On Dec. 1, 2023, the BC Centre for Excellence in HIV/AIDS announced the virtual end of the domestic epidemic of HIV in British Columbia.
“It was a very good day,” Dr. Julio Montaner, executive director and physician-in-chief at the BC Centre for Excellence in HIV/AIDS said.
“That was based on the fact that the HIV transmission within the province had come down to the lowest ever in 90 per cent reduction on HIV new infections,” he said.
“In addition to that, there was a 90-per cent decrease or greater in morbidity and mortality.”
Six months later, Montaner said they started to see a rise in cases again.
“We decided to look deeper into it and we came to a very important conclusion,” he said.
“To make a long story short, using sociodemographic data and genetic data of all of the viruses that are diagnosed in British Columbia, we were able to demonstrate that two-thirds of the infections that were diagnosed in 2023 and so far in 2024 are actually infections that occur outside of the province.”
Montaner said more often than not, people were coming into the province with HIV diagnoses from elsewhere in Canada or abroad with at least 50 per cent of the new infections coming from patients outside B.C.
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He added that unless the rest of Canada adopts B.C.’s method of treating and preventing HIV and AIDS, as shown in the success of the announcement last December, the HIV and AIDS problem cannot be solved.
“The majority of the new cases that we have diagnosed in the province of British Columbia over the last two years are coming from the rest of the country, the rest of Canada and the rest of the world,” Montaner said.
“Two-thirds of the new diagnoses come from elsewhere outside of B.C. At least half of those are coming from the rest of the country.”
B.C. resident Walter Hebert has been living with HIV since 1988.
“Way back then, sexual practices were interesting,” he said.
“HIV wasn’t really on the radar. I remember seeing an article on a Time magazine.”
But in 1995, at the International Aids Conference, he started a medication called AZT.
With Montaner’s help, Hebert was able to eventually use a cocktail of drugs to the point where he is no longer infectious.
He knows the importance of Montaner’s program, he said, and hopes the situation improves drastically.
“I’m living well,” he said. “This pushed me to do my bachelor’s and master’s in nursing. It propelled me way beyond things that I thought I would do.
“Like I say, I feel so happy and and proud that I live in B.C. because if I didn’t, I don’t know if I would be here today.”
Montaner said that for the program to succeed, there needs to be a compassionate approach to infected people who are at risk, and that, unfortunately, some countries are going in the opposite direction.
“We need to see change in the rest of the world,” he said.
“We need a national implementation plan that is going to include free antiretroviral therapy and free PrEP for all Canadians, whether centrally, federally or provincially. It doesn’t matter to me. It has to happen.”
In a statement, Health Canada and the Public Health Agency of Canada said: “Bill C-64 outlines a framework that would help guide collaboration with provinces, territories, Indigenous Peoples, stakeholders and partners to develop national universal pharmacare over time, based on the foundational principles outlined in the Bill.
“The Bill also sets out processes and next steps for other foundational elements of a national pharmacare program, including work on a national formulary, a national bulk purchasing plan, an appropriate use strategy and an expert committee. The consideration of adding other drugs would evolve against the backdrop of these other elements, in addition to ongoing collaboration with provinces, territories, stakeholder and partners.”
The Public Health Agency of Canada said it will continue to examine and share emerging evidence on HIV PrEP and other interventions to help support decision-making.
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