One must congratulate the Federal government of Canada on a pretty brilliant political move in terms of how it allocates its AIDS related resources. Mr Harper's government has decided to reallocate about 26 mio C$ within its AIDS budget. This amount is re-routed away from programs the government does not fancy much, politically. Funding for Ontario's community programs reportedly will be slashed by up to 30%. As one would expect, there has been quite a bit of an uproar in the community, ranging from gay men's AIDS groups to NGOs offering needle exchange programs to injecting drug users. So, all this looks much like a conservative government in conservative policy making action. On the face of it one should go about waving hands and writing bitter letters to newspaper editors - of which, no doubt, there will be many. After all, harm minimization programs for IV drug users work to some extent, and in light of rising numbers of HIV infections among gay men, any half-educated public health practitioner would have reason to be up in arms against Mr Harper's policies. Predictably, unless the provincial government steps in or other sources of funding for such community groups can be found, HIV infections will increase in Canada as a result of the cuts.
Here then is the brilliant bit of the government move. It re-routed the funding not to some conservative pet project or other, but to the Gates' Foundation's Vaccine Initiative. Gates offers to match every dollar provided with the foundation's own funds (well, really the taxes we pay to Microsoft for using its ubiquitous software). So, money is ultimately removed from the immediate fight against AIDS in Canada to the fight against AIDS in the world, particularly so in the developing world. After all, the ultimate solution to AIDS will not be found in prevention programs, it will be in a preventive vaccine - or it won't be a solution to begin with. It is that simple. While it is a bit surprising for a conservative government - actually, for any government - to prioritize much larger needs elsewhere over needs at home, arguably that is what we ought to do. If ever there was a policy aiming at the greatest good for the greatest number, this would probably qualify. A very ethical choice indeed! Or so it seems.
At a first glance, community based AIDS organizations criticizing Harpers government seem selfish at best. But only at a first glance, because, truth be told, in the big swing of things in the federal budget, these few millions to community based AIDS organizations are really neither here nor there. It would have been more than easy for Mr Harper's government to find the money for the Canadian AIDS vaccine initiative elsewhere if it had put its mind to it. There can be little doubt, the 'robbing peter to pay bill' kind of decision making that we are witnessing here, is politically motivated and has nothing at all to do with international public health priorities. The government's grand gesture in response to Mr Gates' even grander gesture suggests that some kind of hard ethical decision had to be made, when really there was no need for this at all.
We should wave our hands and write bitter letters to newspaper editors after all... unfortunately.
