Apo-TriAvir, the generic HIV/AIDS drug. A Canadian law making its export easier is likely finished in parliament. Image courtesy Apotex.

In March, Canada came improbably close to establishing a system to deliver drugs cheaply and quickly to poorer countries. In a vote of 172 to 111, the House of Commons passed Bill C-393, which would have streamlined Canada’s Access to Medicine Regime, a program to provide low-cost generic drugs to the global south. It wasn’t to be: the senate stalled, waiting for the vote of non-confidence that precipitated a spring election. That vote came four days later, effectively trashing the bill.

CAMR allows generic drugmakers to export cheaper versions of brand-name drugs to developing countries, without needing the permission of the patent-holders. “We have tremendous capacity to help address a particular need,” says Richard Elliott, executive director at the Canadian HIV/AIDS Legal Network. But CAMR’s cumbersome red tape kept manufacturers away. Says Elliott: “To leave in place a regime that is not working would be harming millions of people who need access to medicines.”

The program had only been used once since it was introduced in 2005. In 2007, Apotex, the largest Canadian-owned generic drug company, shipped enough HIV medication, Apo-TriAvir, to treat 21,000 patients in Rwanda [PDF]. Apotex says the final shipment went out in 2008. “We’re not likely to repeat the process under the current regime,” says Bruce Clark, Apotex’s senior vice-president of scientific and regulatory affairs. “It’s not just our decision, it’s a practical reality that no second country has made a request under the regime because it’s so complicated.” Bill C-393 would have simplified that process, but its future looks doubtful.

When C-393 passed in the House of Commons, it was supported by 26 Conservative MPs; 25 of those were re-elected, but the bill’s prospects in the new Conservative-dominated parliament look dim. “We saw what Harper did in the senate with the bill,” Elliott says.

On May 5, Elliott discussed CAMR’s future with other major advocacy groups. They’ve decided it’s not time to give up, but it will take time to re-assess the political climate before drafting some next steps. “The legal landscape is more challenging now than before,” he says. “But it’s worth trying to gather some intelligence and make a more informed assessment as to what the prospects might be before moving forward.”

Even with such slight optimism, Elliott expects the earliest the bill could be re-introduced—if at all—would be this fall.

Tamara Dawit. Photo by Nabil Shash.

Tamara Dawit co-founded the 411 Initiative for Change, a non-profit public education program, to tackle the problem of community disengagement among young Canadians. Through 411 she produces and tours 90-minute school assemblies on social issues such as human rights, HIV/AIDS, and girls’ empowerment to encourage students to learn about and get active in their communities.

Unlike some adults who bemoan the apathy of “kids these days” and put the blame on trash TV, rap music, and social media, Dawit embraces pop culture as the spoonful of sugar to make her educational message go down. Her assemblies are a mash-up of TV talk show, newsy video clips, and musical performances featuring an impressive roster of artists and personalities (past tours have included the likes of K’naan, Eternia, Anita Majumdar, and Masia One). But Dawit’s successful formula is no fluke, but a method she says she learned “through trial and error.”

As one of only four black students at her Ottawa-area high school, Dawit, now 30, found herself bullied because of her Ethiopian heritage. “I just felt that people were really ignorant about me—who I was and where I was from,” she explains. She decided to put together a Black History Month assembly to set the record straight. That first year featured a local academic and an African drummer. The show bombed—so she went back to the drawing board.

The following year, she packaged her message in contemporary music and dance, and brought in younger speakers. Fourteen years and 400,000 students later, it’s still the basic model she says works best to create an engaging, safe space for students to learn some tough messages. In fact, Dawit was reminded of how powerful the experience remains for audiences just last month during the girls’ rights tour, when a young woman stood up and confessed to the group that she was thinking of killing herself because she could no longer deal with bullying from her classmates.

Admissions like this girl’s might not be the norm, but they’re far from rare and, most importantly, they spark dialogue and promote understanding between youth. In the end, Dawit says, “those are the things that lead to change.”

Compiled by Dylan C. Robertson & Victoria Salvas

This election means death. Not only have Ottawa scrums, filibusters, and drawn-out committees been killed, pieces of legislation making their way through parliament have all met a harsh end as politicians take to the campaign trail.

