Inuit leaders, MPs urge action on TB elimination as federal budget nears

With the federal budget approaching, Inuit leaders and New Democrat MPs are urging the Trudeau government to tackle tuberculosis in Indigenous communities.

Inuit in particular face a "staggering and unacceptable reality" of tuberculosis rates more than 300 times higher than Canadian-born non-Indigenous people, Inuit Tapiriit Kanatami (ITK) said in a pre-budget submission.

With the clock ticking on a Liberal pledge to eliminate the disease in Inuit regions by 2030, the national advocacy organization for Inuit in Canada is seeking $131.6 million over seven years — and a show of commitment — from next month's budget.

"We remain steadfast in our hope that the government of Canada still stands with us on its pledge to eliminate TB and it needs to spend money to do that," said ITK President Natan Obed.

Tuberculosis is a serious infectious disease that mainly affects the lungs, but it is preventable and curable.

Despite advancements over the last decade, Inuit tuberculosis rates remained virtually unchanged, while the rates for Canadian-born non-Indigenous people decreased. 

This has widened the gap and resulted in a tuberculosis rate among Inuit reported in 2021 that was 676 times that of Canadian-born non-Indigenous people, say government briefing documents from May 2023. The documents say this may have worsened during the COVID-19 pandemic as public health resources were diverted from TB.

According to one official, there is a simple reason why the federal government hasn't shown the same urgency addressing this startling situation as it did the coronavirus pandemic: systemic racism.

"It's not new," said Jesse Mike, director of social and cultural development with land claim management organization Nunavut Tunngavik Inc., in reaction to the numbers. 

"Obviously it's very frustrating, especially when our governments continue to talk about doing really great things with Indigenous communities."

The government acknowledged underlying disparities linked to colonialism, including inadequate health and social infrastructure, substandard housing and chronic food insecurity, contribute to higher infection rates.

Canada pledged $16.2 million for tuberculosis elimination in the budget last year — 12 per cent of the cash Obed said is actually required.

Mike called this an example of the Canadian government's routine underfunding of Indigenous people, warning that without sufficient money and swift action in other areas, the Liberals will miss their targets.

"We're going to continue to advocate for all of those extra funds that we require," said Mike.

"But as it stands, the government of Canada's commitment is not going to become the reality at this rate."

The Trudeau government pledged in 2018 not just to eliminate tuberculosis across Inuit regions by 2030, but also cut infection rates in half by 2025.

Access to medicine

Meanwhile, First Nations in northern Saskatchewan, Manitoba, Ontario and Quebec have also been addressing outbreaks since 2021-2022, the briefing documents say.

Earlier this month, New Democrat members of Parliament raised concerns about a lack of vital medication and regulatory issues hindering efforts to fight tuberculosis.

MPs Niki Ashton, Lori Idlout and Don Davies urged the government to address shortages and ensure access to vital drugs in a March 4 letter to Health Minister Mark Holland, which was provided to CBC Indigenous.

Ashton, whose northern Manitoba riding encompasses several remote First Nations, said in an interview Ottawa needs to step up.

"Canada is not taking the action it needs to fulfil its own pledges, and certainly isn't being seen as a leader on the world stage either when it comes to action on TB," she said.

In winter 2023, Health Canada reported a shortage of tuberculosis drug rifampin, warning the shortage could have greatly impacted rural and Indigenous communities with higher rates of infection. 

Another crucial tuberculosis drug, rifapentine, is not licensed for use in Canada because the manufacturer hasn't applied for approval, which the New Democrats branded a Liberal policy failure.

Holland's office deferred questions to Indigenous Services Canada (ISC), which said the government uses a workaround mechanism to access some unapproved drugs, like rifapentine.

"ISC will continue to work with our partners to support access to critical life-saving drugs for communities," wrote departmental spokesperson Suzanna Su in a statement.

Since 2017, ISC has maintained a rifapentine stockpile through the Drugs for Urgent Public Health Need program and distributed 840 adult courses, the statement said.