allows me an opportunity to reflect on the debate this evening. We have heard many different points of view. I would like to recognize the member for Vancouver East for bringing this to the floor of the House of Commons.

As we can see tonight, although there may be different points of view, we all agree that there is a problem and that we all have to work together to come to a solution. This is one of the great things that Canada brings to the table when it comes to solution seeking: the democratic process. That is what we have seen here tonight.

We have seen a debate of ideas. I know that the health minister is listening. I know that Canadians from coast to coast to coast who are watching this debate or who will read about it in Hansard will provide suggestions, and the government will listen and take action because that is the record of this government.

We need only look at the residential schools compensation, the hepatitis C compensation, the government's historic efforts to bring first nations people on reserve into the Human Rights Act, the tens of millions of dollars that have been invested in bringing clean water to first nations to improve their lives, and the hundreds of millions of dollars that are going to housing projects across the country.

But it will take a multi-party, multi-citizen and multi-government effort to empower individuals to make the best decisions for themselves. I know that this government looks forward to working with everyone to ensure that all people have the opportunity to be fulfilled as human beings and Canadians.

[Libby Davies, NDP, Vancouver East, BC]

Mr. Speaker, this is probably the last comment I will make in the debate because I believe the parliamentary secretary is the last speaker. I would like to thank the members who participated in this very important debate tonight. I hope it brings some greater attention to and understanding of the terrible crisis in the downtown eastside around poverty, HIV-AIDS and the situation facing injection drug users in particular. There are many issues involved.

There is something that I would like to ask the parliamentary secretary. I guess I wonder what will have changed as a result of tonight. I want to be as positive as I can. I hope that as a result of tonight's debate the government has listened very carefully to what has been brought forward.

I want to ask the parliamentary secretary if he might say something about having a better understanding of the importance of harm reduction and whether the government will acknowledge that additional resources are needed for treatment, housing, poverty alleviation and community development. In my mind, that is not questionable, because otherwise we would not have a crisis.

Finally, would the parliamentary secretary acknowledge the incredible broad support that there is for Insite in the downtown eastside? No one tonight has said that the support is unanimous, by the way, but in that community and in Vancouver it is very high. There is about 73% support.

I want to ask the parliamentary secretary if the government will really consider that. Will it move off its political agenda, recognize the incredible importance of the work that Insite is doing and allow it to continue to operate beyond its temporary permit?

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, I believe the minister addressed the Insite question in his earlier remarks.

In regard to the debate tonight, I do think it has been a helpful debate. Whenever we can bring light to the serious challenges that face Canadians, in this case a specific community, that is a good thing.

I could talk about the $270 million in our new homelessness partnership strategy to prevent and reduce homelessness, the $300 million dedicated to the development of first nations market housing, a fund to support market housing approaches for first nations communities, and our efforts to include all first nations people so they can share and enjoy all the human rights we all share here in this House.

There will be different points of view and we have seen that tonight. I know the minister will not only participate but he will look at the debate, as will his advisers, and we will move forward on this important issue.

The other thing we heard tonight is that this is not just isolated to Vancouver. We have to deal with a crisis across the country and there is a lot of goodwill and a lot of effort being brought forward to do that. I know the debate tonight will only enhance the efforts to improve the lot of the Canadians who we have been talking about this evening.

[Bruce Stanton, Conservative, Simcoe North, ON]

Mr. Speaker, I also wish to commend those members of Parliament who made interventions this evening and participated in this debate on an issue that is gripping the world and countries right across the globe. Certainly Canada has been dealing with it the best way it can.

We heard a number of figures being presented tonight of investments and interventions that were made by the previous government and by ours. In light of the grave issues that we are faced with, I wonder if the parliamentary secretary could sum up by commenting on where the substantive evidence or the substantive data might be that would suggest that these interventions that Canada's previous governments and current governments have been making are in any way helping to stem this menace to health in the neighbourhoods like the east side of Vancouver.

I must say, before I let the parliamentary secretary respond to the question, that I also thank the member for Vancouver East, who I think was very diligent in helping to put this topic in front of the House this evening.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, time does not permit me to list everything. The total allocation directed to urban aboriginal peoples is estimated to be over $500 million. It is delivered through a variety of federal departments.

The government has, for example, increased the funding for the urban aboriginal strategy to over $68 million over the next five years. We are also trying to include first nations people on reserves in the human rights legislation. I think many Canadians would be shocked to find out that first nations people on reserve are not included. It seems mind-boggling that anyone in Canada would not enjoy the same human rights that every parliamentarian does.

In budget 2007 we have made announcements dealing with low income families through the working income tax benefit for example. We have announced a new labour market approach that will focus on enhancing the participation of groups more vulnerable to low incomes, such as persons with disabilities, aboriginal Canadians and older workers.

We have a $500 million labour market program that will provide employment support for those not currently covered by EI. We have funding for the aboriginal skills and employment partnership, which will support aboriginal Canadians and that has been doubled.

We have the $270 million new homelessness partnership strategy to prevent and reduce homelessness and $300 million has been dedicated to the development of a first nations marketing housing fund to support a marketing and housing approach for first nations communities.

I will come back to what we have done tonight. All parties have raised an awareness of this issue. The NDP member for Vancouver East has certainly identified a problem that exists in Vancouver and highlighted it. The government is certainly aware of it, but it never hurts to discuss possible solutions. I know the government will be looking at everything to ensure we do the best job for Canadians. After all, that is why we are here.