HIV rate climbs as uncertainty rises about future of dedicated Community Action Fund
As the rate of new HIV infections in Canada continues to climb, advocates say they’re worried about the future of one of the few federal funding tools to support prevention and treatment. The concern is that it could be “consolidated” with other funds in Ottawa’s attempt to reduce its spending by 15 per cent.
The HIV and Hepatitis C Community Action Fund was launched in the 2016-17 fiscal year to replace the AIDS Community Action Program. The current fund—which was receiving an annual investment of $26.4-million—and the existing Harm Reduction Fund—which has typically received $7-million annually, and also supports HIV mitigation efforts—held their last funding round in 2021, with successful projects receiving federal dollars between 2022 and 2027.
With one year to go until the formal expiration date, the webpage describing the initiatives do not have any updates on how or whether they will continue.
Michael Kwag, executive director at the Community-Based Research Centre, said his organization received federal money from the 2021 round, and that the Public Health Agency of Canada (PHAC) has offered an opportunity for organizations to apply for an additional year of funding until 2028.
“Our concern has grown over the last year because the folks at PHAC have been really non-committal about what's happening to the funding program beyond March 2028,” said Kwag, whose organization’s research initiatives focus on the health of people of different sexualities and genders. “Now would be about the time that we would be preparing to develop project proposals for the next five-year cycle.”
Between 2022 and 2027, the Community-Based Research Centre is receiving $2.2-million for one project to help improve the accessibility and uptake of health services for sexually transmitted and blood-borne infections (STBBIs) for certain populations, and $2.14-million for a separate project in development with other organizations.
Both Kwag and Jody Jollimore, executive director at CATIE (which is an information source on sexual health, HIV, and hepatitis C, among other subjects) said they’re concerned that the Community Action Fund could be combined with other existing funds.
They both point to language in the 2025 federal budget, which explains how PHAC will meet its spending cut target of 15 per cent as a part of Prime Minister Mark Carney’s (Nepean, Ont.) comprehensive expenditure review: “PHAC will streamline its program delivery by consolidating grants and contributions programs into larger funds. While these new funds will operate with a lower overall funding envelope once temporary funding ends, their impact will be increased by targeting investments to core federal public health priorities that are central to PHAC's mandate, supporting delivery partners that demonstrate clear and measurable public health outcomes aligned with the new funds' objectives, and leveraging increased program flexibility and responsiveness.”
“Is it suddenly going to be a fund for all priorities of the Public Health Agency?” said Jollimore about the possibility that the fund will change. “Will we be having to compete with public vaccination programs and things? What would that look like exactly?”
CATIE received $4.1-million from the Community Action Fund in 2025-26, which was used to train more than 11,000 frontline workers and volunteers, create 233 new information resources, and deliver more than 800,000 print publications to support prevention, testing, and treatment programs across Canada.
Jollimore said that in discussions about the fund, he has also heard Health Minister Marjorie Michel’s (Papineau, Que.) staff use language similar to what is in the budget.
“The language has been very specific around streamlining, consolidating, and that's found both in the budget, but I've also heard that in meetings with the minister's policy staff, who have talked about ideas. Nothing has been decided. Certainly there are ideas around how to make the Community Action Fund more nimble and agile to the government’s priorities,” Jollimore said.
The Hill Times asked Health Canada whether the Community Action Fund would be consolidated into other funding tools, and whether funding would be extended for this fund or the Harm Reduction Fund.
An emailed response from Health Canada spokesperson Mark Johnson reaffirmed the 2025 budget’s message, saying that changes to its grants and contributions programs include “a modernization exercise,” which will involve “consolidating existing programs into broader funding streams to improve efficiency and impact. This work will continue to include dedicated support for community-based organizations, recognizing their essential role in Canada’s public health response.”
Without naming any particular funds, the statement also said that decisions about “specific funding approaches, including the timing and format of any potential solicitation processes, have not yet been finalized,” and that the department will continue to engage with partners on the issue.
In response to a question about other federal initiatives for HIV prevention and treatment, Johnson pointed to an annual $21-million funding envelope for the Canadian Institutes of Health Research for its HIV/AIDS and STBBI Research Initiative, which “has a strong emphasis on community-based approaches,” and a digital advertising campaign that has run for at least three years encouraging visits to a government website called, “Your sexual health matters.”
Both Kwag and Jollimore said they have not met with Michel though they would both be interested in discussing the issue directly with the minister.
Kwag said he has requested a meeting with the minister, which has not yet been granted, but that he has upcoming meetings with a policy adviser in Michel’s office and PHAC president Nancy Hamzawi. He said he is also trying to have this discussion with Women and Gender Equality Minister Rechie Valdez’s (Mississauga—Streetsville, Ont.) office, which oversees issues related to the 2SLGBTQIA+ community.
New HIV cases jump 22.8 per cent between 2022 and 2024
The uncertainty about the future direction of federal HIV funding comes as new information from PHAC published last month states that the rate of new infections continues to rise. A brief report, Canada’s Progress Toward Ending the HIV Epidemic, states new HIV infections in 2024—an estimated total of 2,517—were up by 22.8 per cent from 2022, when they were estimated at 2,050.
