London's top doctor says there isn't one magic bullet to stop the dramatic rise of HIV and Hepatitis C rates in the region but a supervised injection site and more front line workers would help.
Dr. Chris Mackie, medical officer of health for Middlesex-London, will ask the health board on Thursday to re-allocate resources to address the issue.
Middlesex-London has seen an alarming increase in HIV and Hepatitis C rates over the past ten years, at the same time infection rates across the province have been in decline. Needle sharing among intravenous drug users is believed to be behind the influx of cases in London.
"We give out more (clean) needles total than Toronto or Montreal or any other major city in Canada other than Vancouver," says Dr. Mackie. "When you also see that you have a high Hepatitis C rate which is a sign that needle sharing is continuing to happen, this isn't surprising that we would now see HIV coming into that community."
Provincially, HIV rates went from 7.4 cases to 5.5 cases per 100,000 in the last 10 years while local rates have gone from 5.9 cases per 100,000 in 2005 to 9.0 per 100,000 last year.
For Hepatitis C, the local rates have climbed from 32.2 cases per 100,000 in 2005 to 53.7 cases per 100,000 in 2015.
Dr. Mackie calls the numbers very sad and upsetting. He says they show a need for the health unit to take their drug strategy planning to the next level of urgency. That level could involve establishing a supervised injection site.
"With this new data around HIV it makes it more clear that we have to do that more intensive level of support," says Dr. Mackie. "I don't think that is the only part of the solution, I think we also need to be doing more outreach for people who aren't able to come into those sites, maybe aren't even able to access the needle distribution that we have now."
Dr. Mackie says there is also a need to address the underlying social issues that see people turn to drug use.
"It's really an issue of seeing that people are being marginalized to the point where they don't have any reason to take care of themselves," says Dr. Mackie. "There is no hope for the future so why would I protect myself from HIV if I don't even know where I'm going to get my dinner tonight."
The Middlesex-London Health Unit currently has three sites downtown and a mobile van that distributes clean needles to those suffering from drug addiction.
The MLHU has asked the Public Health Agency of Canada to assign a field epidemiologist to the area to assist local effort.