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

- Brett Forester

With the federal budget ap‐ proaching, Inuit leaders and New Democrat MPs are urging the Trudeau gov‐ ernment to tackle tubercu‐ losis in Indigenous commu‐ nities.

Inuit in particular face a "staggering and unaccept‐ able 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 advo‐ cacy organizati­on for Inuit in Canada is seeking $131.6 mil‐ lion over seven years - and a show of commitment - from next month's budget.

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

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

Despite advancemen­ts over the last decade, Inuit tu‐ berculosis rates remained virtually unchanged, while the rates for Canadian-born non-Indigenous people de‐ creased.

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-Indige‐ nous people, say government briefing documents from May 2023. The documents say this may have worsened during the COVID-19 pan‐ demic as public health re‐ sources were diverted from TB.

According to one official, there is a simple reason why the federal government has‐ n't shown the same urgency addressing this startling situ‐ ation as it did the coron‐ avirus pandemic: systemic racism.

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

"Obviously it's very frus‐ trating, especially when our government­s continue to talk about doing really great things with Indigenous com‐ munities."

The government acknowl‐ edged underlying disparitie­s linked to colonialis­m, includ‐ ing inadequate health and social infrastruc­ture, sub‐ standard housing and chronic food insecurity, con‐ tribute to higher infection rates.

Canada pledged $16.2 million for tuberculos­is elimi‐ nation in the budget last year - 12 per cent of the cash Obed said is actually re‐ quired.

Mike called this an exam‐ ple of the Canadian govern‐ ment's routine underfundi­ng of Indigenous people, warn‐ ing 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 gov‐ ernment of Canada's com‐ mitment is not going to be‐ come the reality at this rate."

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

Access to medicine

Meanwhile, First Nations in northern Saskatchew­an, Manitoba, Ontario and Que‐ bec have also been address‐ ing outbreaks since 20212022, the briefing documents say.

Earlier this month, New Democrat members of Parlia‐ ment 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 encom‐ passes 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 is‐ n'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 ri‐ fampin, warning the shortage could have greatly impacted rural and Indigenous com‐ munities with higher rates of infection.

Another crucial tubercu‐ losis 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 fail‐ ure.

Holland's office deferred questions to Indigenous Ser‐ vices 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 main‐ tained a rifapentin­e stockpile through the Drugs for Urgent Public Health Need program and distribute­d 840 adult courses, the statement said.

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