Plan to reduce Downtown Eastside HIV rate
Published Monday, September 15, 2008 4:52PM PDT
On Vancouver's battered Downtown Eastside, a war is being waged.
In this drug-ravaged neighbourhood it's estimated one in three people is infected with HIV.
For a first class city, this infection rate is the highest in the western hemisphere, on par with the poorest of African nations.
But new research suggests this number could be cut dramatically, and the plan is straightforward.
"The treatment really has a potential role overall in decreasing HIV transmission,'' said Dr. Julio Montaner, a world-renowned aids researcher.
He says only 50 per cent of those in medical need are receiving proper treatment.
His research shows that if that number was increased to 75 per cent, it would have a big impact.
"The reduction in new HIV infections could be somewhere in the order of 20 to 30 to even 50 per cent, depending on how aggressively you pursue treatment," said Dr. Julio Montaner
Here's how it works:
The drug treatment known as Highly Active Anti-Retroviral Therapy -- or HAART can reduce the number of virus particles in a patient to almost zero.
Not only does that mean the patient will live longer, they won't infect others.
"These people don't go ahead to die, they lead a normal life, they're free of disease, they don't plague up our medical system, and equally important we can prevent HIV infections," said Montaner
The B.C. government has said it's on board with the plan.
But the challenge will be to reach those marginalized people in the Downtown Eastside, who aren't seeking treatment.
"I estimate within a period of three to six years, we should be able to fully roll out a successful program of engagement and participation in HIV care," said Montaner
If it works here, it could work anywhere.
"We know how to stop HIV, we know how to stop it, and we know how to do it now," Dr. Montaner said, adding that this British Columbia community could be a model for the rest of the world.
If Dr. Montaner has his way this area, where many have lost hope, will soon become a symbol for the vast potential this drug therapy could have.
"In my opinion, and I feel very strongly not doing the right thing is a crime by omission, it's a sin and in this context it's a crime against humanity."
More on how the treatment works.
The treatment means taking three or more drugs on a daily basis for life. And the cost is covered by the B.C. medical plan.
Still, some of those infected with HIV are not accessing treatment because they have other challenges in life such as mental illness, substance abuse , poverty or homelessness.
So its not just about providing pills but the need for a more comprehensive level of care. And that's what Dr. Montaner hopes the B.C. governemnt will also consider.
If this expanded treatment initiative goes ahead the researchers say it will translate into a staggering savings of $95 million in health care costs.
With a report by CTV British Columbia's Dr. Rhonda Low