The 2021 Canadian federal budget takes concrete steps to address the lack of funding that puts access to sexual and reproductive health care at risk and the lack of data that prevents the development of evidence-based policies and programs. COVID-19 has exacerbated long standing gaps in sexual and reproductive health care, stretching resources that were already thin with the pandemic impacting the accessibility of services because of restrictions on interprovincial and out-of-country travel, reduced capacity for STI testing, treatment and care, contact tracing, contraceptive care including IUD insertion, supporting those impacted by gender-based violence, and those in need of gender affirming, care among other things.
The 2021 budget makes two important and significant financial commitments. Action Canada has long been advocating for these issues with the federal government and welcomes their announcement in the budget.
$45m over three years to fund community-based organizations to make sexual and reproductive health information and services accessible
Charities like Action Canada routinely struggle to fill the gaps in access to sexual and reproductive health care – gaps left by years of government inaction and underfunding.
The impacts of COVID-19 and the pandemic responses on sexual and reproductive health and rights have been wide ranging. Abortion care, contraceptive care and youth sexual health have been de-prioritized in the face of public health crises. This can lead to devastating outcomes for individuals and communities, including higher rates of maternal morbidity, gender-based violence, higher rates of unintended pregnancy, and long-term impacts on mental and physical health.
Nine provinces are experiencing rising rates of sexually transmitted infections (STIs). Outbreaks are ongoing. Individuals are struggling to access testing and treatment as clinics are limited in the services they can provide and labs are overwhelmed. Access to abortion, particularly in rural and remote areas, remains a significant challenge.
Individuals who face the most significant challenges are undocumented (im)migrants and those facing from precarious housing or intimate partner violence.
The quality of sex-ed young people receive in Canada varies wildly and is outdated. Community-based sexual health educators are stretched beyond capacity, offering support where they can. If lessons take place, what is taught often overlook the needs and experiences of many of the students, including those who are 2SLGBTQ+, as well as the current realities in which young people navigate sexual decision-making.
Action Canada manages the Access Line: a confidential Canada wide toll-free number that provides information on reproductive and sexual health and referrals on pregnancy options. Our team of staff and volunteers provide information and referrals to clinics and hospitals that provide reproductive health services, including abortion and STI testing, anywhere in Canada. Over 60% of Access Line callers tell us that travel and location are major barriers for them. Many require financial support from the Norma Scarborough Emergency Fund to pay for the travel, medication, and related expenses coming out of their pocket. Many people rely on the Access Line and Emergency Fund as their last chance to access abortion.
Year after year, the Emergency Fund is drawn down to $0– clearly filling an important gap. In 2019, Action Canada supported upwards of 70 people through the Norma Scarborough Emergency Fund to access care. Without the Fund’s direct financial support, these people would not have been able to get to their abortion appointment. In 2020, our total direct support numbers were even higher. When COVID-19 hit, the number of calls to the Access Line swelled, increasing from about 200 calls a month to nearly 500 at its peak. Our Access Line is now back to relatively normal levels but has been dealing with increasingly complex cases because of pandemic-related travel restrictions and higher levels of stress and anxiety.
We also face ongoing and escalating push-back against sexual and reproductive rights through conspicuous anti-choice tactics. Anti-rights and anti-gender actors have been active all over the world, using this moment of crises to advance their agenda in concerted ways. They use ploys like trying to get abortion designated as non-essential health care or introducing bills that use feminist and human rights language to build support from the public for restrictions on abortion care.
Just a week prior to the release of budget 2021, a bill sought to ban “sex-selective” abortion – a well-known tactic to bring in back-door abortion bans that we know end up hurting the very people those bills purport to be protecting. Reproductive rights aren’t safe, even in Canada. This advocacy work requires a strong and engaged movement that supports and participates in resistance against the backsliding of rights and who fight for real choice and access for all. Support for this movement is needed now more than ever.
Action Canada has taken on work that governments should be doing, and is obligated to do under the Canada Health Act and international human rights law. No charity should be responsible for ensuring people are able to access the health care they are entitled to. Action Canada funds this work through donations from individuals. This is unacceptable. This is why our campaigning and advocacy work is critically needed to hold governments accountable to their obligations.
It is in this spirit that we welcome the announcement of $45m over three years to support the essential work of community-led organizations working to make sexual and reproductive health information and services more accessible in their communities, leaving no one behind. We look forward to working hand in hand with Health Canada to develop a robust, equitable and accessible funding mechanism and strategy.
$7.6m over five years for a national sexual and reproductive health survey
Canada needs a routine national sexual health survey that conducts regular national surveillance on issues including sexually transmitted and blood borne infections (STBBIs), involuntary sterilization, pregnancy intentions and outcomes, contraceptive use, unmet contraception needs, and gender equity markers – including attitudes, men’s sexual health, intimate partner violence, and experiences of sexual violence and of reproductive coercion, with data that is fully disaggregated.
This information will allow decision-makers, health care professionals and community organizations to interpret trends in diagnoses, access to services, needs, outcomes and experiences, access population-level data on testing patterns to evaluate the impact of testing strategies, and address gaps in knowledge related to sexual and reproductive health. We need this data collection to develop programs and policies grounded in evidence and allocate resources that truly respond to the needs of people in Canada.
