Empowerment P In the Beginning . . . In 1981, doctors reported that several young gay men from Los Angeles and New York had inexplicably died from rare cancers, infections, and an uncommon type of pneumonia. As cases swelled, gay communities were stigmatized as carriers of a fatal disease labeled the gay plague. Gradually, as infections emerged among injection drug users, hemophiliacs, and heterosexuals, the world realized that the epidemic did not discriminate. By 1982, doctors named the disease Acquired Immune Deficiency Syndrome (AIDS) but were virtually powerless to treat it or prevent its spread. AIDS hit Vancouver in 1983. While most of the city was paralyzed by ignorance and fear, a group of proactive people living with AIDS (PWAs) mobilized to share information and experiences. Informal support groups were organized in people’s homes. Political lobbying and protests called attention to the urgent need for treatment information and access to experimental drugs. The first community-based AIDS organization in western Canada, AIDS Vancouver, emerged from these early years of coordinated support and activism. Over the next several years, AIDS Vancouver developed into a nationally recognized organization. In 1986, as a condition of receiving federal government funding, AIDS Vancouver was prohibited from providing treatment information and lobbying for experimental drugs. Opposing these restrictions, a handful of visionaries established the Vancouver Persons with AIDS Coalition— a grassroots group which encouraged PWAs to empower themselves by advocating for their rights and their health. The Vancouver Persons With AIDS Coalition conducted its first business meeting in May 1986. Administrative and operational functions were shared by the Coalition’s 15 founding members. Particularly influential among this group were Kevin Brown, Taavi Nurmela, and Warren Jensen who put a human face to AIDS and exemplified the Coalition’s self-empowerment philosophy. Kevin Brown’s leadership qualities made him an obvious choice as founding Chair, a position he held for two terms, until shortly before his death in 1989. In 1990, the Vancouver Persons with AIDS Coalition created a mission statement. Three years later, at its 1993 Annual General Meeting, the membership approved an organizational name change, representing expanded service through a provincial mandate. After 20 years, the Society’s mission remains its fundamental guiding principle: The British Columbia Persons With AIDS Society (BCPWA) exists to enable persons living with AIDS and HIV disease to empower themselves through mutual support and collective action. From our personal struggles and challenges come our courage and strength. Self-Expression In October 1986, the Coalition began publishing a newsletter to keep members connected and informed about support groups, events, advocacy issues, and treatment information. In 1993, the first membership survey was included with an issue of BCPWA News; results from this survey, and others that followed, enabled the Society to assess members’ views on controversial subjects from pharmaceutical funding to priorities for lobbying. To this day, membership surveys remain integral to BCPWA’s policymaking and strategic planning. By 1997, the volume of treatment information was so extensive that the Society’s Treatment Information Program (TIP) launched a separate publication entitled TIP News. BCPWA News and TIP News were eventually consolidated to create a single bi-monthly HIV/AIDS treatment information and news magazine. The first issue of living5 magazine was published in July 1999. Within one year, readership climbed to over 10,500 and 84% of readers surveyed indentified an increase in treatment knowledge as a result of reading the magazine. To keep pace with technology, BCPWA launched its first website in 1997. The site provided information about the Society, current events, and over 100 AIDS-related links. By 1999, <www.bcpwa.org> was voted western Canada’s most popular AIDS site. Some interactive features were added in 2001, and the website was re-designed in 2005 to include more detailed information as well as on-line versions of BCPWA’s print and video resources. The Society’s logo debuted in April, 1990 on the cover of issue #35 of BCPWA News. The image of a pair of outstretched wings against a gradient blue sky, with a single feather below, was developed by former Society Chair Pei Lim. The wings represented freedom through empowerment, support through caring, and strength through abilities. Fully extended, the wings conveyed motion—bearing news, awareness, and hope. The sky signified a new dawn and the feather was a tribute to lost lives. In 2003, a new logo was launched to reflect evolution at BCPWA. The image of a purple ribbon arched over the Society name combines blue from the Society’s first logo with red from the AIDS ribbon, representing a bridge between past and present. Untied, the ribbon encompasses the diverse AIDS community. In July 2006, BCPWA launched a year-long provincewide campaign to end HIV stigma. The campaign was made possible by the BC