The Government of Nunavut has agreed to share detailed data about the spread of tuberculosis with the territory’s top Inuit organization, but it won’t divulge those figures to the public as called for by Nunavut’s Information and Privacy Commissioner.
Nunavut Health Minister John Main and Aluki Kotierk, the president of Nunavut Tunngavik Inc., signed a tuberculosis information-sharing agreement in Iqaluit on Monday. Both described the deal as a first step toward better co-operation on eliminating TB in Inuit communities, something the federal government vowed to achieve by 2030.
“I think it holds a lot of promise in terms of what we can do to support Nunavut Inuit who are impacted by tuberculosis,” Mr. Main said of the agreement. “The TB file is just so heavy that it really makes sense to establish these types of agreements with our partners.”
Nunavut continues to fight an outbreak of tuberculosis in Pangnirtung, a community of about 1,500 people on Baffin Island. More than 160 infections, 35 of them active cases that made patients sick and contagious, were diagnosed in the community between January of 2021 and August of this year.
The outbreak is the worst to be publicly reported in Nunavut in at least five years.
The territorial government divulged those numbers only after The Globe and Mail travelled to Pangnirtung to report on the situation, and after the hamlet’s mayor advocated for transparency.
The Globe’s investigation of the Pangnirtung outbreak found that front-line nurses were begging for help in the summer of 2021 as tuberculosis cases piled up and the territory’s Chief Medical Officer of Health held off on declaring an outbreak.
In some recent years, tuberculosis rates have been as much as 300 times higher in Inuit communities than among non-Indigenous people born in Canada, a disparity that spurred the Liberals’ elimination promise in 2018. But curbing tuberculosis, a contagious bacterial infection that can be fatal if left untreated, is proving a challenge in remote Inuit communities where poverty, overcrowded housing and limited access to medical care make residents particularly vulnerable.
As tuberculosis spread in Pangnirtung, the Government of Nunavut and NTI were at an impasse on the development of a regional action plan to battle TB. The plan was supposed to spell out how $13-million in federal funding allocated to NTI would be shared with the territorial government and spent on TB elimination measures.
But the two sides couldn’t agree on information sharing, let alone a broader plan to tackle TB.
The territorial government refused to divulge TB case counts by hamlet to NTI or the public because it feared communities with TB would be stigmatized. NTI, meanwhile, wanted community-level TB data released publicly as the government did with COVID-19 cases during the worst of the pandemic, arguing Inuit deserved to know. (The government made an exception in the case of the Pangnirtung outbreak.)
NTI’s position was bolstered by a February ruling from Graham Steele, Nunavut’s Information and Privacy Commissioner, that concluded the territorial government had no legal basis to withhold community-level TB data. The ruling arose from an appeal filed by The Globe.
In an interview Monday, Mr. Steele called the information-sharing agreement a positive step, but said that “sharing a secret with NTI means it’s still a secret.” He again urged senior Nunavut health officials to heed his ruling, despite it not being binding on the government.
The text of the agreement offers hope that the Nunavut government will one day make more TB data public. It says the two sides are committed to “creating and sharing a defined set of public-facing indicators that include relevant epidemiologic data.”
Michael Patterson, Nunavut’s Chief Medical Officer of Health, said that work will begin right away. He added that territory-wide TB case counts and rates for 2021, along with an update on the situation in Pangnirtung, should be made public shortly.
As far as the $13-million in federal TB money, about $11-million of which remains with NTI, Dr. Patterson said the two sides intend to negotiate funding deals for individual projects that will contribute to reducing TB in the territory, rather than drafting an “all-encompassing” regional action plan.
Ms. Kotierk, the president of NTI, was not available for an interview Monday. A news release from the Government of Nunavut said that, as part of the information-sharing agreement, NTI has promised to provide “national TB elimination action plan updates and progress, including funding allocations towards the regional action plan.”
NTI, whose formal role is to ensure the government keeps the promises made to Inuit in Nunavut’s founding agreement, also committed to holding an online TB training course for the public.
Federal Indigenous Services Minister Patty Hajdu has been urging NTI and the territorial government to set aside their differences. “This information-sharing agreement between the Government of Nunavut and NTI represents an important step forward in the work to eliminate tuberculosis across Inuit Nunangat,” Ms. Hajdu said in a statement, referring to the four regions that comprise Inuit lands in Canada.
“Access to good, reliable data will help to guide targeted action and investments from all levels of government into the areas that need it the most.”