The New York Times

Tuesday, October 21, 1997

Vancouver, a City With Everything, Finds It Has AIDS Too

VANCOUVER, British Columbia, Oct. 20 (AP) - In this modern, up-to-date city, a pocket of poverty is reeling from one of the worst AIDS epidemics in any wealthy nation.

Fifteen blocks known as Downtown Eastside form the poorest urban neighborhood in Canada - a seamy mix of pawn shops, taverns and decrepit rooming houses. The Eastside's drug addicts are becoming infected with H.I.V., the virus that causes AIDS, at such a rapid pace that health officials have declared the first medical emergency ever in Vancouver.

Experts estimate more than 6,000 addicts frequent the area, perhaps half of them infected with the virus because of pervasive sharing of contaminated needles.

Dr. Martin Schechter, an epidemiologist at the University of British Columbia, said the infection rate among Eastside drug users is nearly 20 percent annually.

The problem has been building for several years, but came into the spotlight this month when Bud Osborne, a community leader and former addict, convinced fellow members of Vancouver's health board to declare a medical emergency. "This epidemic is kind of like the plague," Mr. Osborne said in an interview. "It's going to spread."

Under the emergency, the province allocated $2.2 million to combat the epidemic, and pressure is rising for the national Government to help.

The epidemic is raging despite the city's ambitious needle-exchange program, which started in 1988. More than 2.5 million clean needles are distributed annually, but many addicts do not bother to use them.

Dr. Schechter said H.I.V. infections in the Eastside began multiplying about four years ago when many addicts changed habits: they switched to a dozen or more injections a day of cheap cocaine, rather than two or three of heroin.

"The number of injections per day goes up - the ability to take precautions goes way down," he said.

Though other Canadian cities have similar problems among drug-users, the Eastside stands out in an otherwise prosperous city that is assuming an international role.

Some of Vancouver's addicts are Indians from impoverished rural reservations, but the city's mild winters and relatively generous social programs also attract the down-and-out from across Canada.

"These are people who are totally marginalized, and there's a very callous attitude toward them," said Libby Davies, who was elected this year to Parliament from the district that includes the Eastside.

Ms. Davies has been frustrated by the reaction to her pleas for assistance: She said the Health Minister told her it was a problem for the Justice Ministry, and the Justice Minister told her it was a health problem.

Precise statistics are hard to come by, but the Vancouver Native Health Society earlier this year registered 600 drug-addicted Indians in the Eastside who were H.I.V.-positive.

The society says that at least 31 have died, and that it is recording a new infection each day.

The health board has asked its staff to develop a plan of action by the end of this month. This will probably include expanded needle-exchange and addiction treatment, and recommendations to improve living conditions in the Eastside.

Real estate prices in Vancouver are among the highest in Canada, and little low-income housing is being built. Mr. Osborne, the community leader, said owners of the East-side's cheap hotels are content to let them deteriorate, hoping the area will turn around, lifting property values.