Canada faces a critical choice in its fight against HIV: invest strategically now or pay a far steeper price in lives and healthcare dollars down the line. This is the urgent warning from Dr. Julio Montaner, a leading figure in HIV research, as new data reveals a troubling surge in infections across the country.
A Preventable Surge Amid Proven Solutions
Despite groundbreaking medical advances pioneered in Canada, HIV cases are climbing at an alarming rate. New HIV diagnoses in Canada increased by a staggering 35 percent between 2022 and 2023. This rise is occurring even in British Columbia, a province that has been a global leader in HIV control strategies.
The scientific tools to curb the epidemic exist. Treatment as Prevention (TasP), a strategy developed in B.C., provides antiretroviral therapy to people living with HIV. This not only preserves health but also makes the virus untransmittable through sexual contact. Since its implementation in B.C. in 2010, it has contributed to a greater than 90 percent decrease in AIDS cases, HIV-related deaths, and new infections by 2023.
Complementing TasP is Pre-Exposure Prophylaxis (PrEP), a daily pill for people at high risk of acquiring HIV that is over 96 percent effective. When used together, these strategies can dramatically slow transmission. However, Dr. Montaner notes that PrEP remains seriously underutilized globally and in Canada, representing a massive missed opportunity.
The High Cost of Inaction and Global Uncertainty
The current backsliding is not happening in a vacuum. Internationally, the HIV response is under threat. The current U.S. administration has pulled billions in funding from key health programs, including the Global Fund and PEPFAR. Estimates suggest these cuts could lead to six million new HIV cases and four million additional AIDS-related deaths worldwide by 2030.
Further compounding the problem, the United Nations Joint Programme on HIV/AIDS (UNAIDS) will be phased out starting in 2026, four years ahead of schedule. As HIV knows no borders, these international setbacks have direct consequences for Canada. Dr. Montaner points out that rising HIV diagnoses in B.C. are now partly driven by immigration from other parts of Canada and abroad, including the United States.
A Call for Canada to Lead Through Pharmacare
Dr. Montaner argues that the solution is clear and cost-effective. To save lives and money, Canada must fully fund both HIV treatment and preventative antiretrovirals like PrEP within the forthcoming national Pharmacare program. Investing in these proven measures is not just a healthcare imperative but a fiscal one, as preventing infections avoids far more expensive long-term care costs.
The message is stark: Canada has the science and the strategy to control HIV. What it requires now is the political will and financial commitment to implement them fully, before the rising trend becomes a crisis.
