Letter to Minister of Health
Hon. Jean-Yves Duclos, Minister of Health
House of Commons
Ottawa, Ontario,
Canada
K1A 0A6
National Tuberculosis Elimination Strategy urgently needed to address public health concern
Dear Honourable Jean-Yves Duclos,
Tuberculosis (TB) is an airborne, communicable disease that has existed for millennia yet continues to impact every region of the world. Before the COVID-19 pandemic, TB was the world’s deadliest infectious disease and in 2021 alone, 10.6 million people fell ill with TB and 1.6 million people lost their lives. These tragic realities occur despite TB being both preventable and curable. In nations with the means to prevent and cure TB, such as Canada, TB remains a concern of major public health significance. Nationally, the disease affects Indigenous and newcomer populations disproportionately, which is notable as it is a disease strongly mediated by the influence of the social determinants of health. As a matter of fact, the incidence of TB shouldered by the Inuit population is nearly 300 times higher than the rate in non-Indigenous Canadians, while the majority of total cases in Canada are diagnosed among foreign-born persons. These two facts underscore major health inequities that continue to plague Canada.
Bearing this in mind, we urge the government of Canada to develop a National TB Elimination Strategy. To be effective, such a plan will need to be developed in collaboration with the provinces and territories, who carry out the majority of TB prevention and care services in Canada, and in partnership with Indigenous leaders and TB-affected communities. We support Canada’s commitment to TB elimination and point to the new edition (8th) of the Canadian TB Standards, published with support from the Canadian Thoracic Society, to guide a nationally coordinated effort toward that goal. More specifically, we call for a National TB Elimination Strategy that includes commitments, guidelines, and the funding required to:
1. Improve TB screening strategies among high-priority groups, and expand preventive therapy to those deemed eligible.
2. Address the social determinants of health and barriers to TB care, which can be achieved through addressing the upstream drivers of TB, including poverty.
3. Improve access to essential medicines for TB treatment, including eliminating out-of-pocket expenses for supplementary medications that support treatment adherence.
4. Implement a timely and robust TB surveillance infrastructure, to provide up-to-date surveillance data, appropriately disaggregated to highlight gaps in TB care.
5. Adopt accountability, monitoring, and evaluation measures for TB programming, through the implementation of the program performance monitoring framework outlined in the Canadian TB Standards.
A National TB Elimination Strategy will need input and support from communities and people affected by TB: immigrant Canadians (70% of people with TB), and Indigenous peoples (20-25% of people with TB), particularly those living in more remote, northern areas. TB elimination is possible, but depends on accessible prevention and care services that meet the needs of those most at risk. Progress towards the goal of elimination, therefore, requires the federal Ministries of Health, Indigenous Services, and IRCC to collaborate and coordinate with provinces and territories to set shared targets and strategies in order to achieve success.
The federal government made a specific commitment to reduce the incidence of TB by 50% in Inuit Nunangat by 2025, and eliminate the disease in the Inuit homelands by 2030. With these deadlines approaching, and given the setbacks to TB elimination efforts caused by COVID-19 disruptions, we support the adoption of a National TB Elimination Strategy that would address the national burden of TB. We urge you, as the Minister of Health, to implement a National TB Elimination Strategy, in alignment with your mandate of protecting the health of all Canadians, and follow through on previous commitments to TB elimination.
With kind regards,
[Signatures]
Ziad Aboultaif
Member of Parliament, Edmonton Manning
Valerie Bradford
Member of Parliament, Kitchener South—Hespeler
Don Davies
Member of Parliament, Vancouver Kingsway
Brendan Hanley
Member of Parliament, Yukon
Carol Hughes
Member of Parliament, Algoma—Manitoulin—Kapuskasing
Robert Kitchen
Member of Parliament, Souris—Moose Mountain
Michael McLeod
Member of Parliament, Northwest Territories
Heather McPherson
Member of Parliament, Edmonton Strathcona
Jenny Kwan
Member of Parliament, Vancouver East
Francesco Sorbara
Member of Parliament, Vaughan—Woodbridge
Gary Vidal
Member of Parliament, Desnethé—Missinippi—Churchill River
Arif Virani
Member of Parliament, Parkdale—High Park