Canada: Program Threatened by Cuts; Streetworks Grant Expires

In a development that doctors warn could cause HIV rates to soar, Alberta's three-year, $250,000 (US$162,700) Health Innovation Fund grant to the drug program Streetworks will not be renewed when it expires in June. This leaves the Edmonton group scrambling for ways to meet costs -- or be forced to cut most of its prevention program and half its staff. Alberta awarded the money to Capital Health -- which asked Streetworks to run the program -- as part of a series of one-off grants for pilot projects.

The grant pays for two nurses and two outreach workers who give addicts hepatitis A and B immunizations, fresh dressings and tests for diseases including hepatitis C and HIV. Outreach workers provide help with housing, treatment and health awareness. The money does not fund needle exchange, which is paid for by a renewable, annual $285,000 (US$185,600) grant from the Alberta Community HIV Fund.

Dr. Gerry Predy, Capital's medical officer of health, is putting together a list of Streetworks' successes -- like a drop in the number of ambulance calls to the inner city and a rise in addicts completing hospital treatment -- to aid new grant applications. The program's biggest success could be a reduction in the number of addicts contracting diseases, said Program Manager Marliss Taylor.

Christianne Dubnyk, Alberta Health spokesperson, said HIF money gives regional health authorities the cash to try new ideas -- not to pay for them long-term. "It's a good project that has definitely proved to be one of the most successful," she said. "It's up to Capital Health to decide whether to continue funding it." But Predy said there is no money to pay for the program -- so he is looking at reorganizing existing services.

"Asking regional health authorities to take on any of these programs is delusional -- they don't have the money," said Dr. Stan Houston, director of the Northern Alberta HIV Program and a member of Streetworks' governing council. Streetworks also saw funding for two doctors expire last April, and a $20,000 (US$13,000) federal grant for hepatitis C prevention runs out at the end of March.

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