Keewatinohk Inniniw Minoayawin calls for structural reform as Manitoba declares public health emergency over HIV

MEDIA STATEMENT

FOR IMMEDIATE RELEASE 

Treaty One Territory, Winnipeg, MB — May 7, 2026 — Keewatinohk Inniniw Minoayawin Inc. (KIM) commends the Province of Manitoba’s declaration of a public health emergency in response to rising HIV rates. This declaration signals urgency and has been long overdue. The emergency on increasing HIV diagnoses is not new, and it is not solely a clinical issue. Instead, it is a direct result of longstanding systemic failures, anti-First Nations racism, and ongoing jurisdictional conflict between levels of government.

Manitoba continues to experience some of the highest HIV rates in Canada, with disproportionate impacts on First Nations people and northern communities. For KIM and its partner Nations, this reflects decades of inequitable access to care, fragmented responsibility across governments, inadequate funding, and persistent gaps in prevention, testing, and treatment.

“We are facing a failure of systems,” said Michelle Monkman, interim CEO of KIM. “The tools to prevent HIV exist. What has failed is our ability to ensure equitable, timely, and coordinated access to those tools for First Nations people.”

KIM continues to raise critical concerns regarding jurisdictional ambiguity between federal and provincial governments in all areas of health, and in relation to HIV prevention, testing and accessible pathways to care.

• Canada has indicated that HIV testing is a primary care responsibility, limiting access to federally supported testing resources and deferring responsibility to Manitoba.
• Manitoba has positioned testing within diagnostics, creating uncertainty in responsibility and supply pathways deferring responsibility to Canada.

The inability of Canada and Manitoba to address historical jurisdictional conflict has real and lasting impacts on the health outcomes, overall wellness, and life expectancy of First Nation citizens. This gap has resulted in significant barriers to access, particularly in First Nations where testing, early diagnosis, and timely treatment are critical to preventing transmission.

“When governments evade responsibility, people fall through the cracks. HIV does not wait for jurisdictional clarity, and neither should we. We must act now to save lives,” said Monkman.

KIM stresses that an effective response must extend beyond emergency measures and address the underlying drivers of HIV transmission, including:

• Housing instability and homelessness
• Substance use and the toxic drug supply
• Mental health challenges
• Systemic anti-First Nations racism in healthcare
• Limited access to culturally safe and community-based care

These factors are well-documented in provincial and federal public health reporting and reflect the lived realities of First Nations people.

Both Canada and Manitoba must work together and provide appropriate response to this emergency. KIM is calling on both levels of government to work with First Nations leadership and governance in HIV strategy design and service delivery, prioritizing distinctions-based and community-driven solutions. It is imperative this work be culturally safe, racism free, and have respect for the data sovereignty of Nations in alignment with the rights affirmed through the United Nations Declaration on the Rights of Indigenous Peoples. This includes the right to participate in decisions affecting health and access to equitable services and the principles outlined by the National Collaborating Centre for Indigenous Health.

KIM says the focus must shift from emergency response to long-term system transformation.

“We have seen this pattern before. Emergency declarations without sustained structural change. If this is to be meaningful, it must lead to long-term transformation in how services are designed, governed and delivered,” said Monkman.

KIM is calling for coordinated action across governments, including:

• Clear resolution of federal and provincial roles in HIV prevention, testing, and care
• Immediate expansion of harm reduction, testing, and treatment access in First Nations communities
• Sustained investment in community-led, Indigenous-designed health services
• Integration of HIV response with housing, mental health, and substance use strategies

KIM stands ready to work in partnership with First Nations, the Province of Manitoba, and Indigenous Services Canada to advance a coordinated, equitable, and sustainable response.

“This is a pivotal moment for accountability and action. If we are serious about ending HIV in Manitoba, we must also be serious about transforming the systems that have allowed it to spread uninterrupted,” said Monkman.

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For media inquiries:

Email: [email protected]

Keewatinohk Inniniw Minoayawin Inc. (KIM) is a northern First Nations-led aggregate health organization that works to transform health and wellness services and improve health outcomes for First Nations people.