Reports of cuts to funding alarm the Canadian HIV Community
But has the AIDS budget really been cut? And if not, who wins and who loses? Bob Leahy puts the recent announcements regarding funding of HIV and related diseases in focus
Here’s what we know
Information has been drifting out in dribs and drabs all week as individual agencies received responses to their letters of intent to apply for funding under a $26.4 million fund falling under federal jurisdiction. The word was that there had been massive cuts to AiDS funding in Canada. The reality is far more complicated.
First here’s what everyone was waiting for. Last night the Public Health Agency of Canada (PHAC), a division of Health Canada, shared this on their website. It is a list of those agencies who have been invited to go the next level of the approval process. Note that it does not detail amounts or names of those agencies who submitted proposals that were declined. It does not also reveal situations where the invitation to apply was reduced, sometimes very significantly.
For many this list will present bad news. But there is arguably some good new funding here too within the overall $26.4 million umbrella. In any event, here’s what PHAC has said:
HIV and Hepatitis C Community Action Fund - Next Steps
The Public Health Agency of Canada's HIV and Hepatitis C Community Action Fund is supporting excellence in community programming to address priority public health issues. The Agency is investing $26.4 million a year in community-based programs across the country to address HIV/AIDS, hepatitis C and other sexually transmitted and blood borne infections. This investment has not changed from funding support provided in previous years.
The development of the new integrated Fund was informed following a consultation process with stakeholders beginning in 2014, which resulted in new priorities, confirmed priority populations and eligible activities.
The new, integrated Fund aims to foster innovation, encourage more collaboration and partnerships, maximize efficiencies and increase the effectiveness of community-based investment.
Applicants to the first phase (called "Letters of Intent") have been assessed on individual merit by a group that included the Agency, other federal departments, provincial and territorial governments, subject matter experts and people living with HIV and/or hepatitis C.
Successful organizations were deemed to have the greatest potential to make an impact on HIV, hepatitis C and other related sexually transmitted and blood borne infections in Canada and globally to end HIV/AIDS by 2030.
A total of 124 organizations were successful in the first phase of this process, including 41 new organizations. Additionally, funding for Indigenous organizations will almost double to $4 million annually.
Every organization that applied, regardless of the outcome, has been provided with a detailed explanation, in writing, as to the findings of the review process. A contingency fund of $600,000 is being reserved under the Community Action Fund to address program gaps, emerging issues or urgent needs not covered by projects approved for funding.
The following organizations have been invited to submit full proposals for funding to the Community Action Fund.
Organizations in Alberta may now submit an application for funding to the Alberta Community HIV Fund (ACHF). For information, and to access this joint solicitation between PHAC and the province of Alberta, please visit the Alberta Community Council on HIV website.
National organizations (16 projects)
- Community Based Research Centre
- Action Canada for Sexual Health and Rights
- Sex Information and Education Council of Canada
- Native Women's Association of Canada
- Canadian Public Health Association
- Canadian HIV/AIDS Legal Network
- Prisoners with HIV/AIDS Support Action Network
- Canadian Aboriginal AIDS Network
- Ontario HIV Treatment Network
- Canadian Association for HIV Research
- Canadian Society for International Health
- Interagency Coalition on AIDS and Development
- Canadian Working Group on HIV and Rehabilitation
- Qaujigiartiit Health Research Centre
- Dr. Peter AIDS Foundation
British Columbia (11 projects)
- Health Initiative for Men Society
- Burnaby Association for Community Inclusion
- Simon Fraser Society for Community Living
- University of British Columbia
- Gender and Sexual Health Initiative
- Downtown Eastside Sex Workers United Against Violence Society
- Supporting Women's Alternatives Network Society
- WISH Drop-in Centre Society
- Positive Living Society of British Columbia
- BC Centre for Disease Control
- Positive Living North
- Pacific AIDS Network
- AIDS Vancouver Island
- Progressive Intercultural Community Services Society
- YouthCo HIV and HepC Society
Alberta (5 projects)
- Alberta Community Council on HIV
- Sandy Beach Ki Mamow Atoskanow Foundation
- Sagitawa Friendship Society
- HIV North Society
- Grande Prairie Friendship Centre
- High Prairie Native Friendship Centre Society
- High Level Native Friendship Centre Society
- Nistawoyou Association Friendship Centre
- HIV Edmonton
- HIV Community Link
Saskatchewan (8 projects)
- Planned Parenthood Regina Inc.
- \AIDS Programs South Saskatchewan
- Saskatchewan HIV/AIDS Research Endeavour\
- Sexual Health Centre Saskatoon
- STC Health & Family Services Inc.
- Prince Albert Metis Women's Association Inc.
