Eliminating the extreme and disproportionate rate of tuberculosis (TB) among Inuit in Canada is the goal of a new task force announced in early October by Indigenous Services Minister Jane Philpott.
A result of the Inuit Crown Partnership Committee, formally created earlier this year, the task force is to address the rate of active TB, which for Inuit in 2015 was more than 270 times higher than the rate in the non-Inuit, Canadian-born population.
Nunavut is hardest hit, with a rate of 119.2 per 100,000 population.
Philpott said the establishment of a task force was necessary “in order to effectively work with the range of partners who will be required if we are going to effectively address this very significant issue.”
At the same press scrum in Ottawa Oct. 5, Inuit Tapiriit Kanatami (ITK) president Natan Obed called the high rates of TB in Inuit “one of the most long-standing social-inequity pieces within our communities.”
Quoting the rate, Obed said “This is simply unacceptable.”
“We’ve often said, ‘When is a crisis a crisis?’ And this government, under the leadership of Minister Philpott, Minister Petitpas Taylor, and also the prime minister, have worked with us through the Inuit Crown Partnership table to address joint priority areas,” he said.
“We expect to eliminate tuberculosis. And we are going to take the steps together to make sure tuberculosis is eliminated in Inuit Nunangat communities.”
The Inuit TB Elimination meeting was held Oct. 4 to 6.
“Experts indicated the need for standard access to current TB technologies and tools across Inuit Nunangat, building a strong Inuit work force and community capacity and the need for a comprehensive data and surveillance system. The discussions at this meeting will inform the establishment and work of the Government of Canada task force on Inuit TB elimination,” Obed said.
Housing, food insecurity must be addressed
In early September, Nunavut Tunngavik Inc. and the Government of Nunavut, in consultation with Qikiqtani Inuit Association and ITK, brought Stephen Lewis – co-director of AIDS-Free World and former Canadian Ambassador to the United Nations – to the territory for a four-day fact-finding mission in Iqaluit and Iglulik.
He called the situation in Nunavut a crisis at a news conference in Iqaluit Sept. 9.
“There are 14 out of the 25 disparate communities wrestling with active and latent cases, many of them children,” said Lewis.
Lewis also addressed the shortage of health-care-staff, the colonial inheritance, food insecurity, the housing crisis, and the historical experience of TB in the territory in the 1950s and ’60s.
“It’s a chapter of Inuit history that is largely unknown in the rest of Canada. Yet it ranks with the horror of residential schools, and the missing and murdered Aboriginal women, and the diabolical baby scoop in parts of Canada between the 1960s and ’80s,” said Lewis.
As Lewis noted in a speech delivered in Alberta following his fact-finding mission in Nunavut, “The devastating TB epidemic in Nunavut Inuit communities is curable, capable of elimination.”
Taima TB, a group of research projects aimed at helping Inuit stop the transmission of tuberculosis in their communities, is being touted as the foundation for efforts to address the crisis. The research, with various partners including NTI and respirologist Dr. Gonzalo Alvarez, can provide a framework for government action, Lewis said.
But that won’t be enough.
“This plan to institute prevention and treatment of TB must obviously be accompanied by a Herculean effort to address the social determinants of health,” he said. “It’s crucial that the federal government also deal with poverty, housing, food prices, training of health professionals (there is a desperate need for nurses), and above all, always above all, language and culture.”