Canada underinvests in Black health, one window into broader policy bias
On March 25, the United Nations General Assembly approved a resolution that condemned the trans-Atlantic enslavement of Africans as “the gravest crime against humanity.”
Canada abstained from the UN vote, which is consistent with the state of subjection that this country has imposed on Black communities during enslavement and its long aftermath. It circumscribes our existence into the 21st century.
As Canada moves toward Emancipation Day on Aug. 1, the International Day for the Remembrance of the Slave Trade and its Abolition on Aug. 23, the International Day for People of African Descent on Aug. 31, Canada’s abstention demands continued attention. These dates ask whether Canada is prepared to confront the debt owed to Black communities, including historical Black communities like African Nova Scotian peoples, whose lives unsettle the fiction that slavery did not exist in Canada and anti-Blackness is imported from elsewhere.
From the 15th until the late 19th century, European countries shipped almost 15 million Africans into enslavement. Canada benefitted directly and indirectly from this ownership and exploitation of Black people. Enslaved Africans and their descendants produced value which Europeans, their fellow elites throughout the Americas, and their white allies elsewhere expropriated to seed global capitalism. The expropriation underwrote financial systems whose legacies still shape Canadian wealth.
Abstaining from the UN condemnation is Canada’s refusal to audit a foundational debt.
Enslavement went beyond the theft of labour and economics. It was the violent conversion of African peoples and their descendants into property. In the colonies that became Canada, enslaved Black people were forced to live under a dominant colonial system that claimed full authority over their lives. And its aftermath circumscribes our current everyday existence.
This is not abstract. Black health is one place where Canada’s refusal becomes measurable.
Over the last 40 years, public health authorities have looked askance while an HIV crisis unfolded among Black communities. By 2023, Black people accounted for almost 30 per cent of new HIV infections nationally, and almost 40 per cent in Ontario, despite making up about five per cent and seven per cent of the respective populations. Black people are also more likely than their white counterparts to die of AIDS.
HIV is a symptom of a systemically debilitating process. Black people are substantially more likely than white people in Canada to experience food insecurity, poverty, and housing instability, while earning lower incomes. These inequities are the fabric that binds the Canadian social structure.
Handout photograph
In 2022, we came together as the Interim Committee on HIV among Black Communities in Canada (ICHBCC) to advocate for transformative policy and programs. Since 2023, the Public Health Agency of Canada (PHAC) and Canadian Institutes of Health Research (CIHR) have dodged and prevaricated in response to our principled insistence on engaging Black expertise and experience.
On two occasions, we’ve had to escalate concerns to PHAC’s highest levels about its failure to communicate respectfully. Despite our credentials and experience, we’ve had to enlist a white colleague to intervene on our behalf with CIHR. This is the domestic face of Canada’s refusal at the UN: a refusal to recognize Black life, Black knowledge, and Black claims to justice as authoritative on their own terms.
Then, after three years of obfuscation, and with scarcely any warning, PHAC and CIHR decided unilaterally, at a moment’s notice, to organize a consultation to hear from Black communities, without any clear idea of what would happen next, or when. This is not consultation; it is governance without accountability. It is business as usual—avoid dealing in good faith with communities whose lives and livelihoods are at stake.
The ICHBCC and others have continued to demand a leadership role for Black communities in identifying, designing, and implementing interventions required to confront anti-Blackness, change the conditions that sustain the HIV crisis, and make justice possible. Sustainable HIV prevention requires community trust and material security rather than systematic underinvestment in Black health.
The same logic used to justify the enslavement of African people now systematically underinvests in Black health, and therefore Black life itself. We cannot accept a state of existence that reproduces a 21st-century version of chattelization.
A financial system built upon and enriched by trans-Atlantic enslavement and its afterlives does not suddenly invest equitably in Black survival and a state does not become anti-racist by issuing statements of inclusion while refusing reparatory justice. Canada’s refusal to join the UN majority in condemning the trans-Atlantic enslavement of Africans fulfills the extant post-slavery dispensation.
In response, we promise the state and its institutions that we’re not done yet.
This article was co-written with LaRon Nelson, Maureen Owino, David Este, Wangari Tharao, and Tatiana Sotindjo, as part of the Interim Committee on HIV among Black Communities in Canada.
OmiSoore H. Dryden, a Black queer femme, is a Tier 1 Canada Research Chair in Black Health Studies at Dalhousie University.
Eric Peters has 30 years of professional experience in community organizing, HIV prevention and treatment, harm reduction, program development, policy, advocacy, and activism across Canada and the United States.
Winston Husbands is one of the initial organizers of the Interim Committee on HIV among Black Communities in Canada, and an adjunct professor in the Dalla Lana School of Public Health at the University of Toronto.
The Hill Times