Mr. Speaker, I pay tribute to the member for Vancouver East for bringing this issue to the fore. I know that of all the communities and ridings in this country, her riding has been the most devastated by this particular issue. She has some of the poorest in her riding. She has the highest rate of substance abusers and she has a large number of urban aboriginal communities, as do we in the four western provinces, but hers by far is the largest.
I am pleased to stand and support her statement and to say that we know this is a national disgrace. We know that the studies have shown that 2:1 aboriginal people have new infections of HIV-AIDS. Much of it we know is directly attributed and related to illicit drug use but a whole lot of it is attributed to poverty or lack of housing and all of the other social indicators that have led to the use of substances over the years.
I want to quote from a very well known and respected physician in Vancouver who said, “addicts are made, not born”. The most common precursors are early childhood deprivation, neglect and abuse. For several generations Canada's native children have been far more likely to suffer grinding poverty, abuse and childhood substance addictions than non-natives.
This is not something that we can talk about in the abstract. This is not something that we can stand here and speak in glowing and fine words about how we have strategies and we intend to do this and that. As a physician, I can say that the effectiveness of anything that we do must be shown in the outcomes. I for one have seen many outcomes that have led to very important new ways of dealing with this issue and they have been rejected by the government.
I have to say that when the minister says that HIV-AIDS knows no boundaries and it affects vulnerable people as well as privileged people, while I recognize this, I must say that tonight we are speaking about the most vulnerable people in this country. Therefore, the minister must deal, if he is going to have an effective strategy, with these issues that affect this group of people.
For instance, we know that addiction is primarily a health issue with social correlated factors. I will put this in plain language and I will quote from the result of the report that the hon. member for Vancouver East took her question from today. The report states:
Our findings demand a culturally appropriate and evidence-based response to the HIV epidemic among Aboriginal injection drug users. Canada's drug strategy has recently been the subject of significant criticism. This criticism stems from the fact that resources are overwhelmingly devoted to law enforcement-based interventions, which have been shown to have negative health consequences related to health service interruption and limited evidence of effectiveness as evidenced by increased illicit drug supply and decreasing drug prices.
The minister spoke very beautifully about evidence based but here is evidence that says that the way that his government is going toward a national drug strategy is actually not based on evidence at all, but is based mostly on ideology.
When we speak to this issue, I want to quote from this report because I think this report has been the diving board from which the member launched her plea today. The report also states that we need “to acknowledge the harms of seeking to address addiction through a strategy that” is not culturally appropriate.
An evidence based response to HIV epidemic amongst aboriginal drug users has told us that there must be other cohorts that we must look at.
I want to talk about that today and put it in plain language. There is no place here if we are to resolve this problem. I think we can stand in this House for the next 25 years and each one of us can bleed and speak glowingly and speak with great emotion about the plight that the member brought forward today: the plight of the aboriginal people, of HIV-AIDS, hepatitis C, grinding poverty, lack of housing, an enormous amount of social dislocation because of aboriginal residential school issues, abuse, and urban aboriginal issues that have not even been dealt with by the government and do not even figure in the language about which it speaks.
I want to talk about what we can do. Therefore, there is no place here for ideology or moralistic biases. The way to deal with the complex issues of substance abuse and related diseases, such as HIV-AIDS, hepatitis C and an increasing incidence of tuberculosis in this country among aboriginal people, is to employ a multifaceted strategy that has been proven to be effective.
That is what we mean when we talk about certain strategies which have yet to be proven to be effective. We know this is why clinical research, community and social research is absolutely important if we are to deal with the first part of any public health strategy.
We know there are some basic, public health 101 principles to a public health strategy, and the first one is research and epidemiology. This is what we were talking about today, research and epidemiology that is telling us who the susceptible populations are, where they live and what things make them susceptible.
Many people believe that we can prevent addiction by telling people nice stories and telling them preventive things when they are young, which means that they think addiction is something we learn to do, something we can stop doing at any time we want and that it is purely a behavioural thing. However, medicine has told us that addiction is certainly not a behavioural issue alone, but that is one small part of addiction.
Research and epidemiology are telling us that among urban aboriginal communities and other aboriginal communities the issues are very clear. There are issues of poverty. We heard people speak of the poverty of aboriginal peoples, especially aboriginal women who are among the poorest in our society. We have heard of the lack of housing and the lack of access to health care, especially for urban aboriginal populations.
If we are to address prevention in this instance, we must deal with those things that cause people to become substance abusers. We need to deal with the residential school issues because we know that those have left aboriginal people with exactly what Dr. Maté talked about when he talked about the fact that there had been abuse, early childhood deprivation and neglect. Being deprived of parents for a long time have led to generations of aboriginal people being denied the right to grow up as most of us have.
We must deal with these issues if we are to talk about the first thing that the minister mentioned in his national drug strategy, which was prevention. Prevention is not about making nice speeches and going into a school and telling people they must not take drugs. It is about dealing with these very basic issues that epidemiology has told us contribute to this particular problem in aboriginal peoples and, indeed, in all people.
We also know that there is a link, not only between housing, but between discrimination and social dislocation. The hon. member for Vancouver East spoke very movingly about that.