Before a bill becomes law, it is introduced in either the House of Commons or the Senate. Subsequently the bill goes through readings where it is introduced, given a number code and debated. It can be read again, amended then passed, from the House to the Senate but only becomes law if it is given Royal Assent by the Governor General.

But bills are stopped in their tracks when an election is called. We tracked down the people who pioneered five of the most important bills that died on the order paper when the writ dropped. We asked what they thought of the abrupt death of their projects and if they’ll attempt rebooting them.

While government bills (titled C- with a number under 201) can be reintroduced at an advanced phase with the consent of the House, private members’s bills and motions are entered in a lottery to determine their Order of Precedence, meaning the order in which they can be re-introduced. Only 30 members per session have their motions considered, although the list is replenished if all motions are dealt with.

Here’s a look at the five bills that may or may not rise again:

1. Cheaper HIV Drugs:

Bill C-393, An Act to amend the Patent Act (drugs for international humanitarian purposes), was introduced by then NDP MP Judy Wasylycia-Leis in May 2009. After she left to run for mayor of Winnipeg, the bill was adopted by another NDP MP, Paul Dewar.

The bill, which came to be known as “the AIDS drug bill” would’ve allowed generic drug makers to supply their products to developing countries, so they could fight diseases like tuberculosis and malaria, and help the world’s 15 million AIDS victims. Apotex Inc. had promised to make much-needed antiretrovirals for children, should the legislaiton pass. The bill, which was passed earlier this month by the House of Commons, was sabotaged by its review committee and then by the Conservatives’s attempt to effectively whip the senate, feeling it would hinder Big Pharma.

“It’s pretty outrageous,” said Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network. “This bill had a lot of potential, and we pushed really hard to get it to pass. We had a lot of support from MPs in all parties.”

Dewar said he plans to reintroduce the bill. “We have to abolish the senate though, first,” he laughed. “That’s my plan. Well I’m just joking… but not really.” Dewar noted the bill was lucky to be successfully transferred after Wasylycia-Leis’s leave, as it is not an automatic process. “It was revived when actual co-operation broke out in the House of Commons,” he said. “Through unanimous consent, I was able to pick the bill up. “I’m ready, able, and willing to carry it forward after the election,” said Dewar, who hopes it ranks high in the order or precedence. “There’s so much public support for it. I don’t think they could get away with this again.”

2. Civilizing parliament:

Private Member’s Motion M-517 proposed a reform of Question Period. Conservative MP Michael Chong’s pet project aimed to civilize parliament’s most savage — and ironically unproductive — 45 minutes each sitting day.

The motion sought to strengthen how much discipline a speaker can give, lengthen the alloted time for each question and answer, and aimed at “examining the convention that the minister questioned need not respond.”

“Parliament needs to be reformed and I think the reform of parliament should begin with the reform of Question Period,” said Chong. If passed, the motion would have also stipulated who should be asked questions, most notably dedicating Wednesday exclusively for questions to the Prime Minister, and requiring ministers be present for two of the other four days. Chong noted that he was listed in the Order of Precedence for the first time in six years, and said he would re-table his motion in the rare chance he was listed for the next session. “I’m disappointed that the committee didn’t have a chance to deal with it before the election.”

Chong explained that while many members add motions and bills to the order paper solely to generate publicity for an issue, he fully intends to enact this reform. “I’ll continue to work on this issue through whatever mechanisms are available to me after the election,” said Chong. “Because this problem isn’t going away and I think Canadians want it to be addressed.”

3. Protecting trans rights:

Bill C-389, An Act to amend the Canadian Human Rights Act and the Criminal Code (gender identity and gender expression), was a private member’s bill sponsored by NDP MP Bill Siksay. Introduced in early 2009, the legislation would have make it illegal to discriminate based on gender identity, and aimed to protect transgender individuals by amending the Human Rights Act.

These amendments would have also been made to the Criminal Code, rendering these acts of discrimination hate crimes. The House passed the bill in February, against Stephen Harper’s wishes. However, the fact that it received “unanimous support from the Bloc, several Conservatives, and the Liberals bodes well for the next parliament” says Siksay. The MP is confident in the future of the bill; passing it again will demonstrate the governments’ “commitment to human rights.”