We welcome the earmarking of funds for the creation of a national sexual and reproductive health survey
Moving forward, Statistics Canada must (1) engage in robust consultation with a range of relevant sexual health experts towards the development of a survey and implementation strategy, and (2) work with sexual health experts to ensure the design of the survey integrates a comprehensive set of disaggregated indicators that take issues of race, gender, disability, location, ethnicity, sexual orientation, age, among other factors into consideration, and (3) develop a fully-funded model that ensures the long-term sustainability of a routinely conducted national sexual health survey.
$30b over five years to establish a Canada-wide early learning and child care system
Reproductive justice draws intersections between racial, economic, cultural and other power structures that enable and constrain the ability of individuals, particularly women of colour, to make personal decisions about their lives, such as whether to have children, and, when parenting children, to have the ability to do so in healthy and safe environments. Laws, policies and programs related to childcare, pay equity, paid parental leave, among others, facilitate a more holistic approach to sexual and reproductive health and rights; that consider the structural factors that impact the ability of individuals to make free and autonomous decisions about our bodies, lives, genders, sexualities, reproductive choices, health and well-being.
Action Canada congratulates the decades of advocacy undertaken by child care advocates and their allies. Action Canada wholeheartedly supports this long-overdue commitment and welcomes concrete and timely next steps towards the creation of a national child care system.
$15m over three years for 2SLGBTQ+ projects to support community-informed initiatives
Action Canada welcomes this commitment and calls for the explicit funding of 2SLGBTQ+-led organizations and coalitions. We’ve seen increasing incidences of overt transphobia, transmisogyny and homophobia take place across Canada. For too long, feminist and social justice organizations and movements have allowed trans-exclusionary feminisms to thrive – both through a failure to confront blatant ‘Trans Exclusionary Radical Feminists’ (TERF) activity and failure to bring trans inclusion and liberation into these spaces. Trans movements, theories and organizing are essential to an intersectional, liberatory feminist agenda.
Action Canada calls on the department of Women and Gender Equality (WAGE) to earmark funds to support the work of 2SLGBTQ+–led organizations, with dedicated funding for trans-led organizations, and coalitions, and ensure all funding allocated is core, flexible and sustainable. We further call on WAGE to ensure all WAGE-supported initiatives support a trans-inclusionary approach within their programming.
No meaningful investment in global development assistance
The 2021 budget fails to meaningfully invest in global development assistance or meet the needs of those in the Global South. While Canada begins to recover from the COVID-19 pandemic, greater investment is needed to support a global recovery and to ensure equitable vaccine access. Vaccine nationalism, rising push-back against human rights, and threats to democratic institutions and multilateralism have been exacerbated by the pandemic. With mounting threats of austerity measures among donor countries due to COVID-19, we can expect to see inequalities continue to deepen. Canada, with its Feminist International Assistance Policy, has an obligation to increase its support for official development assistance, ensuring resources flow directly to feminist, women’s rights and social justice organizations working to advance rights in communities across the Global South.
Action Canada is disappointed by Canada’s failure to demonstrate global leadership in this budget. Without meaningful and long-term investments, an equitable global recovery is not possible.
No significant steps taken to establish a national universal pharmacare strategy
While the budget includes an initial commitment of $500m to support the high-costs of drugs for rare diseases, the budget fails to establish a timeline and investment framework for the launch of a national, universal pharmacare strategy.
Hundreds of thousands of individuals are falling through the cracks, unable to afford the medicine and devices they need to support their sexual and reproductive health. The ability to manage your own fertility, decide if and when to have children, have healthy pregnancies, affirm your own gender, and prevent, treat or manage sexually transmitted infections (STIs), including HIV, should not depend on private or patchwork insurance coverage.
For more information, contact:
Sarah Kennell, Director of Government Relations
View the original text in the budget here, and below:
“Supporting Access to Sexual and Reproductive Health Care Information and Services
All Canadians should have access to a full suite of sexual and reproductive health resources and services, no matter where they live. Currently, women, youth, LGBTQ2 people, racialized Canadians, and Indigenous populations face the highest sexual and reproductive health risks and the greatest barriers to accessing support, information, and services. Too often, they do not receive the same quality of care, particularly if they are from marginalized communities. Furthermore, examples like Clinic 554—New Brunswick’s only private abortion clinic—show us that lack of funding puts access to sexual and reproductive health care at risk. Everyone deserves equal treatment in our health care system.
The Government is committed to collaboration with provinces and territories to strengthen our health care system, ensuring equitable and appropriate access to a full suite of reproductive and sexual health services, in any upcoming Canada Health Transfer funding discussions.
To improve access to sexual and reproductive health care support, information, and services—including protecting access to abortion care:
Budget 2021 proposes to provide $45 million over three years, starting in 2021-22, to Health Canada to fund community-based organizations that help make sexual and reproductive health care information and services more accessible for vulnerable populations. These organizations support activities such as producing inclusive training materials for sexual and reproductive health care providers, carrying out public awareness activities, and providing travel and logistical support to individuals who have to go long distances to access abortion care.
In addition, there are currently no existing resources that collect comprehensive data on a wide range of sexual and reproductive health indicators in Canada, limiting our ability to target supports. To address this:
Budget 2021 proposes to provide $7.6 million over five years, starting in 2021-22, for Statistics Canada to develop and implement a national survey on sexual and reproductive health that captures data on race, household income, and sexual orientation–information often not captured in existing surveys. Better information will help ensure governments understand the challenges and improve the support they provide.”