OPINION | Nunavut should tackle TB the way they have COVID-19 — by sharing better data

The Nunavut government saw that timely, accurate, and disaggregated data are an essential component to containing COVID-19. But it doesn't take the same position on tuberculosis.

Co-founders of SeeChange Initiative write that lack of TB data make responding to crisis harder

A file photo of x-ray results from a patient suspected to have tuberculosis (TB). (Rajesh Kumar Singh/Associated Press)

When confronted with the ominous threat of the COVID-19 pandemic, the government in Nunavut made a sound decision.

Dr. Michael Patterson, the territory's chief public health officer, announced that officials would publicly identify specific communities with confirmed coronavirus cases.

"Given the concern and the fear around COVID-19, we thought we had to be transparent," he said.

The Nunavut government saw that timely, accurate, and disaggregated data are an essential component to containing a public health crisis. 

But the government does not take the same position on the other public health crisis in the territory.

The rate of tuberculosis among Inuit is nearly 300 times higher than among non-Indigenous people in Canada — and yet the government does not provide communities with the information they need to support early diagnosis and treatment, which are essential elements to containing the spread of the disease.

"Early detection, getting to the source, isolating the cases — this is how tuberculosis can be contained," Jerry Natanine, an Inuk who is mayor of Kangiqtugaapik (Clyde River), Nunavut, told us. "Awareness is a benefit to the people." 

But the most recent data published on TB in Nunavut are four years old and not sufficiently disaggregated. Citing privacy concerns, the Nunavut government only discloses the number of TB cases for the territory as a whole — an expanse of two million square kilometers. 

Territory-wide data offer no help to a community seeking to understand its burden of disease. 

A view of the front of the St. Therese's Health Centre in Kugaaruk, Nunavut. Sharing data with local health authorities is essential to combatting TB, Kiddell-Monroe and Nash write. (John Last/CBC)

While the government discloses the number of COVID-19 cases for each community, it does not do the same for TB cases. 

Without information about the reality of TB in their communities, community members and local leaders are denied a basic component of autonomous governance. 

But the territorial government isn't solely responsible for the situation. The federal government is implicated in the TB crisis in the North.

In 2018, the Canadian government and Inuit Tapiriit Kanatami (ITK) announced a commitment to eliminate TB from Inuit Nunangat by 2030.

The federal government should support the effort to decentralize access to TB data, which would decentralize decision-making power in a way that is more consistent with Indigenous communities' rights to self-determination and self-governance. A significant expenditure of public funds would not be required for such an initiative. 

Officials should release the annual number of new TB cases (both active and latent) for each Inuit community. Data for Inuit at the national level should also be disaggregated by age and sex.

At a minimum, TB information should be provided to local leadership structures — such as hamlets' health committees — so that communities can implement appropriate, community-specific local responses to TB.

WATCH | Natan Obed, head of Inuit Tapiriit Kanatami, speaks about plans to eliminate TB by 2030:

Eliminating TB in Canada's North

5 years ago
Duration 6:55
'There's a lot of work, but absolutely it can be done,' says Inuit Tapiriit Kanatami President Natan Obed.

Communities must be given the opportunity to make informed decisions about how to best protect their citizens.

The COVID-19 pandemic has shown us the value of sharing more information rather than less. Governments throughout the world have provided the public unprecedented amounts of detailed health data, which have been essential to saving lives. Why should TB be any different? 

We should not fall prey to COVID exceptionalism, a belief that the response to the respiratory pathogen creating headlines every day should be different than the response to the respiratory pathogen that doesn't get the same level of airtime.

We've learned important lessons during the COVID-19 pandemic. Let's not forget them when it comes to the deadly disease known as TB. 

This column is an opinion by Rachel Kiddell-Monroe and Madlen Nash, co-founders of SeeChange Initiative, a non-profit organization which supports local responses to health crises. For more information about CBC's Opinion section, please see the FAQ.

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