Association of Broadcasters who selected the Society as its 2006/2007 Humanity Award recipient. The prestigious award entitled BCPWA to extensive broadcast media exposure valued commercially at $3 million. The campaign included three components: a series of two provocative television and radio ads, a website <www.endHIVstigma.ca>, and a toll-free information line. Self-Advocacy Recognizing that people newly diagnosed with HIV face a multitude of decisions—from disclosure of status and relationships, to health issues and treatment options—the Society published a Positive Living Manual. First printed in 1993, then revised and rereleased in 1999 and 2004, the manual provides current medical and nutritional information and explores a range of social and personal issues commonly encountered by people living with HIV. PWAs also frequently face practical challenges in navigating provincial government bureaucracy to obtain disability benefits. The Society published Positive Change in 1999, a legal information manual geared towards community advocates who assist individuals in applying for disability benefits. In March 2005, BCPWA released a revised, on-line version of this manual, Advocacy ActionKits, a stepby-step plain English self-advocacy tool for members. Self-Sufficiency The Vancouver PWA Coalition organized the first AIDS Walk-a-thon in Canada in 1986, with a handful of members and supporters who marched around the Stanley Park seawall, raising awareness and over $7,000 for PWAs. Over the years, BCPWA’s signature fundraising event has generated more than 5 million dollars to subsidize direct services for HIV-positive British Columbians. The event’s popularity inspired cities throughout Canada to coordinate AIDS WALKs of their own, eventually creating a national phenomenon. On its 20th anniversary, the WALK joined a formalized national movement to raise awareness and funds for AIDS-serving organizations, by re-branding and re-positioning itself as the AIDS WALK for LIFE. In 2002, the Society launched a second signature fundraising event: AccolAIDS, an awards gala recognizing exceptional achievements in the BC AIDS movement. This annual AIDS community gathering honours contributions in areas including: social action, research, health promotion and harm reduction, innovative programs, service delivery, philanthropy, and more. Mutual Support P The Power of Peers Over the years, BCPWA’s support programs have reflected the diverse and evolving needs of its members. In 1986, the Holistic Health Fund was established to reimburse members up to $200 per month in expenses for complementary or alternative therapies, courses, or training. This provision, which subsequently evolved into the Complementary Health Fund (CHF), was unprecedented in Canada and was made possible principally through AIDS WALK revenue. Although the monthly reimbursement amount has varied depending on the volume of requests and available funds, the CHF has assisted thousands of HIV-positive British Columbians over the years. Thirty new programs were created in 1991 to respond to the changing demographics among BCPWA’s membership. Support groups were created for injection drug users, people with alcohol addiction, prisoners, and heterosexuals. Also, nearly-new donated clothing was made available to members through an innovative member-operated enterprise, Polli & Esther’s Closet. The Prison Outreach Program (POP) began in 1992 after an HIV-positive prisoner contacted BCPWA with complaints about inadequate institutional health services. In response, BCPWA mobilized a group of volunteers to travel to provincial and federal institutions to provide information and support to inmates. A tollfree POP telephone line was later set up as an additional confidential resource. As the needs of prisoners changed, POP operations moved from Support Services to Treatment Information and Advocacy. Over the years, POP has provided harm reduction, self-care, training, and advocacy services, as well as access to the CHF for prisoners from some area institutions. As a creative outlet, Theatre Positive was established in 1995. This collaborative troupe has written and performed original productions, inspired by personal experiences living with HIV, to give expression to feelings and to raise awareness about AIDS-related issues. Theatre Positive has performed at the Vancouver Fringe Festival, the BC AIDS Conference, community centres, and the Pride Parade. BCPWA’s Retreat Program brings together members from diverse backgrounds and experiences, in a natural environment that promotes relaxation, recreation, healthy living, and personal growth. One of the annual retreats now focuses on spirituality. In 2005, the SeroSupportive Retreat was added to strengthen, affirm, and enhance relationships among sero-discordant (HIVpositive/HIV-negative) couples. portable subsidies; the organization has maintained close ties to BCPWA since its inception. In 1992, BCPWA, AIDS Vancouver, and the Positive Women’s Network established the Pacific AIDS Resource Centre (PARC), sharing resources and centralizing services for PWAs in one