A life in politics

By Aaron Wherry - Wednesday, August 22, 2012 at 9:43 PM - 0 Comments

The CBC has uploaded video of Jack Layton on the National in 1985.

Laura Stone talks to some of those who visited Nathan Phillips Square this evening and the late NDP leader is toasted with drinks in Sudbury and a picnic in Ottawa.

The Globe and Mail editorial board considers his legacy.

With public cynicism running high, the chord that he struck with many Canadians in his final months and in his passing was a reminder that – with the right combination of decency, optimism, perserverence and grace – it is still possible for our politicians to inspire. Without painting over the more worrisome aspects of his record, that is well worth remembering.

Can mass HIV testing really end AIDS?

By Julia Belluz - Thursday, August 2, 2012 at 2:20 PM - 0 Comments

Dr. Julio Montaner, Director of the British Columbia Centre for Excellence in HIV/AIDS. (Darryl Dyck/CP)

“And if we can stop the transmission, we can stop the disease.”—Dr. Julio Montaner, director of B.C.’s Centre for Excellence in HIV/AIDS, July 19, 2012

At first glance, it seemed wasteful, almost insanely so. After the international AIDS conference in Washington, D.C., last week, health officials from B.C. were trumpeting mass population screening for HIV in their province, and eventually, beyond. According to the media reports, if we could get everyone who has ever been sexually active tested (on a volunteer, not mandatory, basis) it could mean “the beginning of the end” of AIDS.

Of course, there was much overselling in the media—with headlines like: “B.C. aims to end HIV/AIDS with widespread testing“ and “B.C. launches massive program to wipe out HIV/AIDS.” But this screen-everybody approach also seemed dubious from a public health viewpoint. Given the well-known problems associated with over-testing, over-screening, and over-diagnosis in other areas of medicine—from PSA testing to pap smears—why try the catch-all method with HIV? What about the traumas related to false positives and the sheer monetary cost of such an encompassing plan? Plus, Canada doesn’t have a high prevalence of HIV/AIDS. Why would we adopt mass screening for a disease that mainly impacts marginalised or hard-to-reach groups that probably wouldn’t be captured anyway? Science-ish called Dr. Julio Montaner, one of the leading proponents of the program, to find out more.

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Should we make surgeons get tested for HIV, hep B and hep C?

By Julia Belluz - Thursday, July 19, 2012 at 9:00 AM - 0 Comments

Petr Josek/Reuters

When patients go into the hospital for a surgery, it’s next to a miracle they ever leave the building unscathed. It’s not that hospital administrators and health professionals don’t do their best to protect patients—they do. But with the incredible complexity of surgeries and modern hospital systems, the intricate pathways of care, there are infinite possibilities for things to go wrong.

In the media, we tend to focus on the risks related to hospital-acquired infections or the wild pre-checklist days. But there’s another danger that isn’t talked about much outside of medical circles: getting a blood-borne infection, such as HIV, hep C and hep B, from your health-care provider.

Precautions are taken at every turn to make sure diseases aren’t transmitted from doctor or nurse to patient—and vice versa. And the risk of transmission is remote. Extremely, utterly, almost infinitesimally remote. To give you a sense, according to the U.S. Centers for Disease Control, the occupational risk of infection with hep C after a needlestick injury or cut is less than two per cent. That’s somewhere between the risks related to HIV (less than one per cent) and hepatitis B (six to 30 per cent, though surgeons working today would be vaccinated for hep B).

In Canada there have been no documented cases of physicians transmitting hep C or HIV to patients since modern antiviral therapies came on the scene to treat blood-borne pathogens and doctors started implementing what’s known as “universal precautions”—or  avoiding contact with patients’ bodily fluids by using gloves, gowns and masks. There has been one reported case of hep B transmission, but it occurred before antivirals and universal precautions. Worldwide, the documented number of health-care worker to patient transmissions of blood-borne infections since 1991 has been “exceedingly low.”

