AIDS groups face chronic funding woes

On the eve of the BC Persons With AIDS Society’s (BCPWA) 20th annual AIDS Walk Sep 25, Vancouver AIDS groups say both money and awareness are even more crucial now than they were in 1986-but both are getting harder to come by.

Officials at some of British Columbia’s largest AIDS organizations say their groups and others are inadequately funded by the provincial government, even as the number of new HIV infections continues to creep upward in BC, especially among gay men.

And government money isn’t the only money dwindling. The amount raised by charity events such as the upcoming Walk for Life has steadily declined since the late 1990s.

According to Phillip Banks, director of prevention at AIDS Vancouver, the walk has struggled with decreased revenues and community interest, in part due to competition from a huge array of charity events across the country. The Heart and Stroke Foundation’s Mother Daughter Walk, for example, also takes place on Sep 25 at Vancouver’s Jericho Beach and at locations countrywide.

Still, BCPWA chair Paul Lewand says the Walk for Life is a major fundraising vehicle for AIDS groups around the province. The money people raise for the walk is “hugely important,” he says.

“This walk is about helping people who have all sorts of problems,” he says-problems BC’s Liberal government is not doing as much as it could to help address and prevent.

AIDS organizations rely on the provincial government to provide funding for services and programs, at an annual cost of approximately $11 million to the government. Lewand says that amount has changed little since the 1990s.

“Government funding levels have been pretty much static for 10 years,” he says.

During that same time period, Lewand says BCPWA’s membership has doubled, in part because people with HIV and AIDS now live longer with the help of better medications.

“That means there’s 50 percent less money per person,” Lewand says.

Lorne Mayencourt, Liberal MLA for Vancouver-Burrard, disputes claims that his government under-funds AIDS groups.

Mayencourt says the BC government spends closer to $100 million annually on costs associated with HIV/AIDS.

“We spend more than the province of Ontario does annually on HIV/AIDS,” he says. “The AIDS service organizations and the AIDS community has probably the highest funding per capita in North America here in British Columbia.”

The province’s chief goals for HIV/AIDS are to prevent the spread of the disease and to make sure people already living with HIV/AIDS have medication.

Mayencourt says the government has reduced the AIDS mortality rate, has increased funding to individuals by over $300 a month, and has upped the number of housing suites that are available.

Rick Barnes, who formerly worked for AIDS Vancouver and BCPWA, says Mayencourt’s estimation of government HIV/AIDS spending could be correct, but that $11 million is the amount of direct funding to HIV/AIDS specific organizations.

“What Lorne [Mayencourt] is also including in his figures is something around the neighbourhood of $36 million on Pharmacare for HIV/AIDS medications, and he’s probably also rolling in the money it costs when AIDS patients see doctors or spend time in hospitals.”

Barnes also maintains that the Liberal government has not introduced any new housing projects for people with HIV/AIDS since coming to power in 2001, but has simply followed through with projects started by the NDP government before it, such as the Dr Peter Centre.

“They haven’t built one single unit for people with HIV/AIDS, people with disabilities or youth in Vancouver since Lorne was elected,” says Barnes.

Experts say the real losers in the current funding regime are BC’s gay men, who continue to make up as much as 40 percent of all new HIV infections in the province each year and account for 50 to 60 percent of people living with HIV/AIDS in BC.

The number of new HIV infections among BC’s gay men hit a low in 1999 with 106 new infections, according to statistics contained in the 2004 Sex Now survey, a project of Vancouver’s Community-Based Research Centre.

But since then the number has been rising.

In 2000 there were 144 positive test results among gay men; in 2001 there were 153; in 2002 there were 160; in 2003 there were 159; and in 2004 there were 180 new positive test results.

Barnes says there is a funding crisis for gay men with HIV/AIDS.

“There is definitely a funding crisis in BC, probably ongoing for 10 years. Certainly gay men are very underserved by HIV/AIDS programs.”

There has been some effort to “de-gay” HIV and AIDS in the last five to eight years, Barnes continues, as community and health organizations have focused their attention on other populations, most notably injection drug users, a population that saw a spike in infection rates in the 1990s.

