Sask. doctors call for state of emergency over HIV rates

A group of doctors in Saskatchewan are calling on the provincial government to declare a public health state of emergency regarding HIV and AIDS.

"We are seeing an increase in the number of cases," said Saskatoon Dr. Ryan Meili, one of the doctors with the group who works directly with HIV-positive patients. "For example, there were 114 new cases in 2014, 158 in 2015. In the last 10 years, we've seen over 1,500 people infected with HIV in the province."

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When it comes to new cases of HIV, the province has rates two times higher than the national average. 

"When you look at the pockets of real outbreak, it's extremely severe. We're seeing numbers at the level of developing countries with high levels of HIV."

The group called on the government to declare the public health state of emergency Monday morning in Saskatoon, hoping the government will make resources available that would help with the declaration.

"We perceive this as an emergency," said Dr. Stephen Sanche. "Two people are dying every month. Over ten people are being diagnosed with new infection every month and that's only going up. So we're really sounding the alarm."

Those resources could include the development of a coalition of provincial, federal and First Nations leadership to tackle the issue through public education, universal screening and treatment, and support.

The group wants to see universal coverage of antiretroviral treatment for all HIV positive patients in Saskatchewan, regardless of jurisdiction. Sanche said the price tag for that would be around $500,000.

Provincial government response

At today's press conference, a number of officials expressed concern about the provincial government not taking what they call the HIV epidemic serious enough. They also called for more provincial action on the issue. 

In an email response today, a government spokesperson said the province has a strategy to address the HIV issue and increased funding has significantly improved Saskatchewan's response to HIV infections.

The spokesperson highlighted the province's strategy and the improvements, including:

• Outreach clinics in remote, northern and First Nations communities
• Hiring of 10 RNs dedicated to HIV treatment.
• More than 30 full-time positions were added to increase services along the continuum for HIV care.
• An Infant Formula Program for infants born to mothers with HIV.
• $416,000 to the Westside Clinic in Saskatoon to provide physician and outreach services.

We're seeing numbers at the level of developing countries with high levels of HIV.- Dr. Ryan Meili

Meili said the group is once again asking the province to consider adopting UNAIDS 90-90-90 goal by the year 2020.

The goal aims to see:

• 90 per cent of those who are HIV-positive knowing their status.
• 90 per cent of those diagnosed receiving anti-retroviral treatment.
• 90 per cent of those on treatment having a level low enough that they don't risk transmitting the virus to others.

In the group's submission to the provincial government, it says each new case of HIV is estimated to cost $450,000 in medication, and $1.4 million through a patient's lifetime.

The group also stated that due to late diagnosis, patients in Saskatchewan die at higher rates than people with HIV In other parts of Canada.

Meanwhile, Dr. Kris Stewart said he's concerned the health system isn't getting ahead of the issue.

"I think it's extremely worrisome," he said. "I think we're missing opportunities to help individuals but also to prevent a dramatic increase in new cases."

Stewart, an internal medicine physician who works primarily with HIV in Saskatoon, said programs in some areas of the province are working. However, to stop a large increase,

"We have demonstrated success in (Saskatoon), and in certain communities," he said. "Some reserve communities have been extremely progressive in their approach to HIV, and they've demonstrated how successful we can be in preventing the progression of illness and preventing transmission. Other areas, we simply don't have the infrastructure in place. We're not testing adequately, we don't have clinical capacity. The health regions themselves, I'm not sure fully understand what they're dealing with. We need a different response than we have."

The stigma of getting tested

Jason Mercredi, an associate director at AIDS Saskatoon, said there are still not enough people getting tested for HIV in Saskatchewan.

He said everyone should be tested.

"We have people from all walks of life that are diagnosed being positive and we just need to get the message across that it doesn't matter if you think you're at risk or not, just make it part of your standard, normal, physical procedures."

Mercredi said having more people getting tested will also help remove the stigma often associated with testing. 

Saskatoon Tribal Council Chief Felix Thomas said Indigenous communities have been particularly hit hard by HIV, but also said it affects all of society.

"It's still an unpopular disease. And it's still a disease that has a lot of misconceptions about it. And it's still a disease that people think that it only affects a certain segment of the population and that's something we have to get past."