Yet, provincial medical regulators in Canada are targeting blood-borne pathogens in surgeons. The College of Physicians and Surgeons of Ontario just introduced a new policy that asks surgeons—and those who assist in surgery—to report if they have been tested for the blood-borne pathogens hep B, hep C, and HIV in the last year.

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For Roger

By Aaron Wherry - Thursday, December 1, 2011 at 2:46 PM - 1 Comment

NDP MP Glenn Thibeault reflects on his brother, Roger, who died 20 years ago of AIDS.

For World AIDS Day, Thibeault is hoping to bring the experiences he learned from his brother to Parliament. “I hope I can bring the message that our job’s not done yet, that we still need to bring forward awareness, we still need to work harder on research, we still need to work harder on making sure that society understands that on World AIDS Day, it’s affecting everyone,” Thibeault says. “The sad thing that I see in some instances, coming from different parts of the country, there’s still the stigma that this is still a gay disease. It’s not.”

How AIDS really got started

By Brian Bethune - Wednesday, November 23, 2011 at 11:00 AM - 1 Comment

Daniel Rosenthal/laif/Redux

In 1976, a handful of Belgian nuns were operating a badly needed hospital in Yambuku, a remote village in Zaire. Some 300 patients a day came, many seeking antiviral drugs, which nurses provided via the poorly funded hospital’s five reusable syringes. The result of the inevitable cross-infection was the first outbreak of the blood-borne virus Ebola, which killed 280 of its 318 victims—far more deaths than if there had never been a hospital in the first place.

The Yambuku incident is one of the most harrowing proofs ever recorded of the old adage that no good deed goes unpunished. But the story of the Ebola outbreak differs little in its essentials from that of an exponentially more lethal disease, AIDS. Now marking its 30th official birthday—counting from the 1981 U.S. Centers for Disease Control paper about an unlikely pneumonia cluster in Los Angeles—AIDS has so far killed 30 million people. And in Dr. Jacques Pepin’s convincing account of its history, The Origins of AIDS, it emerges as the greatest man-made health disaster of our times.

The disease itself is much older than 30. Molecular studies show that chimpanzees, hosts to the virus that causes AIDS in humans, have carried it for centuries. Pepin, an infectious disease physician and professor at Quebec’s Université de Sherbrooke, uses mathematical modelling to show that dozens of people—chimp hunters or their wives preparing the meat—must have thereby contracted AIDS. One spouse would then infect the other sexually, but those couples became what Pepin calls in an interview “epidemiological dead ends: the disease would develop in them for a decade, and then they would die, with no effect on the larger population.”

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Who’s afraid of a gay man’s blood? We are.

By Julia Belluz - Wednesday, September 14, 2011 at 12:11 PM - 9 Comments

Adam Piotrowski/Flickr

The Statement: “In our case, we’re absolutely certain that going from a lifetime deferral to a five-year deferral or even a one-year deferral … would absolutely make no difference in terms of the risk of HIV (transmission),” Marc Germain, Héma-Québec, 09/08/2011

Starting in November, the United Kingdom will join South Africa, Australia, New Zealand, Japan and other countries that have lifted the lifetime ban on blood donations from men who have sex with other men (MSM) and instead impose a 12-month deferral period after oral or anal sexual contact with a same-sex partner has occurred. This rule will apply whether or not a condom was used.

The policy change is based on the findings of the independent Advisory Committee on the Safety of Blood, Tissues, and Organs, which reviewed the evidence on donor selection criteria, taking into account improvements in blood testing, monitoring from countries with shortened deferral periods, and donors’ compliance with the ban. They concluded that the science “no longer support[s] the permanent exclusion of men who have had sex with men.” Continue…