location. The PARC library was a product of this partnership, housing over 2,500 books, hundreds of journals, newsletters, videos, and audiotapes. Due to space constraints and divergent ventures, PARC gradually disbanded between 2000 and 2002. However, BCPWA, AIDS Vancouver, and the PARC library remain in PARC’s original location on Seymour Street. Various AIDS organizations teamed up in 1997 to provide a Christmas dinner and celebration for PWAs known as Yuletown. As well, BCPWA hosted its annual Christmas Party, serving over 300 dinners to members and their families; this holiday event continues to be an important annual gathering. Collective ActionP Partnerships Throughout the years, BCPWA has collaborated with other organizations and groups on a variety of initiatives and projects. The Vancouver PWA Coalition initiated a housing project in 1990, identifying needs and lobbying to provide adequate housing for its members. Later that year, the British Columbia Housing Commission allocated 25 subsidized housing units for people living with HIV/AIDS; in 1991, the number of PWA subsidized units increased to 44. By 1994, the business of and demand for BCPWA’s Housing Program had exceeded the resources of the Society’s Board of Directors. The Board determined that the best interests of the Society and member housing needs would be served by establishing an independent organization to manage this program. Wings Housing Society, established in 1994, currently administers 111 subsidized units, including Beginning in 1998, AIDS organizations in Vancouver and the Lower Mainland were invited to participate in BCPWA’s AIDS WALK as Community Partners, fundraising for their respective organizations under the AIDS WALK (WALK for LIFE) umbrella. In September 1999, the Treatment Information Program, in partnership with the BC Centre for Excellence in HIV/AIDS, took their Treatment ABCs workshop on the road, traveling to over 25 rural and remote BC communities. Workshop content was customized according to the needs and interests of each community audience, including people living with HIV, healthcare professionals, community groups, and caregivers. A Hard Pill to Swallow The first AIDS medications developed in the mid-1980s were withheld from Canadians by government red tape. In 1986, BCPWA Society founding members Kevin Brown and Warren Jenson met with Health Minister Jake Epp to advocate for the availability of the experimental drug AZT on compassionate grounds. They presented a petition containing over 3,000 signatures and argued that citizens were dying while waiting for treatment. In 1987, Kevin Brown became the first legal Canadian recipient of AZT. Although the release of AZT was a major triumph, treatments remained largely unavailable to PWAs. Answering the demands of activists, the government made a few new AIDS drugs accessible through the Emergency Health Release Program. However, PWAs were required to assume 20% of drug costs, often totaling thousands of dollars per year. In response, Kevin Brown and BCPWA filed an unprecedented court challenge in December 1987, claiming the billing policy discriminated against people with AIDS. Although they ultimately lost the court challenge, they won a symbolic victory when the Supreme Court denounced BC’s AIDS policies. The government’s lethargic movement in research and treatment development pushed BCPWA to launch its own pilot study on AIDS therapy AL721in late 1987. Although the outcome of the trial was not medically significant, it maintains some distinction as the first patient-run research project in Canada. In December 2003, BCPWA initiated a Canadian boycott of pharmaceutical giant Abbott Laboratories upon learning of a 400% price increase on their antiretroviral drug, ritonavir (Norvir) in the US. A year later, the boycott came to a successful end when Abbott USA announced that Norvir would be provided for free to any US resident requiring the drug who was not covered by a government program or private insurance. In 2005, new protease inhibitors TMC 114 (darunavir) and TMC 125 (etravirine) showed promise for individuals with resistant strains of HIV. The release of these drugs became political in December of that year when five PWAs, failing salvage therapy, were denied the medications under Health Canada’s Special Access Program. Knowing that these individuals would likely die without treatment, BCPWA staged concurrent protests outside of Health Minister Ujjal Dosanjh’s campaign and constituency offices, advocating the release of TMC 114 and 125 on compassionate grounds. Participants dressed as Santa’s elves delivered five coffins to the Health Minister’s office, representing the lives that would imminently end without treatment. The protest resulted in independent drug trials initiated by Dr. Julio Montaner of the BC Centre for Excellence in HIV/AIDS. Rights and Freedoms Government policy and prejudice have perpetuated HIV-related discrimination over the past two decades. Over the years, BCPWA has coordinated numerous protests to oppose exclusion, discrimination, and other injustices. In 1987, controversial