- Ahtahkakoop First Nation
- Big River First Nation
- Saskatoon Tribal Council
Manitoba (5 projects)
- Nine Circles Community Health Centre
- Sexuality Education Resource Centre Manitoba, Inc. (SERC)
- The 595 Prevention Team Inc.
- Klinic Community Health
- Ka Ni Kanichihk
Ontario (23 projects)
- AIDS Committee of Toronto
- Wabano Centre for Aboriginal Health
- The Teresa Group
- Regent Park Community Health Centre
- Alliance For South Asians AIDS Prevention
- Asian Community AIDS Services
- Centre for Spanish Speaking Peoples
- Regional HIV/AIDS Connection
- Women's Health in Women's Hands Community Health Centre
- Africans in Partnership Against AIDS
- Black Coalition for AIDS Prevention\
- AIDS Committee of North Bay and Area
- The AIDS Committee of Durham Region
- Maggie's - Toronto Sex Workers Action Project
- Peel HIV/AIDS Network
- University of Toronto, Faculty of Social Work\
- Planned Parenthood Toronto
- La Passerelle - Intégration et Développement Économique
- The AIDS Network
- Middlesex-London Health Unit
- London Intercommunity Health Centre
- Gilbert Centre for Social and Support Services
- Ontario AIDS Network
- AIDS Committee of Ottawa
- AIDS Committee of Windsor
- HIV/AIDS Resources and Community Health
- AIDS Committee of Cambridge, Kitchener, Waterloo & Area
- Fife House
- Réseau ACCESS Network
- Elevate NOW (AIDS Committee of Thunder Bay)
- Toronto People with AIDS Foundation
- AIDS Bereavement and Resiliency Program of Ontario
- African Black Diaspora Global Network
Quebec (13 projects)
- Centre Associatif Polyvalent d'Aide Hépatite C
- \Mouvement d'Informations & d'Entraide Dans la Lutte Contre le Sida
- Portail VIH/sida du Québec
- Point de Repères
- L'Unité d'intervention mobile L'Anonyme
- Centre d'amitié autochtone de Val-d'Or
- IRIS Estrie
- Le Bureau régional d'action Sida
- Bureau local d'intervention traitant du sida
- Sidaction Mauricie
- \AIDS Community Care Montréal
- Groupe d'action pour la prévention de la transmission et l'éradication du sida
- Coalition des organismes communautaires québécois de lutte contre le sida
- Coalition Montréalaise des groupes jeunesse LGBT
New Brunswick (2 projects)
- SIDA/AIDS Moncton Inc.
- \AIDS New Brunswick/SIDA Nouveau-Brunswick Inc.
- \AIDS Saint John Inc.
- John Howard Society of Southeastern New Brunswick
Nova Scotia (6 projects)
- AIDS Coalition of Nova Scotia
- Health Association of African Canadians
- Association of Black Social Workers
- African Diaspora of the Maritimes
- Healing Our Nations
- Hepatitis Outreach Society of Nova Scotia
Prince Edward Island (2 projects)
- AIDS PEI Community Support Group
- \Newfoundland/Labrador (3 projects)
- AIDS Committee of Newfoundland and Labrador
- Labrador Friendship Centre
Northwest Territories (1 project)
Yukon (2 projects)
- Council of Yukon First Nations
- \Blood Ties Four Directions Centre Society
What is reported here is somewhat helpful but to interpret what is going in, and take a position on it, you really need to know more. It’s complicated but bear with us.
Funding: the basics
Because it’s clear that the process is not well understood and that has resulted is some confusion we will outline our understanding of it, not as a participant – PositiveLite.com receives no government funding – but as an observer
So here goes . . .
PHAC has in the past provided community based organizations who respond to HIV - AIDS Service Organizations (ASO’s) plus national partners like CATIE, the International Coalition on AIDS and Development (ICAD), the Canadian HIV Legal Network etc. It's now called the Community Action Fund (CAF). This fund has remained stable for the last five years and importantly, will remain stable under the new allocations that are proposed.
But there is a qualification. Initially this pool funded the HIV sector only but the government has moved, somewhat controversially, towards an integrated approach to HIV that included at first Hep C. That approach was later expanded to include sexually transmitted infections (STI’s) and what has become known as BBI- blood-borne infections. So money available to fight HIV only is now spread wider and more thinly. Thinner still as more agencies were invited into the fold in the latest funding process which is now the subject of so much discussion.
So how would the government decide who got what? See the PHAC description above. The new process that was decided on this year after several years of community back and forth was an invitation to organizations to submit letter of intent (LOI) that they wished to apply for funding within the $26.4 Community Action Fund. This time the call went out not just to ASOs and NGOs but to others not part of the traditional network but who do engage to some degree in this kind of work. The John Howard Society is often quoted as an example; its principle focus is on rehabilitation of those incarcerated but its work also touches on HIV and Hep C prevention. So, the government’s argument goes, in an integrated service delivery approach, why would such agencies not be entitled to some of the $26.4 million pot? Some have argued that this further dilutes the money available to ASOs and the like; they would be correct.