4. Improving First Nations’ water:

Bill S-11 Safe Drinking Water for First Nations Act, was introduced in May 2010 and would have developed federal regulations for governing water provision, disposal and quality standards in First Nations communities.

An issue that has received much attention recently is the issue of providing First Nations reserves with safe drinking water. An assessment from 2001-2001 found that three quarters of the drinking water systems in First Nations communities were at risk.

Despite the dire situation on many reserves, many First Nations leaders criticized the bill, feeling they were left out of the creating of the legislation and not offered funding to get it off the ground. The Assembly of First Nations felt that the bill presented lofty goals but sparse plans for financial investment and support, which in the long run, could leave reserves in worse condition.

5. Copyright reform:

Bill C-32, An Act to amend the Copyright Act, was the third attempt at copyright reform killed by an election call, dragging on a 14-year effort.

The bill sparked controversy for attempting to criminalize the use and promotion of software that circumvents digital locks, generating high-profile criticism, a minister’s comment that critics were “radical extremists,” and an indutry-led astroturfing campaign. But the bill also aimed at tackling online piracy, and making it legal to transfer music from CDs to iPods.

MP Tony Clement, who introduced the bill as Minister of Industry, told us he plans to reintroduce the bill if re-elected. “It’s just another example of important legislation that has now been discontinued because of the opposition parties passing a motion of non-confidence,” said Clement. “This is a very necessary piece of legislation to help regularize certain habits of consumers and also protect artists from wealth-destroying pirates. “I’m hoping that if we get a majority government, we can actually concentrate on the issues like C-32 and privacy protection and other aspects of the digital economy.”

Illustration by Dave Donald.

Dear Progressive Detective: I’m an HIV-positive Canadian, and I’ve heard troubling stories about people being criminally charged for transmitting the disease. Can that happen here? What are my rights and responsibilities under Canadian law?

Under Canadian law, criminal charges can be laid if an individual does not disclose his or her HIV-positive status prior to engaging in certain activities, including sharing needles. While there are no specific laws regarding HIV transmission, charges of criminal negligence causing bodily harm, aggravated assault, and even murder have been laid. This isn’t happening only in Canada, but many say the number of HIV-related criminal cases here is rising, and has been since 2000.

Of more than 60 cases in the past decade, however, Johnson Aziga’s first-degree murder trial has easily garnered the most attention. Six years after the Ontario man’s 2003 arrest, the jury’s guilty verdict made history as the first murder conviction in a criminal case involving HIV transmission. Aziga had infected seven women with HIV; two died of AIDS-related lymphoma during the trial. Additionally, Aziga was guilty of 10 counts of aggravated assault, prompting Crown prosecutors to proceed with a dangerous-offender application. Defence lawyers are currently appealing the application, and Aziga won’t be sentenced until it’s resolved sometime this spring.

In the meantime, groups such as UNAIDS and the Ontario Working Group on Criminal Law and HIV Exposure are worried. Both are currently assessing whether criminalization, in the long run, will achieve criminal justice and prevent the transmission of HIV—or if it will undermine human rights and public health. If Canada starts using criminal law as a blanket solution to HIVrelated sex offences, it may be a slippery, and troubling, slope, say the groups. For instance, HIV-positive women have a 30 percent chance of transmitting the virus to their child during pregnancy, delivery or breastfeeding. Should they face criminal charges?What about women and girls who do not disclose their status in fear of violence or abandonment?

Because of all these factors, UNAIDS proposes that criminal law only be applied to cases of intentional transmission. They also suggest that, as an alternative to criminal law, governments further expand programs promoting education, counselling, support, and other proven forms of HIV prevention.

Finally, we suggest subscribing to our RSS feed to ensure you never miss a new article going online, and following us on Twitter or becoming a fan on Facebook for updates, new articles and tasty links.

The cover story this issue is Elizabeth Wright‘s look at Canada’s broken drug approval process. The way that pharmaceuticals in this country get approved for medical use is needlessly secretive, rushed, and inefficient, many experts say, and its dysfunction puts everyone’s health at risk. And with Big Pharma in the driver’s seat—from the doctor’s office to the federal research labs, it’s increasingly clear that a more accountable, transparent, and independent drug approval process is necessary.

