Manitoba declares public-health emergency over rising cases of HIV

Manitoba has declared a public-health emergency over its HIV infection rates.

The province says new cases of HIV have been “steadily increasing,” driven by intravenous drug use and unprotected heterosexual sex.

“Manitoba continues to experience some of the highest rates of HIV in Canada,” Dr. Brent Roussin, the province’s chief provincial public health officer, told a news conference Thursday morning.

Last year, there were 328 new HIV cases reported in Manitoba, compared to 291 new cases in 2024, 142 new cases in 2021 and 90 new cases in 2019.

In 2024, Manitoba reported 19.5 cases per 100,000 people, roughly three-and-a-half times the national rate.

READ: HIV infections in Manitoba reach highest rate in country

The province says rates are highest in the Prairie Mountain Health and Northern Health regions. “But the absolute number of cases, the highest number of cases occurs in the Winnipeg region,” Roussin said.

The chief provincial public health officer says Indigenous people are disproportionately affected.

Roussin acknowledged the spread of the virus is facilitated by other factors such as homelessness, mental-health issues, and various barriers to access to care.

“We need to continue to work across sectors,” he said. “So this includes mental health, addictions, housing, and corrections, because we know HIV does not occur in isolation from these broader social and health challenges.”

Roussin says by declaring the issue a public-health emergency, the government can support a more coordinated response with other organizations and community groups. The province is launching an HIV response steering committee coordinated through public health.

He says it’s not about creating fear but that a level of urgency is needed to address the issue.

The province’s focus is to develop targeted supports for people in communities most affected by HIV, such as increased awareness and use of pre-exposure prophylaxis (PrEP) and enhanced testing for early diagnosis.

“Our goal here is to ensure every person in Manitoba, regardless of where they are, regardless of their background or their circumstances, can access the care and support they need,” Dr. Roussin said.

It’s the first time Manitoba has declared a public health emergency related to HIV.

“This emergency is driven by a number of factors, one being injection drug use, homelessness, mental health issues, as well as a rise in other sexually transmitted and bloodborne infections, as well as various barriers to access to care,” said Dr. Roussin.

Melissa Morris has been living with HIV for over 20 years. She says she wishes the province had declared an emergency sooner, but believes it will help address the stigma surrounding the disease.

“We’ve known that it was going to happen for a long time. And that the numbers are going to skyrocket. And that we would be in an emergency. And so I think it’s a little bittersweet. Like it should have really happened a lot sooner, and we are in response mode rather than being proactive,” said Morris.

Dr. Laurie Ireland, the medical director at Nine Circles Community Health Centre, said, “I think we have a way to go. Certainly, there is a well-established science that being on treatment prevents transmission. So the more we can link people to care, get people on treatment earlier, we should see a turn in the rise in numbers of HIV.”

In 2024, about 70 per cent of HIV transmission in Manitoba was related to injection drug use.

Marion Willis with St. Boniface Street Links says, “We need to address the root cause of substance use and homelessness,” saying, “The provinces can’t do it on their own. They are just not going to be able to do it on their own. We need a new national strategy.”

AMC reacts

The Assembly of Manitoba Chiefs (AMC) said in a statement Thursday afternoon that “Manitoba’s declaration of a public health emergency in response to rising HIV cases must result in immediate First Nations-led action, not another temporary government response without long-term change,” adding that the province’s HIV program reporting shows that First Nations and Indigenous peoples are particularly vulnerable and at significant risk.

“This crisis did not happen overnight,” said Grand Chief Kyra Wilson. “First Nations have warned governments for years that addictions, homelessness, poverty, mental health gaps, racism in health care, and lack of access to culturally safe services were creating the conditions for a public health disaster. First Nations are now carrying the heaviest burden of this emergency.”

The AMC adds that many First Nations citizens are made vulnerable by inequitable systems, as they face limited access to primary care, testing, prevention, transportation, harm reduction, addictions treatment, stable housing, mental wellness supports, and culturally safe care.

“First Nations are at heightened risk when health systems are inaccessible, delayed, or unsafe,” said Grand Chief Wilson. “No one should be turned away from care because they use substances, live in a remote community, do not have transportation, lack a health card, are unhoused, or have experienced racism in the health system. An emergency response that does not remove these barriers immediately is not an emergency response at all.”

The AMC would go on to say that the provincial and federal governments need to respect existing First Nations mandates supporting First Nations control over health services, emergency response, and long-term health system transformation. They are also calling for:

• Immediate emergency funding for First Nations-led HIV testing, prevention, treatment, and outreach;
• Expanded access to PrEP, harm reduction, addictions treatment, and mental wellness supports;
• Mobile and community-based services for northern, rural, remote, and urban First Nations citizens;
• Investments in housing, transportation, and wraparound supports; and
• A First Nations-led HIV Emergency Response Table with decision-making authority and clear accountability from Manitoba and Canada.

“Declaring an emergency is only meaningful if it changes outcomes for First Nations people,” said Grand Chief Wilson. “The response must be urgent, adequately funded, culturally safe, and led in partnership with First Nations governments and communities.”

-With files from Sofia Frolova