Prossy Luzige often gets calls from people looking for HIV tests that they can do in the privacy of their own homes.
The program co-ordinator at CAYR Community Connections in Ontario says the take-home tests are crucial to connecting with people as Canada’s HIV infections climb.
But the groundbreaking initiative to provide the kits across Canada is in peril, as funding runs out at the end of March.
“What will happen after the funding ends?” Luzige asked. “What kind of answer are we going to give such community members?”
The federal government indicated it is looking to sunset the self-test program, said Sean Rourke, a scientist who was a principal investigator in a study that helped get the tests approved in Canada.
“There is no backup plan here,” he said.
Rourke is also a director with REACH Nexus at Canadian Institutes for Health Research, which facilitates purchasing and distribution of most of the tests.
“This program has worked,” he said. “There’s no question.”
The test, called INSTI, uses a drop of blood to deliver results in about a minute. The program was to expand to include a test for both HIV and syphilis, which was approved by Health Canada last year.
Many front-line workers say the tests are game-changers in stopping the spike in new HIV diagnoses.
There were 1,833 new diagnoses in Canada in 2022,marking a nearly 25 per cent increase from the year before.
Montreal public health officials recorded 310 in 2022, a 120 per cent increase from the previous year, marking the highest number of new reported cases in a decade.
Thousands of other people across the country are estimated to be undiagnosed.
The first self-test was approved in Canada in 2020. Rourke was part of the program to provide the tests on a large scale beginning in November 2022. The initiative was lauded with Carolyn Bennett, the federal minister of mental health and addictions at the time, saying it would “reduce barriers that come with conventional testing methods.”
“Ensuring that everyone in Canada has access to testing and treatment options for infectious diseases like HIV is a top priority for the Government of Canada,” Bennett said in a 2022 news release, announcing a one-time investment of $8 million to purchase and distribute the tests.
An extra $8.6 million was provided to extend the program until the end of next month. No additional funds have been pledged.
“PHAC is continuing to explore options to make HIV self-test kits available to community-based organizations after March 31, 2024,” the Public Health Agency of Canada said in an emailed statement.
Rourke said it doesn’t make sense not to extend funding.
If somebody knows their status, they can live a normal life and won’t infect others, Rourke said. Testing is a key component to stopping the spread, but HIV is still marred by accessibility and stigma.
The self-testing kits can bridge that gap, he said, adding data shows they work.
More than 215,000 kits have been distributed to nearly 400 organizations across the country. There are also websites and information pamphlets for people to get support and health-care information.
Many people who have picked up the tests fill out an anonymous survey, which gives researchers important real-time insight, Rourke said.
Forty-five per cent of respondents said they were testing for the first time. The tests also reached Indigenous and other racialized people, as well as those who work in the sex industry or inject drugs.
One test costs about $35 online.Rourke said through a negotiated purchasing arrangement, it costs the program $10.
“Cost isn’t an issue. This program works. We have data showing that it’s effective. We have engagement,” Rourke said.
“Why not keep on funding it, right? There’s just no good reason not to.”
Concerned front-line workers from across the country have reached out to Rourke and his colleagues about the future of the program.
A girl who was too worried to be tested for HIV in a clinic returned later after learning about the self-testing option, wrote Ontario support worker Ana Kovacevic in an email to REACH.
Tieryn Steele with the Manitoba Harm Reduction Network said there are major issues around stigma and access to HIV testing in Flin Flon, a northern mining city on the boundary with Saskatchewan.
“People walked into my office, who would have never gone to the hospital to get tested, specifically for these kits,” Steel wrote to REACH.
Manitoba and Saskatchewan have the highest rates of new HIV diagnoses. Saskatchewan’s rate is more than four times higher than the national average.
Shiny Mary Varghese, executive director of AIDS Programs of South Saskatchewan, said the tests are especially useful for newcomers who may come from cultures where topics around sex and HIV are taboo.
Varghese said it’s critical that federal funding continues so people know they have HIV, get access to treatment and stop further transmission.
“It’s not a death sentence,” she said.
“As long as they are on treatment, they can have an optimal life.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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