Just weeks after Canada’s top doctor said the country was experiencing an “alarming increase” in syphilis cases, the federal government announced a “renewed” action plan to combat sexually transmitted and blood-borne infections (STBBI) for the next six years.
The plan includes new funding directly targeting syphilis.
Ottawa is dedicating $2.45 million to the plan, with $1.45 million to go towards community-based organizations to create and deliver resources and activities to raise awareness around syphilis.
In addition, $1 million will go to the Canadian Institutes of Health Research for research projects on the sexually transmitted infection (STI).
The announcement comes as Canada continues to face an increase of STBBIs, with the Public Health Agency of Canada noting in its report on the action plan “there has been a lack of progress towards STBBI elimination.”
It notes rates of bacterial STIs — chlamydia, syphilis and gonorrhea — have been rising rapidly, with hepatitis B and C as well as HIV also not declining in line with global targets.
Infectious syphilis rates increased by 109 per cent between 2018 and 2022, with congenital syphilis — when a pregnant person passes the infection to their baby — jumping by 599 per cent in this same time period.
And while the number of cases of syphilis among gay and bisexual men who have sex with men have remained somewhat stable, the increased “burden” in recent years can be linked to a rise among heterosexual populations and women.
Canada’s chief public health officer Dr. Theresa Tam warned on Feb. 14 about the “alarming increase,” with congenital syphilis’ six-fold increase being most concerning. She added at that time that due to some not exhibiting symptoms, especially in the early stages of infection, there was an increased likelihood of people being unknowingly infected.
“This makes it easier for the infection to spread undetected, which reinforces the critical importance of early testing, diagnosis and treatment,” Tam stated.
The STBBI action plan was first announced in 2019, outlining several priorities to tackle these types of infections including supporting community efforts to reach those without a diagnosis, improving access to testing and support, and reducing the stigma that can surround the issue.
“Everyone in Canada should have access to the sexual and reproductive health services they need, no matter who they are or where they live,” Holland said in a release.
Federal health officials say they are looking to further improve access to STBBI testing for key populations including First Nations, Metis and Inuit communities, LGBTQ2 individuals, as well as sex workers and people who use injection or inhalation drug-use equipment.
Support for harm-reduction programs will also continue to be a focus, with Holland also noting STBBI-related stigma and discrimination is a key focus.
Under the plan, the government said it’s following four core pillars set out by the Pan-Canadian STBBI Framework established in 2018, which focuses on prevention, testing, initiation of care and treatment, and ongoing care and support, with priorities to guide actions by Ottawa.
These priorities include addressing stigma through increasing awareness of the undetectable equals untransmittable (U=U) message surrounding HIV — a person with an undetectable viral load cannot transmit the virus — as well as promoting the reduction of stigma through public education efforts.
In addition, they plan to work on reducing the “over-criminalization of HIV non-disclosure,” which the government says can lead to stigmatization of people living with HIV and could lead to some not getting tested.
In order to support harm-reduction programs, the action plan includes extending the prison needle exchange program and overdose prevention service in order to limit STBBIs in federal correctional facilities. The government also plans to invest in community-based and led projects incorporating harm reduction approaches to meet the needs of key populations.
Expanding the range of testing methods, including funding community-based approaches to reach the undiagnosed, and deploying certain technologies that support equitable access to high-quality screening, is another factor the government will take towards improving testing accessibility.
The government’s goal with the “renewed” action plan, however, is reaffirming its commitment to achieve global STBBI targets from the World Health Organization that includes zero new HIV infections, a 90-per cent reduction in new cases of chronic viral hepatitis B and C infections, and 90-per cent reduction in syphilis and gonorrhea incidence globally.
According to the plan, the government plans to implement its priorities through what it calls existing mechanisms including the Syphilis Response Steering Committee, the Pan-Canadian Public Health Network and regularly scheduled meetings across government departments.
— with files from Katie Dangerfield