A tuberculosis outbreak in the Canadian Arctic has prompted frustration in a remote Inuit community and highlighted the persistence of an illness that has largely been wiped out in the rest of the country.
The outbreak also lays bare the dismal living conditions and overcrowding in many Arctic communities, despite Canada’s status as one of the world’s wealthiest nations.
Officials in Nunavut say there are 31 cases of active tuberculosis in the hamlet of Pangnirtung, a community of 1,500 on Baffin Island. There are also an additional 108 cases of latent tuberculosis – a form of the illness that puts patients at risk of developing an active form of the respiratory illness in the future and can be resistant to vaccines.
Tuberculosis, one the largest killers in North America in the 20th century, is caused by the contagious bacterium Mycobacterium tuberculosis, which predominantly attacks the lungs. It can cause a fever and in some cases, a chronic bloody cough. The outbreak in Nunavut is the worst since 2017, when a teen girl died of the illness.
Territorial officials had so far resisted sharing precise data with residents and news outlets. On Thursday they released data that showed the scope of the outbreak.
“The information should have been provided to us regularly to begin with,” the Pangnirtung mayor, Eric Lawlor, told the Globe and Mail. “This is more concerning than Covid, actually.”
The government of Nunavut spends about C$10m a year on treatment alone but says the costs of prevention and eradication are far higher.
Because of chronic overcrowding in houses, poverty and a lack of access to medical care, the average annual rate of TB among Inuit is 290 times higher than in Canadian-born, non-Indigenous people, according to a 2018 report from the Public Health Agency of Canada.
In 2020, there were 72.2 active cases of TB per 100,000 population among Inuit, according to the public health agency. The national case rate is 4.7 per 100,000.
The outbreak, while it has concerned health officials, has also served as a stark reminder of the region’s troubling historical relationships with the illness.
Indigenous peoples, including the Inuit, were involuntary test subjects for experimental tuberous vaccines beginning in the 1930s. That treatment is the subject of a class action lawsuit.
Beginning in the 1940s, Inuit were separated from their family and brought to tuberculosis sanatoriums in southern Canada.
Many lived in the facilities for years, and their families often weren’t told about their whereabouts or conditions, even when they died. The practice continued until the 1960s.
The treatment of Inuit was the subject of an apology by Justin Trudeau in 2019.
“For too long, the government’s relationship with Inuit was one of double standards, and of unfair, unequal treatment,” the prime minister said.
The year earlier, Trudeau pledged to eliminate tuberculosis in the region by 2030 – a promise that he looks unlikely to fulfill, given that rates of the illness have little changed since his pledge. While the coronavirus has delayed eradication plans, critics say insufficient political and government funding is also to blame.