How General Idea predicted the future

By Sara Angel - Thursday, July 28, 2011 at 3:05 PM - 5 Comments

Photograph by Jessica Darmanin

Among the many reasons to celebrate this week’s centenary of media guru Marshall McLuhan’s birth is that he gave life to General Idea (GI), one of the world’s most subversive art practices. Next week, Haute Culture: General Idea, the first comprehensive retrospective of the three-man Canadian cultural collective, opens at the Art Gallery of Ontario. It’s the 25-year-long story of A.A. Bronson, Felix Partz, and Jorge Zontal, who came together in 1969 as roommates in a Toronto house that had once been a store. “We were unemployed and bored,” says Bronson, 65, explaining how the group began their art career by dreaming up fictitious retail identities for their home’s large storefront window. “One day we turned the place into a romance bookshop with boxes of Harlequins we found in the trash. The door to the house was always locked and there was always a sign that said ‘Back in 5 minutes.’ ”

Quickly the three earned a reputation as a gang that was redefining the role of the artist. “For GI, he was no longer someone who made things to hang on walls,” says Frédéric Bonnet, Haute Culture’s curator, “but a commentator on society.” They attended parties in matching outfits, obsessively documented themselves as real and fictionalized characters, and lived together as a threesome. “They introduced the idea that a relationship can be a triangle,” Bonnet says, “and not just a couple with two kids.”

The group chose the name “General Idea” to describe their practice, which was media omnivorous and favoured intellect over technical virtuosity. GI demonstrated this to the world in 1971, when they staged the Miss General Idea Beauty Pageant at the Art Gallery of Ontario, where contestants were both men and women. With this piece of performance art, Bronson, Partz, and Zontal imitated popular culture to plug themselves into one of the most important dialogues of the day: the questioning of gender stereotypes.

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The legacy of Pope Benedict XVI

By Brian Bethune - Friday, February 11, 2011 at 7:00 AM - 36 Comments

Franco Origlia/Getty Images

In this story first published in 2011, Brian Bethune considered the ways Pope Benedict XVI was changing the Catholic Church:

It wasn’t supposed to be this way, not according to confounded Vatican watchers. Cardinal Joseph Ratzinger was already 78 years old when he became Pope Benedict XVI in 2005. He was widely seen as the arch-conservative doctrinal enforcer, the sharp spear point wielded by his charismatic rock star predecessor—Joshua to Pope John Paul II’s Moses, in the words of one Jewish scholar. The consensus opinion was that Benedict would provide a quiet, business-as-usual continuance of John Paul’s 27-year reign and, given his age, a brief pontificate that would allow the 1.1 billion-strong Roman Catholic Church time to catch its breath and consider its future options.

No one, it seems, asked Benedict what he thought of the caretaker idea.

From inflaming the Islamic world by quoting medieval anti-Muhammad remarks to welcoming disaffected Anglicans into the Roman fold, becoming personally embroiled in the clerical sex-abuse scandal, endorsing the (sometimes) use of condoms, writing a passage in his newest book exonerating Jews from the charge of killing Christ, and a host of less headline-grabbing initiatives (including a casual acceptance of the theory of evolution), Benedict—as he celebrates his 84th birthday and sixth anniversary as Pope (April 16 and 19, respectively)—continues to be far more active, innovative, and outright newsworthy than expected.

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Grace under fire

By Brian Bethune - Thursday, December 9, 2010 at 8:00 AM - 14 Comments

Stefano Rellandini/Reuters

There is always, in the spiritual and political life of the Roman Catholic Church, a fire smouldering somewhere: minority Christians under persecution here, an abortion initiative in a Catholic country there, rebellious laity, scandalous clergy. So Pope Benedict XVI had no particular reason, on New Year’s Day, to foresee that the long-running clerical child sexual abuse scandal would suddenly burn white-hot, and spread far outside the confines of his Church. But as the penitential season of Lent began in February, hundreds more victims surfaced with their harrowing stories, not only in Ireland and the U.S., the epicentres of the scandal, but across Europe, including Benedict’s native Germany.

This time it was more than the original crimes that angered the faithful and outsiders alike. The focus was increasingly on the cover-up—the swearing of victims to secrecy, the shuffling of pedophile priests to fresh starts (and fresh opportunities) in unsuspecting parishes—and the way that cover-up touched the papacy itself. Questions were raised in the media and among Catholics about Benedict’s role, before he became pope, in determining the Vatican’s treatment of predatory clergy, a response widely condemned as ineffectual at best and criminally negligent at worst. Benedict found himself launched on an annus horribilis that would prove as awful as any experienced by a pope in modern times.

