How should an activist be?

By Jihyun Rosel Kim 

Before I began my internship, I was told it would involve mostly research. That statement is technically true – the majority of my time here was spent wrestling with Quicklaw, writing memos, or making information charts. However, one thing I’ve learned about the Legal Network is that it is truly committed to the issues identified in its mission statement, and will speak out in various ways.

1. Quiet action at the Court of Appeal

On June 15, staff of the Legal Network and other members of the community (including members of the Ontario Working Group on Criminal Law and HIV Exposure) participated in a “quiet action” campaign at the Ontario Court of Appeal. The Court was scheduled to hear an appeal on a case involving HIV status non-disclosure (R. v. M.), where both the Canadian HIV/AIDS Legal Network and HIV/AIDS Legal Clinic of Ontario (HALCO) were intervenors.

The "HIV Positive" action at the ON Court of Appeal

At trial, the judge ignored case law by not applying the significant risk test (i.e. a person living with HIV must disclose his/her status to the partner when the sexual activity poses a “significant risk of bodily harm”) set out in R. v. Cuerrier. Instead, he charged the defendant with aggravated sexual assault simply on the ground that the defendant did not disclose his status. Although the defendant stated he used a condom (which further diminishes the already-low risk of HIV transmission), the trial judge said it did not matter whether the sex was protected or not.

To demonstrate to the Court that people living with HIV and their allies were concerned about such overbroad use of criminal law, the Legal Network organized a t-shirt campaign—members showed up to the courtroom all wearing the same t-shirt with the logo “HIV Positive” at the front. There were about 18 people at court, and since the assigned courtroom for the hearing happened to be a smaller one, we effectively filled the gallery.

Unfortunately, the Court decided to stay the appeal, to wait for the Supreme Court decision on HIV non-disclosure (R. v. D.C.; R. v. Mabior) later this year. Even though it was a bit anti-climactic, one of the justices did take notice of the audience uniformly dressed in “HIV Positive” shirts to address us directly, and say that he realizes these issues are important and that he will make sure to rule on the issues carefully once the Supreme Court decision came down.

2. Action around cuts to refugee health care

At the end of April, Citizenship and Immigration Canada announced changes to the Interim Federal Health Program, which would effectively cut most supplemental health care benefits for refugee claimants, and all access to government-funded health care services for failed refugee claimants (who may reapply to stay in Canada under humanitarian and compassionate grounds). The only exception would be when the claimant’s health condition presented a “public health risk”—such as HIV. As of now, the public outcry seems to have made Kenney’s office backtrack a little bit from their initial cuts these days, but most of the cuts still remain.

On June 18—the national day of action to protect refugee health care—the Executive Director emailed everyone about the protest in Toronto, and encouraged everyone to attend the protest with him. So later on that day, I went to the Citizenship and Immigration Canada office on St. Clair Avenuewith a team of policy analysts and the ED of the Legal Network, and joined a few hundred people who were chanting “health care for refugees!”

Through participating in these actions, I’ve learned about the joys of being out on the streets with other people who believe in the same things as I do, which offers tremendous comfort in times where laws and policies seem to be going to a dark place. These experiences won’t appear on my CV as things I accomplished, but they nevertheless had a big impact on my outlook on activism and effective advocacy.

And for that intangible feeling of joy that came from connecting with other like-minded people who are committed to making things better, I am very grateful to the Legal Network.

Investigating “access” to HIV/AIDS treatment

My first two weeks at the Canadian HIV-AIDS Legal Network have felt like an intense and stimulating crash course. One of my first tasks was to gather information on access to HIV/AIDS treatment to help a policy analyst prepare for a guest lecture. The policy analyst also asked me to go beyond the numbers and find any factors that may complicate the numbers that I found. By the time I finished the research, I came out questioning the word “access” altogether. Here were my findings:

    • At the end of 2009, 36% (about 5.2 million) of the 15 million people in need in low- and middle-income countries were receiving antiretroviral (ARV) therapy, which is used to suppress the HIV virus.[1]
    • Only 21 countries provide data on people with HIV who inject drugs.  Out of the 21 countries, only 9 countries had a treatment rate of 10% for this demographic. [1]
    • Some countries may have initiatives and programs that sound great and accessible, but the whole picture is always more complicated. For example, the National AIDS Control Organization (NACO) provides free first-line ARV treatment in India. However, accessing treatment for sex workers is still difficult due to the negative disposition of health workers. One sex worker recalled to the researchers: “If I am going to be in a condition to take tablets [ART], I will not go there because they denigrate us.”[2]
    • Migrants also face additional barriers to HIV/AIDS treatment, due to strict immigration policies. For example, EU’s Return Directive, established in 2008 and enforced in 2010, enables a member country to detain migrants up to six months.[3] This may make public health interventions regarding HIV/AIDS to migrants more difficult.

 If these facts sound a bit foreign and removed, there is also the issue of differing coverage of ARV drugs by province that can cause mobility issues. Some provincial health care systems don’t cover newer form of drugs. Quebec won’t reimburse claimants who buy medication out-of-province.[4]

“Access” has become one of the buzzwords of human rights law. In many reports I read, there are often goals or objectives that have to do with improving or increasing access to certain services. In our efforts to improve access, we must not only focus on the numbers, but also focus on who gets to access services or programs as well, and how social structures and stigmas limit the effectiveness of certain programs.

 

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[1] UNAIDS, Report on the Global AIDS Epidemic, 2010.

[2] V. Chakrapani et al. Barriers to free antiretroviral treatment access for female sex workers in Chennai, India,” AIDS Patient Care and STDs 23 (11) (2009): pp. 973-980 at 976.

[3] Directive 2008/115/EC, European Union, art. 15.5. (http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:348:0098:0107:EN:PDF)

[4] Deborah Yoong, “Access and Coverage of HIV Medications across Canada”, published on Toronto General Hospital’s website: http://www.hivclinic.ca/main/drugs_reimbuse_files/Provincial%20Coverage%20of%20HIV%20medications.pdf)

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