Dr. Julio Montaner, who helped develop the treatment-as-prevention model, penned an open letter calling on federal parties to adopt an initiative called the 90-90-90 target.DARRYL DYCK/The Globe and Mail
A B.C. HIV/AIDS pioneer who has helped establish a standard of care for treatment and prevention that is used worldwide is calling on the leaders of Canada's federal parties to endorse an ambitious global target for fighting AIDS.
In an open letter sent on Tuesday, Julio Montaner, director of B.C.'s Centre for Excellence in HIV/AIDS, said committing to an initiative called the 90-90-90 target would be a significant step toward eliminating the disease.
The letter was sent to Conservative Leader Stephen Harper, NDP Leader Thomas Mulcair, Liberal Leader Justin Trudeau, Green Party Leader Elizabeth May and Assembly of First Nations National Chief Perry Bellegarde.
The 90-90-90 target, based on the B.C. centre's treatment-as-prevention model, is for at least 90 per cent of all people living with HIV to know their HIV status by 2020; at least 90 per cent of all people with the virus to have access to high-quality antiretroviral therapy; and at least 90 per cent of those on treatment to have sustained viral suppression.
Countries including the United States, China, South Africa, France and Spain have signed on.
Meeting these targets by 2020 "will lead to a 90-per-cent reduction rate in the global burden of HIV/AIDS by 2030, when compared to a 2010 baseline (including AIDS-related morbidity and mortality, as well as HIV transmission)," Dr. Montaner wrote in his letter.
In an interview on Tuesday, Dr. Montaner noted the 90-90-90 target is a Canadian contribution to global health.
"It has been formally endorsed by Ban Ki-moon, the secretary-general of the United Nations, and it's now been widely recognized by multiple countries around the world," he said. "Yet, Canada is neither formally endorsing it domestically nor raising the flag internationally."
Dr. Montaner, who in December received the Order of Canada for his work in this field, has written to the Conservative government about adopting treatment-as-prevention every year since it was introduced in 2006.
He said he believes the political reluctance has to do with the stigma of HIV and AIDS.
"If this was insulin, there would be no hesitation to embrace it as the next Canadian breakthrough," he said. "Because it's HIV, nobody wants to touch it."
He noted that some groups are disproportionately affected by HIV/AIDS. First Nations people, for example, make up only 4 per cent of the Canadian population but accounted for 16 per cent of new HIV infections and 21 per cent of new AIDS cases in 2013.
B.C. is the only Canadian province to adopt the model. Treatment-as-prevention consists of testing widely for HIV and offering highly active antiretroviral therapy immediately to those who test positive. This treatment has been shown to virtually eliminate progression of the virus to AIDS and to reduce transmission by 96 per cent.
The Globe and Mail contacted Canada's federal parties seeking comment on the letter. Ms. May said she has spoken in favour of the treatment model in the House of Commons and has on her MP website a petition she helped design and deliver that calls for the immediate implementation of a national AIDS strategy based on it.
"We are totally in favour of these goals," Ms. May said in e-mail on Tuesday.
A Liberal spokesman said the party had received Dr. Montaner's e-mail and is reviewing it.
The Conservative Party and the NDP did not reply by Tuesday evening.
In 2013, the most recent year for which statistics are available, B.C.'s HIV diagnosis rate was on par with the national rate, at 5.9 cases per 100,000 population – the lowest since HIV reporting began in 1985, according to the Public Health Agency of Canada (PHAC). The province with the most caes was Saskatchewan, at 11.4 per 100,000, and the lowest was Nunavut, at zero.
The annual reported number of AIDS cases has declined steadily since the mid-1990s, due largely to the introduction of highly active antiretroviral therapy, according to the PHAC.