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How public health failed

By Larry Krotz - Monday, November 29, 2010 at 1:00 PM - 17 Comments

With an almost eight per cent infection rate, 60 per cent of government health spending in Kenya goes toward AIDS; John only recently began to practice safe sex | Marco Negri/Zuma/Keystone Press; Larry Krotz

John is something unusual in Kenya, a gay man who openly admits to both that and to being a sex worker. Homosexuality there has long been anathema, labelled by former president Moi as “foreign, not done by Kenyans.” Putting the lie to this, John every morning dabs on some Hugo Boss cologne, stops into an Internet café to check out a gay website for arriving tourists, then cruises the streets looking for business. But when we sat down and talked in Nairobi, John, who is 32 years old and asked not to be identified by his full name, admitted something astonishing: despite his high-risk occupation and the fact that AIDS has been around almost his entire life, he claimed not to know until last year that he could get HIV through sex with men. In Kenya, the HIV epidemic is overwhelmingly a heterosexual calamity. Eventually tested, he knows he is positive and, though he now uses condoms, for a long time he very likely spread the virus.

Astoundingly, a full generation after the arrival of AIDS, especially in that most hard-hit of regions, southern Africa, disinformation remains rife. As the 23rd World AIDS Day approaches on Dec. 1, what is similarly disturbing is that strategies needed to prevent the spread of this awful epidemic never came close to being effective. Statistics alone tell the tale. True, more and more people are on life-prolonging antiretroviral therapies (ART), something that mushroomed when costs dropped to $100 per year per patient with the arrival of generic drugs. Yet for every 100 people put on ART, southern Africa registers 250 new HIV infections.

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HIV epidemic is "halted," UN says

By macleans.ca - Tuesday, November 23, 2010 at 10:58 AM - 5 Comments

The number of new HIV infections—and deaths as a result of AIDS—are decreasing globally, new statistics from the UN show. Stigma and discrimination continue to be a problem for the roughly 33 million people in the world with HIV, but there are signs the epidemic is declining: last year there were 2.6 million new HIV infections, down almost 20 per cent since the peak of the epidemic in 1999. And in 2009, 1.8 million died from AIDS-related illnesses, a drop from 2.1 million in 2004. Meanwhile, AIDS researchers have found that taking a daily antiretroviral pill greatly reduces the chances of becoming infected with the virus, the New York Times reports. In an article published in the New England Journal of Medicine, they reported on a study of hundreds of gay men randomly assigned to take drugs, and found they were 44 per cent less likely to get infected than the equal number who took a placebo. Looking at the men who took their pill faithfully every day, the pill was more than 90 per cent effective. Observers call it the best news in the AIDS field in years.

BBC News

New York Times

Protesters demand affordable AIDS drugs

By Mitchel Raphael - Friday, October 8, 2010 at 3:52 PM - 0 Comments

Protesters hit the Hill to push MPs to pass Bill C-39. This bill would make it  easier for generic drug companies to produce affordable AIDS medications for the developing world.

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Idea alert

By Aaron Wherry - Friday, February 5, 2010 at 11:28 AM - 38 Comments

Keith Martin says there’s already a framework for addressing maternal and child health internationally. And, as luck would have it, he helped write it.

Last summer, at the pre-G8 Conference on International Health in Rome, parliamentarians from around the world developed a concrete work plan to reduce maternal mortality called, “Strategic Investments in Times of Crisis.” This was given to the G8 and G20 leaders at their meeting a few days later.

The plan called for strategic investments in people’s access to primary care: basic surgical facilities, medications, a full array of family planning options, diagnostics, adequate nutrition, clean water, power, and most importantly, trained health care workers. With these assets in place, most obstetrical complications could be treated, along with 80 per cent of the medical problems one encounters in the emergency departments of developing countries. This includes major killers like gastroenteritis, which causes 2.2 million deaths per year, pneumonia, 2.1 million, malaria, 2 million, and HIV/AIDS, which claims more than 2 million lives per year.