amendments to the Health Act sought to quarantine people infected with HIV. BCPWA retaliated against this violation of civil liberties with a march through the city and a 200-person rally on the steps of the Vancouver Art Gallery. The bill never passed. In the mid-1990s many PWAs endured significant cuts to their government benefits due to legislative changes that effectively re-defined sources of revenue. To compensate for this loss of income, BCPWA advocates began applying for additional monthly allowances for members under Schedule C 2(1)(L) of the Disability Regulations. This provision allowed for an additional monthly health allowance, for people with life- have been categorically denied liver transplants in British Columbia, despite evidence that HIV-positive candidates have equivalent survival rates to uninfected transplant recipients. Since the fall of 2003, the BC Transplant Society has assessed HIV-positive patients for transplant eligibility but has yet to approve a candidate for the procedure. BCPWA continues to lobby for revisions to the Transplant Society’s eligibility guidelines for HIV-positive people. threatening health conditions and no other financial resources, to purchase health-care goods or services. With all applications denied in 1996, the advocates revised their legal arguments and subsequently attended and won nearly 600 tribunals the following year. More than $9 million in Schedule C benefits has In 1990, the Society boycotted the IV International AIDS Conference in San Francisco in opposition to discriminatory US legislation requiring disclosure of HIV status by all visitors. The same year, BCPWA called for a boycott of White Spot Ltd. restaurants when the company wrongfully terminated a member after his HIV status was discovered; the member sued for damages and won. In addition, to protest severe NDP cutbacks to AIDS prevention programs, BCPWA boycotted the 1996 International AIDS Conference in Vancouver. The Society held the position that it was hypocritical to showcase the city as an international AIDS leader while the provincial government imposed ruthless funding cuts to HIV/AIDS programs and services. BCPWA capitalized on the International AIDS Conference to advocate for the renewal of the National AIDS Strategy (NAS), due to expire in 1998. To get NAS back on the political agenda and a protest march from the Vancouver Public Library to General Motors Place, site of the 1996 conference. The demonstration received global media attention and was influential in the December 1997 renewal of NAS. The re-named Canadian HIV/AIDS Strategy committed $42.2 million per year with no expiry period on funding. been awarded to BCPWA members since 1997. In spite of successes, the tribunal and appeal process was time-consuming. The waiting list to meet with a BCPWA advocate exceeded two years and, even after submitting applications, lengthy delays followed. By 1998, over 60 people had died waiting for approval of Schedule C benefits. In 2000, the Buddy Program was implemented to address the volume of work; a team of 18 volunteers received extensive training to assist members in the complex processes involved in accessing Schedule C (1)(L) healthcare benefits. However, still overwhelmed with applications and tribunals, BCPWA pressured for legislative reform. Finally, in the fall of 2001, the Monthly Nutritional Supplement Benefit (MNSB) was introduced, entitling eligible PWAs to an additional $225 per month in provincial benefits to purchase nutritional supplements, vitamins, and purified water. Schedule C was repealed, except for current recipients, and was replaced with the new MNSB regulations and legislation. Relative to the previous Schedule C (1)(L) application and tribunal process, obtaining the MNSB was simple and efficient, resulting in almost $650,000 paid out to members to date. Equality with respect to medical treatment and health care has been an ongoing challenge for persons with AIDS. PWAs A Positive Future Since 1986, the British Columbia Persons With AIDS Society has been dedicated to empowering people living with HIV disease and AIDS through its vision of empowerment, mutual support, and collective action. Unique among other AIDS organizations in Canada, BCPWA’s consumerdriven foundation and operating structure ensures that the goals and direction of the Society reflect those of its more than 4,400 members. The Society’s work is carried out collaboratively by volunteers and staff, both members and allies, who share a commitment to BCPWA’s mission. Reflecting on our 20 year history, amid the many struggles, challenges, and losses, BCPWA can take great pride in our collective achievements. Still, with no cure for HIV on pharmacy shelves and new infections still prevalent, the need for consumerdriven programs and services for people living with HIV/AIDS remains immense. The BCPWA Society will endeavour to provide support, foster personal empowerment, advocate for rights and freedoms, and engender hope in persons living with HIV and AIDS until a need no longer exists.
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