Also in this issue: Brad Badelt reports on the mystery of B.C.’s 2010 salmon run, which saw record-breaking numbers of fish returning to west-coast rivers. The fish-farming industry said it proved that Pacific salmon stocks are perfectly healthy and there’s no need to worry. But was last year’s boom a sign of resurgence—or a last gasp? Plus we bring you a special eight-page photo essay by Ian Willms from the dark heart of the tar sands. In Fort Chipewyan, 300 kilometres downstream from the world’s most environmentally destructive project, residents are living—and dying—amidst a skyrocketing cancer rate and deteriorating ecosystem.

And there’s plenty more: Paul McLaughlin interviews Silicone Diaries playwright-performer Nina Arsenault; Jason Brown explains how Canada is losing the global race for geothermal energy; Ellen Russell asks why we can’t have more muscular banking reforms; Lisa Xing sends a postcard from Jeju Island, South Korea, where the last of the pacific “mermaids” live; Dylan C. Robertson explains how the Canada-European Comprehensive Economic and Trade Agreement will change our world; Kapil Khatter shows why that “organic farmed fish” you buy may be anything but; Daniel Wilson untangles the right wing’s curious fixation on aboriginal tax exemptions; and Emily Landau sneaks a peek at the next genre-bending project from KENK publisher Pop Sandbox.

PLUS: Christina Palassio on poetry in schools; Navneet Alang on Wikileaks; Jackie Wong on painter Michael Lewis; Flavie Halais on the West Coast’s greenest city; Victoria Salvas on criminalizing HIV-AIDS; Denise Deby on the fight to save Ottawa’s South March Highlands; and reviews of new books by Renee Rodin, Lorna Goodison, David Collier, and David Lester.

This issue also includes debut fiction by Christine Miscione and new poetry by Jim Smith.

G8 Leaders meet in L'Aquila, Italy, July 8, 2009.

Prime Minister Stephen Harper announced on January 26 that he was going to use Canada’s Group of Eight presidency to push for an annual G8 summit agenda focused on women’s and children’s health. Former UN Special Envoy for HIV/AIDS in Africa Stephen Lewis said it best when he called the announcement an act of “chutzpah.”

First of all, Canada lacks credibility on this issue internationally, having consistently failed to meet our own humanitarian aid targets for decades. Secondly, and even more galling, we lack credibility in our own backyard. Consider that aboriginal infant mortality is markedly higher than the general population—Inuit infants are three times less likely to make it to their first birthdays. Among 17 peer countries, one study found, Canada is tied for second-last place when it comes to infant mortality (only the U.S. level is higher). Consider this is the same government that cut funding to the Court Challenges Program, the legal fund that since 1978 had supported legal challenges by minorities, including women. And the same government that heavily cut funding to Status of Women Canada, closing many of its offices across the country. The same government whose pay-equity legislation disappointingly maintains the status quo by encouraging public employers to consider “market demand” when determining wages (the same demand that caused the inequity in the first place). And this is the government that replaced a popular national childcare program with clumsy $100-per-month cash payments to parents. The resulting system isn’t just functionally inept, it’s ideologically offensive: it needlessly tops up budgets for families who can already afford quality childcare, and squeezes the ones who can’t. Since $100 won’t realistically cover the actual cost of quality childcare, the options become choosing not to work—the Ozzie-and-Harriet fantasy that social conservatives prefer, which is only available, of course, to two-parent families with one earning a sufficient living—or covering the difference between the government’s payment and the actual cost.

In other words, the prime minister’s call for the G8 to boost human rights and development for women and children around the world fits both dictionary definitions of chutzpah: unbelievable impertinence and worthy audacity. No one doubts that urgent action is needed to prevent hundreds of thousands of deaths among women and children worldwide, and if the G8 and G20 listen to the PM when they meet in Muskoka and Toronto in June—and more importantly, take real action that will save real lives— then it will be a great accomplishment, domestic criticisms aside.

But given the G8’s stunningly poor record on exactly these issues, there’s no reason to expect that’s how it will go. The Organization for Economic Co-operation and Development recently announced that the collective aid pledges the G8 nations made at their 2005 Gleneagles summit remain unmet five years later—by the outrageous margin of more than $20 billion. If the prime minister really wants to make a splash at this year’s summit, he should leave his platitudinous speech at home and show up with a signed cheque instead.

