Open Letter: Canadian HIV Advocates to the Carney Government
Dear Hon. Anita Anand, Minister of Foreign Affairs, Hon. Marjorie Michel, Minister of Health, and Hon. Randeep Sarai, Secretary of State for International Development,
We are writing on behalf of a civil society group of Canada’s leading HIV community-based organizations, including people living with HIV, health researchers, scientists, and other advocates to express both concern and urgency regarding the state of the global and domestic HIV response. Canada has long played an essential role in shaping and sustaining progress against HIV and AIDS through its political leadership and financial commitments, including to the Global Fund to Fight AIDS, TB and Malaria (the Global Fund) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). Yet, today, the remarkable progress we have made is at unprecedented risk — around the world and here at home.
This past spring, The New York Times highlighted the devastating story of Peter Donde, a 10-year-old boy in South Sudan who acquired HIV during childbirth. Peter relied on life-saving HIV medications provided through U.S.-funded programs. When the U.S. administration cut international HIV aid, Peter lost access to treatment and died. His story is not an isolated tragedy—it is a dire warning. UNAIDS projects that the U.S. decision to retreat from global HIV efforts could result in 2,000 new HIV infections each day and over six million preventable deaths worldwide over the next four years.
This marks a devastating reversal of decades of progress and collective investments made by governments, private sector partners, civil society, and diverse communities affected by HIV. Since 2004, global deaths from HIV have fallen from over two million annually to approximately 600,000 in 2023. This decline has been possible only through sustained investment, scientific innovation, and international solidarity. If countries like Canada falter — even for a moment — in their funding commitments, millions more lives like Peter’s could be lost.
Canada has a proud record of global leadership in the HIV response, and in human rights. Through contributions to the Global Fund, UNAIDS, and bilateral programs, we have helped expand treatment, prevention, and care across the world. Now is not the time to step back, but to step up. We urge the Government of Canada to increase its financial contributions to global and domestic HIV programs and to continue exercising strong political leadership in the international fight against HIV and AIDS.
At the same time, there is unfinished work within our borders. Canada’s national HIV response is falling short, particularly for marginalized, stigmatized, and criminalized communities. Rates of new HIV infections have been rising steadily across Canada. According to the Public Health Agency of Canada, new HIV diagnoses increased by about 85% from 2020 to 2023. In Manitoba, rates rose by more than 40% from 2022-2023, while Saskatchewan’s rate reached 19.4 per 100,000 people—more than triple the national average. We are the only G7 country with rising rates. These alarming increases are a clarion call for urgent policy and programmatic change, increased investment, and renewed political leadership.
As UNAIDS Executive Director Winnie Byanyima said in September to parliamentarians and civil society representatives gathered in Ottawa, “Canada must not step back in the fight against HIV at this critical time, when human rights are increasingly threatened, the hard-won gains of the HIV response are at risk, and as we support countries to accelerate the transition to ensure inclusive, sustainable, and multisectoral national HIV responses. We need Canada to continue to defend all human rights.”
The burden of HIV in Canada is not evenly shared. Black, Indigenous, and other racialized, stigmatized, and criminalized communities are disproportionately affected, representing a significant proportion of new diagnoses, despite making up a much smaller percentage of the overall population. Indigenous and Black communities in particular continue to demonstrate resilience and leadership through community-driven health services, yet these efforts remain severely under-resourced. Marginalized communities, including 2SLGBTQI+ people, older adults, and people living with disabilities face significant barriers to accessing appropriate prevention, treatment and support leading to health inequities. Without targeted, sustainable investments, the disparities in HIV outcomes will only deepen.
We believe Canada has both the opportunity and the responsibility to reshape its domestic HIV strategy to reflect today’s realities, while adhering to its international human rights commitments. HIV funding amounts are not keeping pace with an expanding epidemic, inflation, harmful legislation is creating access barriers to essential evidence-based public health services, and longstanding community-led and civil society HIV organizations are no longer able to afford to stay open despite ever-growing demands from our most affected communities. The federal government must work in partnership with provinces, territories, civil society, and community organizations to ensure equitable access to testing, treatment, support and prevention. This includes scaling up programs that have proven impact, such as HIV self-testing, comprehensive harm reduction services,linkage-to-care initiatives and peer-based supports, which reduce barriers and reach those who are often left behind by traditional healthcare systems.
By investing in approaches that meet people where they are—equity-based, culturally safe, trauma-informed, low-barrier, accessible,evidence-based, and community-driven—we can turn the tide of rising infections. Everyone in Canada, especially Black, Indigenous, and other marginalized, stigmatized, and criminalized communities, deserves equitable access to quality HIV prevention, care, and treatment when and where they need it. This is not only a matter of health equity but of human rights. Investment in HIV prevention also doesn’t just save lives, it saves millions as each new diagnosis costs Canada $1.44M in lifetime care, adding up to $2.1B in 2021 alone.
Canada’s global credibility is tied to its domestic performance. To be a beacon of leadership on the world stage, we must demonstrate that our commitments to ending HIV and AIDS are consistent both abroad and at home. Failing to address the alarming increases in domestic HIV infections while calling for global solidarity risks undermining our influence and moral authority in international forums.
We therefore respectfully urge the Government of Canada to:
- Increase Canada’s contributions to the Global Fund, UNAIDS, and other international HIV initiatives to ensure progress toward ending AIDS as a public health threat by 2030.
- Reshape the domestic HIV strategy with explicit focus on addressing inequities faced by Black, Indigenous, and racialized, stigmatized, and criminalized communities. This must go hand in hand with increased funding for community-driven programs that reach those most affected, while addressing the harmful laws and policies that continue to drive new infections.
- Expand investments in innovative approaches such as self-testing, linkage-to-care, investments in HIV prevention medications, including Lenacapavir, a new game-changing HIV drug, and culturally safe harm reduction programs that break down barriers and connect people to life-saving treatment.
- Strengthen collaboration with Indigenous leadership and organizations, ensuring they have the resources to provide effective, community-designed solutions.
The HIV pandemic is not over. It remains a global and national challenge that demands urgent attention, sustained investment, and political will. Canada’s actions in the coming months will determine whether we continue to move toward the goal of ending HIV as a public health threat by 2030—or whether we risk a devastating reversal that could cost millions of lives.
We ask for your leadership in ensuring that Canada remains a strong, principled, and effective partner in the fight against HIV—both globally and here at home. Dr. Jason Nickerson of Médecins Sans Frontières (MSF Canada) reminded us during the recent round table:
“Children are dying. This is not about charity. It is about responsibility and solidarity with the people whose lives depend on the decisions made in capital cities like here in Ottawa.”
Thank you for your attention, and for your continued commitment to protecting the health and well-being of people in Canada and around the world.
With respect and determination,
Endorsers