The president of a major Inuit organization reiterated her call for transparency after The Globe and Mail’s investigation into a major tuberculosis outbreak in Pangnirtung, a settlement of about 1,500 people on Baffin Island, was published. In an interview, Aluki Kotierk, president of Nunavut Tunngavik Inc., said the country’s economy is growing rapidly. (NTI), stressed the need for the Government of Nunavut to release TB data for individual communities. In the Feb. 24 letter, Ms. Kotierk urged John Main to consider the territory’s Privacy Commissioner’s decision to release TB case counts for all 25 Nunavut communities. He wrote that the government’s refusal “endangered the health” of residents and acted as an obstacle to the signing of a crucial TB action plan The Feb. 7 non-binding decision by the Privacy Commissioner stemmed from an access to information objection filed by The Globe. In Nunavut, medical staff saw signs of a devastating tuberculosis epidemic. The government did not Nunavut admits a major tuberculosis outbreak broke out in Pangnirtung months later In the letter, Ms. Kotierk said the information requested by The Globe — including TB counts and rates, broken down by community, age and gender — was essentially the same information NTI wanted released before signing a joint action plan. for tuberculosis with the territorial government. “Nunavut’s continued refusal … to provide timely and complete this and other relevant information has jeopardized the health of Nunavummiut by impeding the implementation of the tuberculosis action plan,” Ms. Kotierk wrote in the letter, a copy of which was provided to NTI at The Sphere. Until a plan is in place, NTI will not give the regional government any more than the $13 million in federal money it received to begin working toward the Trudeau government’s goal of eliminating tuberculosis in Inuit communities by 2030. In 2018, when Ottawa made the pledge, it committed $27.5 million over five years to Inuit Tapiriit Kanatami, a national organization representing 65,000 Inuit. ITK distributed the money to four regional Inuit organizations, the largest of which is NTI. Each Inuit group, in collaboration with local health officials, had to come up with an action plan tailored to their specific needs. Nunavut is the only Inuit territory where an agreement has not yet been reached. NTI has an important official role in Nunavut. It is charged with ensuring that the territorial and federal governments keep the promises made to the Inuit in the Nunavut Agreement, the territory’s founding document. The Globe investigation, based on more than 200 pages of internal documents obtained through an access to information request, revealed that frontline nurses were begging for help managing TB in Pangnirtung last summer, months before the outbreak was announced on Nov. 25 . , 2021. The government did not reveal the extent of the spread until six months after the outbreak was declared. This followed the Globe sending a list of questions for its investigation and the mayor of Pangnirtung calling for more transparency. There were 139 cases of tuberculosis detected in Pangnirtung between January 2021 and May this year, the largest outbreak detected in the territory since 2017. Thirty-one were active TB disease. The rest were latent infections that are not contagious and do not make people sick, but which may eventually develop into active tuberculosis. Given its population of only about 1,500 people, Pangnirtung’s 2021 TB incidence rate ranks among the highest in the world, exceeding rates regularly seen in less developed countries in Africa. Nunavut’s Department of Health declined to release TB case numbers for any other community, saying doing so would risk pinpointing patients to small settlements, stigmatize entire communities and serve no practical purpose outside of an outbreak. Mr. Main explained those concerns in his response letter to Ms. Kotierk, which was obtained by The Globe through a separate access to information request. “In the past, settlements have raised concerns about releasing data because of stigma,” Mr. Main wrote. “Even in cases where individuals could not be traced, there was increased attention and stigma towards particular communities where there were cases.” He offered to discuss providing community-level TB data in confidence to NTI and village officials without making it public. But Ms Kotierk said in the interview that such an approach would perpetuate the “colonial” idea that “we can’t make our own health decisions – that we’re not self-determining, intelligent people”. Joe Savikataaq, Jr., the mayor of Arviat, also wants the local government to release TB case counts for communities. His settlement of nearly 3,000 people in the central Kivalliq region has been battling tuberculosis for the past few years, but he doesn’t know the true extent of the problem. Arviat was the site of Nunavut’s first major COVID outbreak in November 2020. The local government provided regular public updates on the number of COVID cases, a transparent approach that Mr. Savikataaq Jr. said. helped alleviate the stigma associated with the new virus. “Donations poured in from all over the country to Arviat,” he added, “so there was nothing wrong with releasing numbers. No names were ever released, only numbers, and that should be the same for TB.” In 2020, the most recent year for which national data is available, there were 72.2 active TB cases per 100,000 diagnosed in Inuit patients, compared to a national case rate of 4.7 per 100,000. Despite being 15 times higher than the national average, the tuberculosis rate among Inuit in 2020 was down significantly from a 10-year annual average of 184.14 per 100,000 from 2010 to 2019 – a decline that some experts attribute to fact that TB cases were not diagnosed in the first year. of the pandemic. High TB rates among Inuit reflect the poverty that plagues isolated Arctic villages and other indigenous communities across Canada, said Elizabeth Rea, the co-chair of Stop TB Canada and a Toronto physician. TB bacteria are more likely to spread in overcrowded, poorly ventilated homes, and they are more likely to become seriously ill if they are malnourished, smoke cigarettes and suffer from chronic diseases. “It is appalling that Canadians who were born and lived all their lives in a country as rich as Canada … should suffer from outbreaks of tuberculosis and tuberculosis,” said Dr. Rhea. Ms. Kotierk added that it is important to share detailed information about the burden of TB on Inuit communities. That way “the rest of Canada can’t forget” the ongoing health crisis. “Why keep it a secret so that everyone can feel comfortable and forget that we live under conditions that do not even cover the basic needs of shelter and food, which contributes to the high rates of tuberculosis in our communities?” he said. The Morning Update and Afternoon Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.
