In September 2016, a group of doctors in Saskatchewan called on the provincial government to declare a public health state of emergency as new HIV and AIDS cases increased dramatically in the province. A year later, the number of cases has continued to rise — and one region has even witnessed an 800% increase.

In Saskatchewan in 2014, there were 114 new cases. In 2015, there were 158. In 2016, there were 170.

Ryan Meili is a physician in Saskatoon and is running to be Saskatchewan’s NPD leader. He was one of the doctors that decided it was time for the government to intervene.

“It’s not just the new cases, we see high levels of morbidity and mortality from HIV, from AIDS. People in Saskatchewan are not just contracted the virus, they’re getting really sick and they’re dying from it,” Meili told Global Citizen.

When the doctors called on the government, they put together a plan of action that would help them adopt UNAIDS 90-90-90 goal.

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UNAIDS 90-90-90’s plan works towards ensuring that 90% of people who are HIV-positive know their status, 90% of those diagnosed are receiving anti-retroviral treatment and that 90% of people on treatment have a level low enough that they don't risk transmitting the virus.

They hoped resources would be made available to help after calling for the state of emergency. Notably, they wanted universal coverage of antiretroviral treatment for all HIV-positive people in the province.

Unfortunately, the request did little to mobilize government action.

“We still don’t have anything resembling a plan that's proportional to the size of the problem,” Meili said. “And we’re seeing the illness change its pattern.”

While the province has seen decreases in city centres like Saskatoon and Regina, they’ve seen enormous increases in some of the smaller more remote communities, like in the Sunrise Health Region, which saw an 800% increase in HIV cases in 2016.

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For more than 10 years, the Sunrise Health Region saw an average of two new cases per year. In 2016, there were 18 cases.

There are less resources to support and reach areas like these.

Following the emergency request, a government spokesperson said that increased funding had already improved Saskatchewan's response to HIV infections, but Meili said much more was — and still is — needed.

“There have been no major increases, and in fact if you look at inflation, you could say that we’re actually getting less for HIV than we were years ago,” he explained.

Government representatives have been meeting with the group of doctors over the last year, according to CBC, but changes to the systems in place need to be made.

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Meili believes the province should be using a prevention model to tackle this issue. While the government is willing to say this is a problem, he says they have not been willing to mobilize.

There are other issues to be addressed in Saskatchewan as they relate to this one.

“There are elements of poverty, and marginalization and the effects of colonisation that have influenced the drug use patterns in the province,” Meili said. “[There is] a lot more IV use and that certainly facilitates the spread of the disease.”

“But there is also the underlying neglect of this particular problem and the drug problem feeding into it and the poverty and marginalization of the people that are at highest risk,” he said.

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A government spokesperson told CBC that Saskatchewan has a strategy to address the HIV issue.

Meili says that there are elements of funding and support in place, but that the province has not had an HIV strategy since the one used during 2011-2014.

"Work remains to make testing, services, and patient-centred care more accessible, especially in rural and remote areas," the province said in a written statement.

Together with Saskatchewan HIV Collaborative and HIV-positive patients, the province is working to develop a three-year work plan, according to CBC.

This plan will involve provincial and federal health systems working together, a focus on education and addressing the obstacles some regions face when it comes to receiving treatment and service.

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Saskatchewan has the highest rates of HIV in Canada. There were 2,091 HIV cases reported between 1985 and 2016.

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