Henrietta Lacks lived only to the age of 31, and it’s the acute case of cervical cancer that killed her that also brought change to the world. During radiation treatment, doctors scraped her cancer cells for research. Those cells eventually became known as HeLa, and they are immortal. HeLa cells continue to duplicate to this day, and they’ve been used in everything from polio vaccines to gene mapping to AIDS research.

It’s a truly fascinating story from a science and medical background – how one group of cells can live more than 50 years after the woman they came from died.

But it’s the back-story that sets The Immortal Life of Henrietta Lacks, written by journalist Rebecca Skloot, apart. Lacks and her family were unaware that her cells were harvested and used in medical research, and they only recently found out about her scientific importance. Her immediate family, currently based in Baltimore, never received any compensation for her cells—despite the fact that they were taken without permission and subsequently used by wealthy research companies.

As Skloot develops the story into a profile of Lacks and her family, we get an intimate profile of Henrietta’s daughter, Deborah, as well as her sons and husband. Immortal Life reads like a murder mystery most of the time, even though we know who committed the crime.

Says her daughter Deborah:

“I always thought it was strange, if our mother cells done so much for medicine, how come her family can’t afford to see no doctors? Don’t make no sense. People got rich off my mother without us even knowin’ about them takin’ her cells, now we don’t get a dime.”

It’s easy to praise The Immortal Life of Henrietta Lacks: it’s engaging and well-written. But the importance of the book might be just as overlooked at Henrietta herself, who has been rarely praised as the person responsible for saving lives around the world. This book goes some way toward correcting that original injustice. The Immortal Life of Henrietta Lacks shouldn’t be placed on the bookshelves of only those interested in medical research and history—the story weaves itself through various genres, and is related to politics, race relations, gender studies and health care. Skloot proves that Lacks is: “An unsung heroine of medicine.”

In the end, medical research is about people, and it’s people like Lacks and her family we should be reading about to understand our current health policy, what it means to the average Canadian, and what our health system could become. The media is often to blame for taking science reporting and leaving it at that—cells and researchers and technical terms. But it’s who that research is helping that should be the focus.

Update, Friday, March 19: It seems to me that it’s impossible to truly know where the government stands. One moment the foreign minister says birth control isn’t included in their G8 maternal health push. The next the prime minister’s backing up on that, saying discussion around birth control’s not out of the cards.

***

There were mumblings during the Olympics about our government’s plans to focus on maternal and children’s health during the upcoming G8 meeting in Muskoka. At the time, it was announced that abortion would not be discussed during the talks—an unfortunate revelation, but really not terribly surprising.

But now the Tories are saying they won’t even be discussing birth control during the meetings—yet another backwards decision from the powers that be in Ottawa.

The decision, they say, is based on the fact that they plan to focus discussion on “saving lives”—implying that birth control isn’t part of that. An article in the Globe and Mail quotes Foreign Minister Lawrence Cannon as saying:

“It does not deal in any way, shape or form with family planning. Indeed, the purpose of this is to be able to save lives,” Mr. Cannon told the Foreign Affairs committee.

Maternal and children’s health will be forever tied to access to birth control, not least access to abortion. As comedian Rick Mercer wrote on Twitter when the news came out, “…caucus, read a book.” The idea that contraception use doesn’t have anything to do with saving lives is so out-dated I’m astounded the government would be actually say it out loud. Condom use decreases the spread of HIV/AIDS and other STDs, and it can be argued that hormonal birth control saves the lives of countless children who would have been born into dangerous, unhealthy situations.

Aside from this is the idea that women use birth control only because of the desire to not have children. Birth control is about more than just reproduction. There are a variety of health reasons as to why birth control is important. Many women risk their lives when pregnant due to underlying health issues. Many women are only able to stabilize and handle their monthly periods thanks to the hormones that birth control provides. And men avoid not only fatherhood, but sexually transmitted infections also through the use of condoms. Having, or not having, children is part of a more complex equation.

All of this to say that contraception will continue to play a role in saving lives around the world, and can have a strong impact in helping countries develop. The fear, of course, is that the Harper government is taking up right where the Bush administration left off—promising global health funding on terms that birth control not be included in the plan.

