An open-air tuberculosis sanitorum in Manitoba in 1912 (Photo: Archives of Manitoba)
Each year, the UN and its World Health Organization mark World Tuberculosis Day on March 24. It's an opportunity to draw attention to the approximately 9 million people who get sick with the bacterial infection each year — a third of whom, the WHO says, are not even counted by their national health systems.
If you thought that Canada had done pretty well in the fight to eradicate TB, well you'd be right — we have one of the lowest infection rates in the world. But new people are still infected with the disease each year — and drug-resistant strains are posing new threats from a disease that's typically considered curable. Below, five things to know about TB in Canada.
1. About 1,600 people are diagnosed in Canada each year
The incidence of TB has been steadily decreasing in Canada, but unlike polio, say, it hasn't been completely eradicated. In 2012, the most recent year for which numbers are available, the Public Health Agency of Canada reported 1,686 active cases, for an incidence of 4.8 cases per 100,000 people (in countries with high incidence, that number can reach the mid-hundreds, as in Lesotho, where it's 630 per 100,000). Under a new federal plan announced yesterday, the government's goal is to reduce incidence to 3.6 per 100,000 by 2015.
2. Those cases aren't evenly distributed across the country
As you might expect by its share of the total population, Ontario sees about a third of those cases, but British Columbia comes in second, despite being half the size of number three, Quebec. According to PHAC, two sub-groups have a disproportionately high number of cases: Aboriginal Canadians and foreign-born individuals. Despite accounting for four per cent of the Canadian population, Aboriginal people make up about 23 per cent of all cases. That's particularly acute in the North — the incidence rate for Inuit in 2012 was 400 times the Canadian-born non-Aboriginal rate. For foreign-born individuals, the incidence rate is about 20 times that of the Canadian-born non-Aboriginal population.
3. Despite the low incidence, treating TB isn't cheap
According to one 2008 study, Canada spent $74 million fighting TB in 2004 — that's about $47,000 for every active case, including money spent on hospitalization, out-patient care, laboratories, drugs and research.
4. Drug-resistant TB isn't a large concern in Canada — for now
According to the WHO's 2013 Global Tuberculosis Report, an estimated 450,000 people developed a multiple drug-resistant TB infection last year, and there were about 170,000 deaths from MDR-TB. In Canada, the spread of TB drug resistance has been below the global average, according to a study conducted by PHAC, and the percentage of resistant strains has remained stable for the last decade. To ensure this remains the case, PHAC says strict adherence to treatment programs must be maintained.
5. Canada is part of the Stop TB Partnership
Canada is one of many countries signed onto the international Stop TB Partnership, which aims to reduce the global burden of TB to half of 1990 levels by 2015, and bring the global incidence down to less than one per million by 2050. According to the WHO, levels of new cases have been reduced 45 per cent since 1990, although total active cases worldwide have only fallen by 37 per cent since 1990 — which means the 2015 target will not likely be reached.