“There’s no question that is needed,” says Barnes of targeting injection drug users. “The problem is that gay men’s vulnerability to HIV/AIDS has not really been addressed during those years.”

The provincial government only directly funds one program targeted toward gay men’s health-Gayway, affiliated with AIDS Vancouver-at a cost of about $170,000 annually.

“That funding is woefully inadequate,” says Barnes.

Banks says Gayway has seen “teeny” increases to its funding dollars from the government. However, after paying for expenses such as the Gayway office space (a cost of about $25,000 per year in rent) and staff salaries, there is little money left to send HIV prevention messages to gay men.

HIV prevention is more complicated than simply handing out condoms to guys at local gay bars, Banks says. Proper prevention campaigns involve extensive research, marketing and adequate money.

Barnes and Lewand both point to a 2003 BC Liberal government document which they say promised more funding but has yet to come through.

The document, called Priorities for Action in Managing the Epidemics, HIV/AIDS in BC: 2003-2007, lists a 50 percent reduction in new HIV infection rates as one of its chief goals.

“In British Columbia, the HIV/AIDS epidemic is a very serious public health challenge,” wrote then-Health Minister Sindi Hawkins on Sep 29, 2003.

“Priorities for Action clearly outlines provincial aims, positioning British Columbia to engage effectively in strategic discussions with Health Canada as it considers renewal and funding levels associated with the Canadian strategy on HIV/AIDS. Ministry staff and I will be working with our federal counterparts to ensure BC receives an appropriate share of the new funding associated with the federal strategy, as well as the federal hepatitis C and drug strategies,” wrote Hawkins.

“So far not one penny has gone into making this happen,” says Lewand. “The priorities are there but it’s not backed up with funds, or not adequately.”

As for the government’s goal of a 50 percent reduction in new HIV infections, Barnes says that won’t happen in time for 2007.

“We’re over half way there and we’re not going to see that decrease. In fact, we could be on the verge of a significant increase.”

Mayencourt defends the document by saying the government consulted with AIDS organizations throughout BC while the document was created and those groups approved the plan. He says 25 percent of government funding is to be used for prevention by AIDS groups.

“If the AIDS service organizations thought that the HIV/AIDS strategy that they helped create is a good plan, why isn’t it happening?” asks Mayencourt.

“I do not know for the life of me, I just don’t know for the life of me, where anybody is working at all on prevention,” he says.

Mayencourt says the most frequent AIDS awareness message he sees in Vancouver is the Youth AIDS campaign sponsored by ALDO shoes, which is not funded by the provincial government.

“AIDS service organizations are the ones that are supposed to be distributing prevention messages,” he says. “I haven’t seen any.”

“The challenge of that remark,” responds Banks, “is that [Mayencourt’s] government last year provided additional resources to our national gay men’s assumptions [advertising] campaign. If he’s unaware of where the funding from his government is going, he may want to pay more attention.

“What it comes down to,” continues Banks, “is we don’t get enough money from the provincial government through the Coastal Health Authority to do mass media social marketing campaigns.”

“The document, as it was,” says Barnes, “appeared to be as good as it was going to get with a Liberal government. The major problem with the document is that it doesn’t come with funding.”

Banks says what’s needed most is strong leadership on HIV/AIDS within the funding structures of government. “Leadership will require someone to be responsible for AIDS,” he says. “The challenge is having AIDS on the agenda.”

Banks recently approached Mayencourt for a discussion on HIV/AIDS, but says he is not yet satisfied his message has been heard. “I can’t say that I left with a feeling that suggested the government was going to start investing more in HIV.”

Barnes says laying blame in this issue is complicated, adding that the primary problem is a lack of attention to gay men’s health by the government and to some extent by AIDS groups.

“This particular government seems to be pretty vindictive to groups that speak out,” says Barnes. “They [AIDS groups] can see it straight on the wall that if you say something you’re going to get hit. To some extent that’s why they haven’t spoken out. But at the same time, they’ve done a disservice to gay men’s health.”

Members of the community can still register for the Vancouver AIDS Walk for Life online or by telephone (see below). Walks will also be held in Kamloops, Kelowna, Nelson, Cranbrook, Prince George, Smithers and Nanaimo.