Editorial: Boost AIDS funding, don't shuffle it

Plan to transfer AIDS dollars north ignores need for more cash up and down the Island

Times Colonist, 25 September 2007

It would be fine to cut AIDS funding for southern Vancouver Island if there was evidence of waste or inefficiency, or the services were no longer needed.

But the Vancouver Island Health Authority has not advanced those reasons for what will likely be a second attempt to reduce money going to HIV/AIDS services in the region by 30 per cent.

Instead, the authority says it has been doing an inadequate job on AIDS prevention and support in the north Island. To fix that, it proposes major cuts in this region, with the money being shifted to the north. The $1.5-million budget for HIV/AIDS programs would remain the same.

The issue highlights two problems. First, it is a reminder of the reality that certain kinds of health issues -- like addictions, mental-health services and HIV/AIDS -- are always at risk as the unpopular orphans in the health-care system. Extra spending on cancer treatment or more hip surgeries is going to be cheered more enthusiastically than an investment in addiction services.

That's not just a criticism of VIHA or government. They are responding to public attitudes, which often see mental illness, addiction or even AIDS as less worthy than other illnesses.

But we expect better from the health authorities and government. They know that these are real health issues. They know that a single case of HIV creates an average $250,000 cost to the health-care system. They know that over the last 15 years the Island health areas have had the highest rate of HIV deaths in the province. and they know that the rate of new infections is increasing in the region.

Prevention -- through education, harm reduction and other measures like the needle exchange -- and support are both necessary. And that is the work AIDS Vancouver Island and other agencies do.

And second, the approach to this issue highlights a broader concern with the accountability of the five regional health authorities created by the government in 2002.

VIHA faces this decision because it does not have the money to provide needed services. In health care, there will likely always be unmet demands. But a health authority board accountable to the population it serves would advocate publicly for more money to deal with critical health issues, rather than chip away at existing services to meet a budget imposed by the provincial government.

VIHA's funding from the province has increased at an annual compounded rate of about 4.3 per cent since it was created in 2002. But the combined effects of population growth and basic inflation have equalled about 3.6 per cent a year.

The aging population and much faster growth rate of medical costs mean the money is simply not enough to meet patients' needs.

The HIV/AIDS funding issue illustrates another accountability problem. At the weekend AIDS Walk for Life, Liberal and New Democrat MPs, an NDP MLA and a city councillor all criticized any funding cuts to regional efforts.

But Liberal MLAs from the south Island were silent. Do they believe the cuts are reasonable? Are they advocating for their communities, or their party?