‘No backup plan’: Funding for HIV self-testing kits ending in March - CityNews Edmonton | Canada News Media
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‘No backup plan’: Funding for HIV self-testing kits ending in March – CityNews Edmonton

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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.”

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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