PRESS RELEASE

HIV/AIDS Costs Canada $2 Billion a Year

Decline in AIDS cases/deaths contrasts sharply with developing nations increase

June 2001, Halifax, Nova Scotia— HIV/AIDS cost Canadians more than $2 billion in 1999 in direct and indirect costs. Health care costs accounted for about $560 million; prevention, research and supports to AIDS victims for about $40 million; and lost economic production due to premature death and disability for nearly $1.5 billion.

The estimates are contained in a new report, The Cost of HIV/AIDS in Canada, released today by GPI Atlantic, a Nova Scotia based non-profit research group, to coincide with the 20th anniversary of the first AIDS diagnosis in 1981. The study was prepared for the Maritime Centre of Excellence for Women’s Health, for a Commonwealth Secretariat study on Gender, Health and HIV/AIDS.

Since the virus was first diagnosed 20 years ago, 47,000 Canadians have tested positive for HIV. Of these, 17,165 have developed AIDS, of whom 70% (or 12,088 Canadians) have died of the disease. Health Canada estimates that 15,000 additional Canadians are HIV positive but have not been tested and are unaware of their infection. This means there are as many as 50,000 Canadians (or one in 600) currently living with HIV/AIDS.

But the news is not all bad. Education, prevention and drug treatments have dramatically lowered the rate of HIV infections, AIDS diagnoses, and AIDS deaths in Canada, particularly in the last five years. There were 25% fewer HIV-positive tests in Canada in 1999 than in 1995, 80% fewer AIDS cases, and 92% fewer AIDS deaths. New AIDS cases in Canada in 1999 dropped to 325, the lowest level since 1984.

While there is no known cure for the virus and the disease is still fatal, HIV is being much more successfully managed through drug treatments, and the lives of those infected are being significantly prolonged. Since 1990, the average age of death due to AIDS has increased from 36 years to 41 years.

The GPI report notes that the economic cost of AIDS remains high as existing HIV cases continue to turn into AIDS, but the cost will begin to decline this decade as investments in prevention and disease management begin to pay off. Cumulative AIDS cases in 2000 were 20% higher than in 1995, but only 2% higher than in 1999, and they are expected to decline for the first time next year. If AIDS deaths had continued at 1995 rates (1,427 for that year), there would be 3,906 fewer Canadians alive today.

"Because of the enormous economic burden of HIV/AIDS," the report concludes, "prevention and management strategies are highly cost effective, and will produce significant long-term direct and indirect cost savings to the Canadian economy."

The Changing Profile of HIV/AIDS

The GPI report also notes that the profile of HIV/AIDS has changed dramatically in the last decade, with the proportion of new HIV infections due to male homosexual activity dropping from 75% of total infections in the late 1980s to 38% today. By contrast, new infections attributable to heterosexual activity rose from 6% to 19% of total infections, and more than doubled in absolute numbers, while infections due to intravenous drug use rose from 9% of all cases to 28% today.

Women also represent an increasing proportion of HIV infections, up from 10% a decade ago to 25% today, and of new AIDS cases diagnosed each year, up from 9% as recently as 1995 to 21% in 1999.

Bucking the national trend, AIDS cases among Aboriginal Canadians have continued to rise, and there has been a general shift in rates of infection from middle class gay men to vulnerable populations, including the poor, unemployed, minorities, and the poorly educated. Rates of infection in the Canadian prison population are estimated to be at least 10 times greater than in the general population.

GPI Atlantic warns that, because the new drug therapies are less likely to reach many marginalized Canadians, the sharp drop in AIDS cases in recent years may not continue. "The growing association of HIV/AIDS with social exclusion indicates that continued future reductions in HIV/AIDS incidence in Canada will increasingly depend on alleviation of underlying social and economic causes," the GPI report states.

AIDS in Canada and the World

The GPI report notes that Canada’s successful investment in prevention and management of HIV/AIDS has not been matched in developing countries with fewer resources. In 1999 alone, AIDS killed 2.6 million people worldwide, including half a million children, an increase of more than 70% in just three years. AIDS now kills more people than any other infectious disease and is the main cause of death in Africa.

There are now 34 million adults and children in the world living with HIV/AIDS, nearly 70% of them in sub-Saharan Africa alone. Of those, 55% are women. The disease is spreading so rapidly that one in six of the 34 million victims became infected in 1999 alone.

The human, social and economic costs of the disease are devastating, with children orphaned and left without teachers, health care systems unable to cope, and lost productivity slowing growth rates. Twelve per cent of South African educators are HIV positive, and 25% of Ugandan households are now providing for an orphan. Health care expenditures for HIV/AIDS patients in Africa have been estimated at 21 times greater than for the general population.

The GPI report concludes:
"Canadian successes in stemming the HIV/AIDS epidemic are accompanied by the unchecked and devastating spread of the disease in Africa and elsewhere. The enormous drain on the resources of developing nations, to say nothing of the immense burden of human suffering and premature death, demands that strategies proved successful in Canada be applied without delay where the need is greatest. Such investments can be highly cost effective, producing enormous savings in direct health care costs and retained productive capacity.

"Rather than becoming complacent about HIV/AIDS dues to successes at home, it is incumbent upon Canada and other wealthy nations to apply their successful experience abroad, to provide the necessary resources for education and prevention in developing nations, and to facilitate the low-cost provision of drugs that can assist HIV patients to manage the disease successfully. That assistance should not be regarded as a "cost," but as an "investment" that will reduce the appalling costs of the disease and has already been proven to do so in Canada."