The Associated Press; 50 Rockefeller Plaza, New York, NY 10020 - Thursday, October 16, 1997; 5:19 a.m. EDT
David Crary, Associated Press Writer

The 15 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 contracting the AIDS-causing HIV virus at such a rapid pace that health officials have just declared the first medical emergency in Vancouver's history.

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

Dr. Martin Schechter, a University of British Columbia epidemiologist, said the infection rate among Eastside drug users is the highest in North America at nearly 20 percent annually. In other words, out of every 100 addicts who were were free of HIV at the start of the year, 20 would be HIV-positive by year's end.

The problem has been building for several years, but came into the spotlight this month when Bud Osborne, a community activist and former addict, convinced fellow members of Vancouver's health board to declare a medical emergency.

"This epidemic is kind of like the plague," Osborne said in an interview. "It's going to spread."

Under the emergency, the province has allocated $3 million ($2.2 million U.S.) to combat the epidemic, and pressure is mounting for the federal government to help. Vancouver's coroner and deputy police chief have joined AIDS specialists in urging the government to decriminalize possession of small amounts of illegal drugs for personal use.

"It's time to recognize that we have a public health crisis and take it out of a criminal context," Schechter said.

The epidemic is raging despite Vancouver's ambitious needle-exchange program, which started in 1988. More than 2.5 million clean needles are distributed annually, but many addicts don't bother to participate and instead share used needles.

Schechter said HIV infections in the Eastside began multiplying about four years ago when many addicts changed habits -- switching to a dozen or more injections a day of cheap cocaine rather than two or three injections of heroin.

"The number of injections per day goes up -- the ability to take precautions goes way down," he said. "That's how you get this explosion."

Though other Canadian cities also have problems with HIV among drug-users, Vancouver's Eastside stands out -- a blight in an otherwise prosperous city that will play host to 18 heads of state next month at an Asia-Pacific economic summit.

Some of Vancouver's addicts are Indians from British Columbia's impoverished rural reservations, but mild winters and traditionally generous social programs attract the down-and-out from across Canada. Some are fleeing provinces where conservative governments have recently slashed welfare benefits.

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

Ms. Davies has been frustrated by the federal 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.

"It was just an appalling response," said Davies, who wants the government to permit doctors to prescribe hard drugs to addicts.

Precise statistics on the epidemic are hard to come by, but the Vancouver Native Health Society earlier this year registered 600 drug-addicted Indians in the Eastside who were HIV-positive. The society says at least 31 of them have died in recent months, and is recording roughly one new HIV-positive diagnosis a day.

The health board has asked its staff to develop a comprehensive action plan by the end of October. It will likely include expanded needle-exchange and addiction-treatment programs, and recommendations to improve living conditions in the Eastside.

Real estate prices in many Vancouver neighborhoods are among the highest in Canada, and very little new low-income housing is being built. Osborne said owners of the Eastside's cheap hotels are content to let them deteriorate, hoping gentrification will sweep into the area in a few years and boost property values.

"If you don't have a decent place to sleep, all the health care in the world isn't going to make a difference," said Vancouver's chief medical officer, Dr. John Blatherwick.

Copyright 1997/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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