Nowhere in the government's national drug strategy has it talked about housing. The minister spoke about it but I have not seen a housing strategy by the government. I have not heard it discussed in its Speech from the Throne. It was never in any of its budgets. It has never been discussed. In fact, I understand there was a housing meeting in Vancouver today and the minister responsible for housing did not bother to turn up.
We talk the talk and there are lots of wonderful words coming from the minister but there is no substance to them. There is no action on it and so nothing has been done.
What is even worse is that the Kelowna accord, which was brought forward by our government to deal, in a culturally sensitive manner, with issues, such as housing, education and health, was cancelled by the government. It was one of its first acts. The Kelowna accord would have worked in a totally new way. It would have worked with aboriginal people who would have been part of the solution, part of that public policy development and public policy implementation. That is what is meant by those nice words that the minister used, “culturally sensitive”. The phrase “culturally sensitive” is actually a strategy and an implementation based on that kind of thing.
When I hear about a national drug strategy that talks about prevention and that talks about enforcement, I do not hear other words. Public health strategies deal with good research in, first, epidemiology; second, prevention; third, something called harm reduction; fourth, treatment; and fifth, rehabilitation and being able to get oneself back into some sort of mode of life again after one has been ill or has had a disease.
In the case of substance abuse, enforcement must be a sixth factor in a very clear public health strategy, public health 101. This is not ideological. This was drawn up in my head. This is public health strategies.
If the government is going to talk about a reasonable or a believable national health strategy, it must talk about it. I have just talked about prevention, epidemiology and the things that link them that has not been talked about and is not being done by the government.
Let me talk about harm reduction. I listened to the minister saying that he had no evidence that the Insite program actually achieved any results. That was extremely interesting because Insite is one of the most progressive forms of harm reduction on the North American continent. He was quoted as saying that during the time that he had decided that he would not support fully the Insite for a short period of time and temporarily he would let it go on. So this wonderful program is in limbo.
The second thing is that I heard his leader, the Prime Minister, say that he did not believe in harm reduction, as if harm reduction were the Easter Bunny or Santa Claus or something that one had to believe as an article of faith. Harm reduction is a clinically proven set of strategies that came about from people having done the work done in those strategies, implemented them and looked at how the results occurred.
Harm reduction is a fundamental piece not only of public health but of medical care. Harm reduction is saying that if we people or children are dying of gastroenteritis that we will look at giving them different water to drink while we fix the water system. Harm reduction is about helping people to survive and have as little illness as they can while we are trying to find a solution for them in the long run. Harm reduction is reducing the harm to the person or the community until such solutions can be found to solve the problem.
When the minister speaks about a vaccine as if it were the silver bullet, I must say that this is the end objective, but what about now? What about the people who are currently suffering or have died? What about harm reduction?
Harm reduction in the government's eyes is a moral issue. As I said before, if we look upon this as a clear public health issue, then we should not talk about morals. We realize that needle exchange does not help people to use more drugs. Needle exchange helps to prevent people who are using intravenous drugs from getting HIV-AIDS, hepatitis C and other diseases. If they have hope of living they may to want to go into detoxification or into treatment. They may make good choices for themselves and eventually find a new rehabilitative way of life. That is what harm reduction does for them.
I am very proud of the Insite program because I was the federal minister responsible for the Vancouver agreement at the time when we brought in Insite. With the City of Vancouver, the province and the community all agreeing to do this, we got the money to set up this particular facility. Within six months, the facility was directed at doing two things. One was that it was directed at saving lives because overdose deaths were happening in that community in large amounts. Within six months of Insite being set up, overdose deaths had gone to zero.
This was a clinical study done by St. Paul's Hospital and UBC HIV-AIDS clinical trials network. This was not done by a bunch of people sitting around a corner thinking they wanted to prove something. This was done by real researchers applying absolutely appropriate methodology to do this. That was the first thing. It had actually achieved its objective in six months.
The most surprising thing that came out of this was an indirect effect that they did not expect. The people who came to Insite were the people who actually did not go to doctors or nurses, did not go to institutions, and were not interested in getting care. These were the really marginalized people in society. Thirty per cent of them within a year were seeking detoxification. That was a remarkable side effect. No one could believe the percentage. One-third of the people who were going to Insite were seeking detoxification. Once they had been detoxified, many of them moved on to counselling. They also moved on to getting treatment, whether it was methadone or opioid use or other ways of getting themselves back into living ordinary lives and not getting HIV-AIDs, hepatitis C and other diseases.
As I said before and as I will say again, ideology should have no place in public policy, especially not in public health policy, and especially not from a government that has the ability to save lives by doing the right thing, and the proven right thing in this case.
I want to talk about treatment. I am very proud of this because I was responsible for assisting the UBC researchers in a program called NAOMI. It is a three year project. They are looking at new methods of treatment that would work on narcotic or opium addicts or heroin addicts who were resistant to methadone treatment. The project involved giving them either a synthetic opioid or heroin and seeing how it worked. Those results are not out, but from what I hear from some of the researchers, there are going to be remarkable results in the use of opioids.
This is going on in Europe. These projects have been shown to be successful in Switzerland. Belgium is starting a new opioid study. We have people who are ready to do these studies on treatment, and yet the government is not even speaking to them. I am meeting with them tomorrow with our leader, Mr. Dion. We are going to speak with these people who have been begging for a meeting with the minister--