In a level-headed statement, the assistant medical dean at the University of British Columbia, Dorothy Shaw, told the Globe we need to focus on common ground to save lives. But in politics, common ground is uncommon—and I fear this is only one more step in eroding our government’s commitment not only to public health, but to women’s rights as well.

The evidence in favour of safe-injection sites is overwhelming, but the federal government appears determined to shut Insite down.

Despite ongoing efforts by the Harper government to shut it down, Insite, the Vancouver-based supervised-injection site, is alive and thriving, with over 10,000 registered users and around 800 daily visitors. To Mark Townsend, an Insite representative, it’s a success story that needs to be replicated in other cities.

Established in 2003 as a scientific research project to help marginalized populations struggling with addiction, mental illness, and HIV/AIDS in Vancouver’s notorious Downtown Eastside, Insite operates under a constitutional exemption from federal drug laws and is the only legal supervised-injection site in North America.

Since its inception, Insite has been subject to rigorous, independent third-party research that has lead to highly positive articles in publications ranging from the New England Journal of Medicine [PDF] to The Lancet [PDF]. Results have been nearly unanimous: Insite improves health access for the highest-risk users, reduces costs to the health care system, decreases crime, and improves neighbourhoods.

For Townsend, it is a testament to the narrow-minded, ideology-driven policies of the Harper government that it is still trying to have the courts rule Insite a violation of federal criminal drug law.

The latest round of court battles started in May 2008, after the B.C. Supreme Court issued a landmark decision—that it would be a violation of the charter rights to life, liberty, and security of person for addicts not to have access to harm reduction in the form of a safe-injection site. It is this ruling that the federal government is currently appealing; there is no word yet on when a decision will be made. [UPDATE: The B.C. Court of Appeal dismissed the challenge on January 15, 2010; the government indicated it would appeal to the Supreme Court.]

Townsend is hopeful, though, that Insite will survive both its current battle in the B.C. Appeal Court and the inevitable future showdown in the federal Supreme Court. Still, in light of the government’s intransigence, Townsend insists that what is needed now is more action from Insite’s supporters: the best way to fight for the future of safe-injection sites is, where appropriate, to set up more.

“People need to stop talking, get off their asses, and actually do something,” he says with frustration, remembering how Insite immediately transformed Vancouver’s Downtown Eastside for the better.

Queer rights are on trial left, right and centre this month.

Here in Canada, an HIV-positive gay couple from the States has won their appeal against Citizenship and Immigration Canada. Until now, the majority of HIV-positive applicants have been excluded because of the excessive burden they posed on health services. This couple was initially rejected, but appealed on the basis that they could afford to cover their own health costs. CIC might still choose to appeal themselves, but the case is still encouraging for future HIV-positive immigrants to Canada — providing they have some cash behind them. Xtra has more here.

Meanwhile at the Ontario Superior Court, an HIV-positive man named Kyle Freeman is challenging the ban on blood donation by gay men. The trial moved to closing comments last week, and a decision is expected in a few weeks. Freeman’s lawyer Patricia LeFebour said in her closing remarks, “The current rule unfairly singles out the entire gay population,” and “doesn’t take into account the reality of today’s HIV statistics of gay men.”

Across the border, an interesting legal challenge has begun against the ban on same-sex marriage in California. Perry v. Schwarzenegger opened on Monday, and there is some speculation that this case may progress all the way to the US Supreme Court. Queer rights groups are divided over whether this would be good news. Some claim public opinion in the US is still deeply divided over gay marriage and for the Supreme Court to rule in its favour would trigger a major backlash. Others think a favourable ruling from the Supreme Court is unlikely, and that an unfavourable one could set the cause back a decade or more. The New Yorker has an interesting piece on the case, and you can also track the progress of the trial at this new Courage Campaign blog.

In Uganda, it is still unclear whether a bill imposing life sentences and even execution for homosexuality will pass into law. President Museveni has intervened, saying that the death penalty is a bridge too far, but the harsh prison sentences may still remain part of the bill. In the meantime though, debate over the bill is stirring up some seriously ugly anti-gay sentiment in the country.

Cate Simpson is a freelance journalist and the web and reviews editor for Shameless magazine. She lives in Toronto.