Dr. Earl Hershfield, former director of the Manitoba's tuberculosis control program is pictured in Winnipeg in this October 23, 2009 file photo.Photograph by: Wayne Glowacki, Winnipeg Free Press
BERLIN — Over the past year, Canada contributed close to $140 million to global efforts to fight tuberculosis and other diseases in developing countries, including Sudan, Ethiopia and the Philippines.
But at home, where the silent killer has remained a scourge in remote First Nations communities for more than a century, the government will fork over a significantly smaller $10.8 million between 2010 and 2011 to combat the disease.
Some medical experts and aboriginal leaders say Canada’s international image masks the fact some Canadians still live in conditions often described as Third World, with residents of isolated reserves living in overcrowded homes rotten with black mould and with limited access to running water.
Gaps in access to treatment and effective outreach programs are as problematic in remote First Nations communities as they are in some of the poorest parts of Africa.
"Canada is seen as a wealthy country," said Chief Wilton Littlechild, a lawyer and advocate from Ermineskin Cree Nation in Alberta.
"That perception masks the real situation in indigenous communities. People think all communities are healthy and wealthy, but that’s not true."
Last year, a Winnipeg Free Press series revealed certain Manitoba communities have some of the highest TB rates in the world — up to 100 times that of the Canadian average.
While experts say it is shocking that TB exists in wealthy nations, Canada is in the same bind as nations across the globe. No one has figured out exactly how to treat TB and simultaneously address the underlying social conditions that help the airborne disease spread.
In an email statement, Christelle Legault, a government spokeswoman, said Canada has reviewed what other countries are doing to fight TB to determine whether some components would be useful in preventing and controlling the disease in First Nations communities.
Former Manitoba TB control director Dr. Earl Hershfield said Canada doesn’t need to borrow ideas or components of TB control from other nations. It just needs to commit to solving the problem.
"There are a lot of things you could do, but there’s zero political will to do anything," Hershfield said.
At a recent conference in Berlin, global experts discussed why a preventable, curable disease killed 1.7 million people last year.
Some believe new drugs and state-of-the-art diagnostics are the way of the future and that a faster method to track, treat and cure the airborne infection will make it easier for patients to adhere to a strict treatment regimen.
Others think that’s putting the cart before the horse, and that medical leaders from all nations need to start pushing governments to examine the real reason TB still exists: poverty.
"Maybe all the effort in treating TB is not enough. Maybe we need to do something about social determinants (of health)," Dr. Anne Fanning, former Alberta TB-control director and World Health Organization medical officer, told a crowd of medical colleagues in Berlin. "We’ve accepted (disparities) but ceased to address them."
Worldwide TB rates peaked in 2004 and began to decline, according to WHO’s evaluation co-ordinator, Katherine Floyd, who said the slow drop comes on the heels of an intense 15-year push to halve TB rates by 2015.
http://www.globalwinnipeg.com/health/Canada+accused+ignoring+rates+remote+First+Nations/3966051/story.html#ixzz18l4Z1sgU
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