Jacob Zuma: not so rotten after all

By Nancy Macdonald - Tuesday, January 19, 2010 at 4:29 PM - 2 Comments

By now, Jacob Zuma’s South Africa should be careening toward the ranks of failed African states. Eight months ago, after an election anointed him president of the continent’s proudest democracy, editorialists everywhere drew thinly veiled comparisons to Zimbabwean dictator Robert Mugabe, who turned Africa’s shining light into a country that rivals only Somalia for sheer dysfunction. Even the most generous assessments had Zuma—once described as an “embarrassment” by Archbishop Emeritus Desmond Tutu—shackled by “suspicion” and “doubt” about his shambolic past, and fitness to lead Africa’s biggest economy. Yet under Zuma, South Africa has made pragmatic, positive strides in many areas, including health and the economy.

Early indicators were not good. Zuma, a former goatherd with no formal schooling and a stable of wives, has also twice stood trial. In April, the fraud, corruption and racketeering charges he’d been fighting for almost a decade were dropped, and in 2006, he was acquitted of rape (despite the acquittal, the case revealed “shocking” judgment, according to noted South African journalist Mark Gevisser: “He had unprotected sex with an unstable HIV-positive woman who regarded him as a ‘father.’ ”) To the chattering classes, Zuma seemed to embody the “rottenness” that famed novelist André Brink described as having befallen the country in A Fork in the Road, a memoir published in the weeks running up to the election.

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Insite, foresight, hindsight

By Colby Cosh - Tuesday, January 19, 2010 at 10:27 AM - 70 Comments

The B.C. Court of Appeal’s ruling on Vancouver’s Insite shooting gallery for heroin addicts makes for interesting reading. We are all so busy arguing over the merits of harm reduction, and the wisdom of the Harper government’s attempt to shut down the clinic, that it is easy to forget the big constitutional issue that was the chief concern of the court here. You would think that Canadian jurisprudence had developed a clear objective rule for settling even the trickiest “double aspect” issues, wherein both federal and provincial governments can claim that some crumb falls within their respective spheres of constitutional power.

You would, apparently, be wrong. Continue…

Politicians and prison outfits

By Mitchel Raphael - Wednesday, June 24, 2009 at 9:25 PM - 53 Comments

AIDS activists dressed in black-and-white striped prison uniforms took to the Hill to protest the criminalization of HIV transmission, noting it is the only potentially fatal pathogen being treated this way.

The AIDS activists were supported by NDP MPs Libby Davies and Bill Siksay.

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UPDATE: A Canadian HIV vaccine closer than ever

By Kate Lunau - Wednesday, November 12, 2008 at 12:45 PM - 0 Comments

There could soon be an HIV vaccine manufacturing facility on Canadian soil.

Today, the University of Western Ontario announced it’s one of four Canadian organizations under consideration by the federal government to build such a facility, which would create clinical trial lots of vaccine candidates. In fact, UWO researcher Dr. Chil-Yong Kang has already developed an experimental vaccine, for use in toxicology tests and eventual human trials; but because no Canadian facilities existed, he did his work in the U.S. “Had a facility been available in Canada, the vaccine could have been produced here,” UWO says.

In 2007, the Canadian government collaborated with the Bill & Melinda Gates Foundation to support the Canadian HIV Vaccine Initiative. One of CHVI’s priorities is to build a pilot-scale HIV vaccine manufacturing facility. This priority is shared by the Global HIV Vaccine Enterprise, which has identified a lack of appropriate facilities as a major roadblock towards efforts to create a vaccine. To that end, Canada will be spending $61.1 million, and the Gates Foundation $28 million, over five years.

Later today, Dr. Kang is expected to announce more details on his work. Stay tuned.

