Board of Health Deputation

Today AIDS ACTION NOW’s Nicole Greenspan will be deputing at the Toronto Board of Health meeting as they discuss their budget recommendations for 2012 based on the Toronto Service Review process.

Board of Heath,

I’m here to represent AIDS ACTION NOW!, a group of people concerned about issues related to HIV, Hepatitis C, and the health and wellbeing of marginalized groups in Toronto.

I am here to comment on the recommendations included in the Toronto Public Health 2012 Operating Budget Request, in light of the recently made public Core Services Review Final Report that will be presented at Executive Committee next week.  In this climate of fear, when the Mayor proposes that austerity measures are the only answers to the problems he has determined we have, I am looking to you, the Board of Health for leadership, and a commitment to evidence-based policy and ensuring the health and well-being of this city.

From the documents that are available to the public, I can see that you have achieved a 10% reduction in the operating budget for 2012 compared to 2011.  From what I can tell, you have not proposed any reduction to the sexual health and drug prevention services that are an essential part of what Toronto Public Health provides.  However, there are other ways in which HIV and drug prevention work gets carried out that are vulnerable to being cut by the Mayor’s agenda to reduce the services that help contain the HIV, syphilis and Hepatitis C epidemics in this city.  The Community Partnership and Investment Program, which include the AIDS and Drug Prevention Community Investment Programs, is included in the Core Services Review Final Report, with the recommendation that the smaller grants be eliminated.  This recommendation is included in a laundry list that includes cuts to affordable housing, and childcare. The climate that has been created by the Mayor’s agenda and the Core Services Review is a terrifying one, which attempts to divide us and make people fight over ever smaller pieces of the pie.

There are currently over 17,000 people living with HIV living as residents in Toronto. Many people who have HIV also have Hepatitis C.  These people come from all different walks of life, they pay taxes, vote, live in the suburbs and downtown, and invest in this city. Many are from disadvantaged and marginalized populations and face a great deal of difficulties. This makes life for them, their families and their children, uncertain. The services that provide support to these populations are an essential part of support to residents of our city. Investing in the health of people living with HIV, Hepatitis C, and syphilis is not just about being humane and having compassion, it is also a good investment for our City.

There is a wide range of scientific evidence indicating that HIV prevention programs, including needle exchange, are far cheaper than the cost to take care of people who become sick.  We know that we are currently containing the HIV epidemic in the City of Toronto.  We know we have a syphilis problem that we need to address. We know we have effective, evidence-based programs, and that we are not running these at a scale which address these epidemics more completely.

We have seen over the past year that the province is willing to take these issues seriously. For example, this past spring, they transferred an additional $100,000 to Toronto Public Health to enhance the response syphilis; The Mayor opposed this transfer. We know we have these problems, and we know we need to maintain or expand our current efforts to respond to them.  Why then, is the talk at City Hall only about deficits and cuts?  Why is the Board of Health not here talking about the need to protect and maintain the vital work we do, the greater investments we still need to make, in protecting the health of Torontonians?? The conversation we are forced to have because of the Mayor’s agenda is the opposite of what we should be talking about, and why isn’t the Board of Health being more vocal about this?

AIDS ACTION NOW! is a part of a force in this city that is going to make the Mayor’s agenda something that cannot be implemented, and especially not quietly. The Mayor says that his Core Service Review recommendations are just “scratching the surface of what’s needed”.  I say what is needed is a strong, vocal, Board of Health that is willing to take leadership and make sure that the health of marginalized populations and ordinary Toronto residents is protected.  That cutting small grants and programs that help with social determinants of health that drive the HIV epidemic will have negative health impacts, and that the city will suffer substantially.  You know your constituents will be harmed by these kinds of cuts, that negative health impacts result from losing these kinds of services.  Why are you not more vocal about protecting grants, public housing, and childcare services?

As a Board of Health, you have an opportunity to show innovation, compassion, and fiscal responsibility. I urge you to take the opportunities you have and make sure that the Mayor’s political agenda to stop services to our communities is not successful.  What we need is more, not less.  Please do the right thing.

Nicole Greenspan


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