It’s hard not to agree that this trend runs parallel with what is sometimes called the "normalization of HIV", a point of view which sees HIV as just another chronic manageable condition not entitled to any special funding treatment. Others within our community dispute that.
Bear in mind too that we are talking about federal funding here only. And the feds will be quick to make clear that CAF is not the only money they allocate to Canada’s HIV/BBI response. They will tell you, for example, that money goes to CIHR for research, to HIV work in correctional services and to indigenous communities as well as to administrative overhead. The total HIV/BBI domestic allocation is reportedly about $80 million. They will also tell you of Canada’s contribution to international aid and the Global Monetary Fund which was just increased by 20% to about $800 million.
Of course the community based funding that an agency may receive is often only a fraction of their total operating budget, the other major contributors being provincial funding, fundraising revenues and for some agencies, funding from their local municipality. In Ontario, the funding from the federal government is quoted at just 8% of total operating budgets for ASOs combined with other entities like the OHTN, testing services etc. Source: OCHART, View from the Front Lines latest report.
What people are saying
Chief among the prospective casualties was the Canadian AIDS Society (CAS) whose efforts to hold on to both a position of influence and a dwindling membership have been covered extensively by PositiveLite.com in the past. CAS, an agency very reliant on PHAC funding for its existence, had their letter of intent rejected, implying they may have to close come March 31, 2017. Executive Director Gary Lacasse this week said this . .
“We here at the Canadian AIDS Society received no funding from the process, but through this process we are committed to our mission and goals, and we know that there are many organizations across the country who had their applications either significantly reduced or rejected altogether as ours were. Make no mistake, we find this turn of events not just undesirable, but completely inconceivable given the current goals of the international community”
CTAC, who face losing much of their funding, expressed similar sentiments. Said their press release:
“It is with great shock and dismay that we are communicating the Public Health Agency of Canada’s (PHAC) decision to reject CTAC’s Letter of Intent submission for the HIV and Hepatitis C Community Action Fund. The requested contribution agreement would have provided a significant source of funding to CTAC after the expiry of the current contribution agreement on March 31, 2017.
At this time of introspection, CTAC staff has convened to discuss a forward-looking strategy to ensure the continuation of the agency’s unique role and commitment in supporting people in Canada living with HIV and HIV/hepatitis C co-infection.”
The Ally Centre in Nova Scotia, a small organization that provides support for those with HIV, Hepatitis C and other blood-borne pathogens is one of many smaller agencies whose proposals were rejected. It was the first to go public. Said its board chair to CBC news "It's a small amount of funding. We got our letter back from them saying sorry but we're not interested. It's just unimaginable to us really ."
Social media came alive this week when community members got hints of what were seen as dramatic cuts across the country, with concerns raised that money had been diverted from domestic AIDS organizations to the Global Fund, which the Canadian government recently increased its contribution to. (That's not the case.) Much of the discourse came out of the proposed 70% reduction in PHAC funding to CAAN and its potential impact on rising infection rates in the indigenous population. Said one angry facebooker “NO WONDER WE were able to give so much at the AIDS REPLENISHMENT (GLOBAL FUND) TAKE away from the real issues. And sweep the Aboriginal People under the rug once again. This is SHAMEFUL AND A DISGRACE. US ADVOCATES MUST SPEAK UP.”
Some Facebook commenters cited the need for transparency like this Ontario ASO ED “We need to ask PHAC to be transparent- who applied, who was accepted (and under what conditions -- i.e. reduced funding request) who was rejected. I have heard that comments were inconsistent depending on who at PHAC reviewed the LOI”
The Canadian Positive People Network (CPPN) is expected to issue an open letter focusing on the issue of transparency in particular. among other issues.
Meanwhile little has been released about those agencies who have received new or increased funding. But PositiveLite.com has learned that one of these is likely to be a pan-Canadian gay men’s sexual health alliance invited to apply for more than $1 million, designed to boost the response to a population which continues to represent the largest share of new infections in Canada.
The organizations invited to apply will do so and have until November 24 to submit a full application. As for the others, it seems there is no appeal process. At the same time, we expect to see continued bargaining between the national partners and PHAC officials and it’s possible we will see some movement. Note too that there is $600,000 currently unallocated which may or may not represent opportunities for second thoughts.
Given that we still don’t have a complete picture of the NET impact of these allocations on the community, PositiveLite.com is suggesting that it is premature to take an editorial position. Rest assured though that we will continue to report on this situation as it develops and may in time take a more definitive stance.
Stay tuned for more news.