UPDATE: UWO has just released more information on Dr. Kang’s vaccine. From the press release:

“Kang’s vaccine uses a killed whole HIV-1, much like Jonas Salk’s killed whole polio virus vaccine. The HIV-1 is genetically engineered so that it is non-pathogenic and can be safely injected, and can be produced in large quantities, according to university officials.”

Sumagen Canada Inc, a subsidiary of Curocom of Korea, is fully funding Dr. Kang’s work on this vaccine.

Was Jane Doe the bait?

By Charlie Gillis - Thursday, October 30, 2008 at 12:00 AM - 8 Comments

Her name is covered by a publication ban, but it waits on the witness list of Regina vs. Johnson Aziga like a ticking bomb. “Jane Doe” is the last woman known to have slept with Aziga, a man on trial in Hamilton, Ont., for allegedly killing two women and endangering the lives of nine others by knowingly exposing them to HIV. Sometime in the next few weeks, Doe is expected to take the stand as the Crown tries to pin first-degree murder on Aziga, in a prosecution that has been denounced by some AIDS advocates as an attempt to “criminalize” HIV.

It promises to be a dramatic moment, in part because Doe wants to do a lot more than put her ex-boyfriend behind bars. In January, the 34-year-old from Brantford, Ont., filed a civil suit against a raft of public officials and institutions, from Hamilton Public Health Services to the police officers who investigated Aziga for murder. In it, she accused them of negligence and breach of duty for sitting by as she walked headlong into the disease that will hasten the end of her life. The specifics of her claim are damning in the extreme: after seven years of keeping tabs on Aziga; after learning he was having unprotected sex with numerous women without disclosing he was HIV-positive; after obtaining court orders to stop him from doing so; after placing him under police surveillance for weeks during which she dated him, the authorities simply left her to become infected.

The allegations are not yet proven, and the city, the health unit and the police say they intend to defend themselves. Still, the case underscores how nearly 25 years after researchers identified the virus that causes AIDS, authorities seem no better fixed to stop someone who is recklessly spreading it before lives are needlessly lost. No less than 70 people have faced criminal charges in such cases since the early 1990s, according to statistics compiled by the Canadian HIV/AIDS Legal Network, most of them criminal negligence or sexual assault causing bodily harm. But the cops and prosecutors come into play only after public health officials throw up their hands, by which time others—sometimes several others—have been infected. In most provinces, public health officers have the prerogative to issue court-enforced behaviour orders, and even detain reckless individuals, notes Ryan Peck, executive director of the HIV & AIDS Legal Clinic of Ontario. “The powers are there,” he says. But at a time when authorities are hyper-aware of the stigmatization of AIDS, medical officers see court orders as a last resort. And quarantining HIV-positive people? Unheard of.

The Aziga case, in particular, unfolded as a slow-moving catastrophe. A Ugandan-born immigrant with a firm command of English, Aziga initially acted co-operatively with public health officials after being diagnosed with HIV in 1996, according to testimony heard at his criminal trial. He attended counselling sessions and kept his job as an analyst with the Ontario Attorney General’s Ministry. He appeared to understand his responsibilities under the law, agreeing to practise safe sex and to inform his partners of his HIV status.

When public health officials decided he was duping them is not yet clear: Doe’s $6-million civil claim alleges that “in or about the year 2000, [the public health service] determined that the defendant Aziga was engaging in an ongoing pattern of unprotected sexual intercourse with unsuspecting women,” and that several women in a number of communities had become infected. In October 2002, the health unit issued an administrative order under Section 22 of Ontario’s Health Protection and Promotion Act directing Aziga to wear a condom, disclose his status to sex partners and attend counselling. That month, in a phone conversation with a public health nurse, he acknowledged having unprotected sex with at least one woman without informing her of his HIV-positive status, his trial has heard. By the following April, testified Dr. Elizabeth Richardson, Hamilton’s chief medical officer of health, the department had a list of 20 names of HIV-positive women in the region who had named Aziga as a sex partner. Alarmed, officials went to court to obtain a stricter order—this time under Section 102 of the act—which would allow them to detain Aziga if he failed again to comply. But they never got around to exercising that power. Instead they called the police.