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Monica Shandal is a tuberculosis survivor and member of the support network TBpeople Canada. This piece was written in collaboration with Ekatha Ann John, the Global Health Policy and Advocacy Manager at Results Canada.

In 2021, when the world was grappling with COVID-19, my personal battle against an ancient killer unfolded in the quiet corridors of an Alberta hospital. I was diagnosed with tuberculosis (TB) and unexpectedly thrust into a year-long journey marked by multiple hospital visits, tests, and drugs with serious side effects.

I know that my protracted battle with TB wasn’t owing to a lack of scientific capacity in Canada, or even the globe. I saw the world roll out multiple vaccines for COVID-19 less than a year after its declaration as a pandemic. Yet, TB continues to be fought with outdated tools. The Bacillus Calmette-Guérin (BCG) vaccine – the only vaccine for TB – is more than 100 years old and has limited effectiveness. This is shocking considering TB has been affecting humans for over 9,000 years and is currently the world’s leading infectious disease killer.

I was, however, fortunate to have supportive health care. As I connected with TB survivors and others around the world affected by the disease, it dawned on me that my positive experience with the health system was rare. My collaborator on this piece, Ekatha, lost a friend to TB in India. We are united in our frustration that TB continues to devastate communities in Canada and abroad.

Like COVID-19, TB is an airborne respiratory infection. Despite being preventable and curable, in 2021 (the year I got my diagnosis) TB claimed 1.6 million lives worldwide, and more than 10 million people fell ill with it. Although the overall prevalence of the disease is low in Canada, it remains a significant concern among newcomer populations. Inuit people are also more likely than non-Indigenous Canadian-born people to be infected. Globally and within Canada, it’s estimated that COVID-19 further delayed the fight against TB by a decade, as resources were redirected to the emerging pandemic.

Last month, Canada attended the second United Nations High-Level Meeting (HLM) on TB, where world leaders came together to take stock of the progress made toward global TB elimination targets set by the UN and Canada in 2018. Unfortunately, nearly every target in those declarations has been missed, and funding needs have more than doubled owing to years of underfinancing as well as the effects of COVID. Earlier this year, the government of Nunavut had to deal with its largest reported TB outbreak since Canada promised in 2018 to eliminate the disease from the region by 2030.

The UN meeting began with some positive news. Prime Minister Justin Trudeau had announced that Canada would invest $25.5-million over three years in the Stop TB Partnership’s TB Reach initiative – an innovative financing mechanism that locates people needing care in hard-to-reach communities. Canada also helped to ensure there was strong language in a new political declaration outlining key targets and commitments to TB elimination, allowing for greater accountability.

However, we were pained to see that Canada had no high-level political representation at the meeting itself, despite two ministers and the Prime Minister attending other events at the UN in New York that week. Another glaring omission was the lack of inclusion of people with lived experience of TB in Canada’s official delegation, who had been included in 2018. This, again, was a missed opportunity to include the voices and experiences of those disproportionately affected by TB, including Indigenous communities.

Dr. Theresa Tam, Canada’s Chief Public Health Officer, who represented Canada at the TB HLM, reaffirmed Canada’s commitment to ending TB, expressed strong support for the political declaration and reiterated its past commitments, including the $1.2-billion pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Canada made promises again, but we still lack a specific strategy for eradicating TB – dooming us to repeat the same mistakes. For Canada to deliver, it must back up the targets it set with more concrete political and financial investments. More specifically and urgently, Canada must implement a National Tuberculosis Elimination Strategy, developed in collaboration with the provinces and territories and in partnership with Indigenous leaders and TB-affected communities. Canada must also meet its “fair share” target of allocating 0.15 per cent of its total research and development expenditure to TB.

Now more than ever, people affected by TB need hope and solutions. This can still be a year of action for Canada to help get the world on track. Failure to take action would be a missed opportunity with consequences that will affect millions of lives. For Ekatha, the disease left her bereaved. In my story, the disease left me with the pain of knowing that my struggle could have been avoided if decision-makers had turned more of their attention to this deadly disease earlier.

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