That is an even higher increase than the findings of the previous 2024 report, which found that new HIV infections in 2022—an estimated 1,848 at the time the data was released—were up by 15 per cent over 2020, when the figure was estimated to be 1,610.
The increase in Manitoba was severe enough—325 cases in 2025 versus 90 in 2019—that the province declared the issue a public health emergency this past May
Jollimore said the COVID-19 pandemic contributed to rising national numbers as public health priorities shifted to the pandemic.
“During that time, clinics were closed or repurposed. It was difficult to get testing. It was difficult to get health-care appointments to get your treatment, … or your PrEP,” he said, referring to pre-exposure prophylaxis, a medication that helps prevent HIV transmission.
Kwag said the higher rates are “not entirely surprising,” considering stagnant federal funding for HIV, but are “frustrating” because Canada has the tools, including medical resources both for prevention and treatment, that could bring down rates.
The increasing number of infected Canadians puts this country’s ability to meet its international targets by UNAIDS at risk. The United Nations program focused on ending AIDS is asking signatories, including Canada, to meet the following goals by 2030: that 95 per cent of people living with HIV are diagnosed, 95 per cent of those that are diagnosed are receiving treatment, and 95 per cent of those on treatment have a suppressed viral load.
As per last month’s data from PHAC, 91 per cent of people with HIV were diagnosed, 86 per cent of those with a diagnosis were receiving treatment, and 96 per cent of those being treated had a suppressed viral load.
Health Canada's Johnson said in his statement that the Government of Canada "remains committed to the global goal of ending HIV" and other STBBIs as public health concerns by 2030.
Jollimore said he likes to remind people that these statistics are about Canadian people.
“If you want to slice this from an equity issue, you can look at it and say, ‘Well, look at the Canadians that are being impacted by HIV. They're the least privileged Canadians, and so of course we need to do more.’ If you want to slice this from an economic sort-of lens, then it also makes sense. Each new infection is $1.44-million in health-care costs over the lifetime of that individual. When you're looking at these recent estimates, that's over $3-billion in health care just in one year of new infections,” Jollimore said.
More education, public awareness needed, says Sen. Cormier
Equity is a key premise in a report tabled last October by Independent Senator René Cormier (New Brunswick), a longtime advocate for an improved HIV response. Entitled Toward Fair and Equitable Public Health: Ending HIV and STBBIs, the report is a synopsis of an inquiry into the issue launched by Cormier, and includes recommendations from himself and other Senators.
In an interview with The Hill Times, Cormier stressed the need for more sexual health education in schools but also increased communication efforts by federal public health officials to reduce the stigma around HIV and increase awareness that the disease is not confined to a single population.
“I'm from the [gay] community, so people from my generation, we were there when [HIV/AIDS] happened at the beginning. But the young people, they either think that it belongs to our generation and that it doesn't belong to them. … It couldn't happen to them,” Cormier said.
While noting that he doesn’t want to single out any particular group, Cormier said HIV impacts various populations, including Black people, Indigenous Peoples, women, etc.
PHAC’s 2026 statistics—which don’t provide much detail in terms of demographics—state that 50.4 per cent of the estimated 70,900 people with HIV in Canada are gay, bisexual, and men who have sex with other men. More than one quarter—27.5 per cent—are women, and 12.6 per cent are people who inject drugs. (The brief report released last month is a preview of a more comprehensive document, which a Health Canada spokesperson told The Hill Times is expected to be released before the end of the year).
In an indication of how the epidemic can vary between regions, a press release about the Manitoba public health emergency states risk factors in the province are different from the national trends, with more than 50 per cent of cases belonging to females, and most newly diagnosed cases occurring in females under the age of 40, which increases the risk of perinatal cases. The release also said that Indigenous Peoples are disproportionately impacted.
Cormier said there needs to be more public health communication on the fact that “undetectable [HIV] is untransmittable”—a statement he continually repeats in his own public speeches about the disease.
Cormier said he would like to see more funding from the federal government for Canadians and international organizations working on the issue, as well as research, especially for data that can help explain why rates are increasing.
The Carney government indicated in Budget 2025 that global health funding would be cut as a part of its spending review. The Canadian Press reported last November that the federal Liberals made “Canada’s first-ever cut” to funding for a major international development program for fighting infectious diseases. That program, which this year received $190-million less than Canada’s 2022 pledge of $1.02-billion, is the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Without mentioning any names, Kwag said the work to reduce HIV rates has supporters in “many” MPs and Senators who know how important this is.
“I'm optimistic that with more supporters, that we'll be able to kind of reach the minister of health and hopefully the Prime Minister's Office as well, because this is something that I think they have an opportunity to provide some commitment ahead of some other budgetary moves that they need to be making, and so we feel this is kind of like [a] critical juncture now to make the strategic move to sustain the investment,” Kwag said.
tsanci@hilltimes.com
The Hill Times