National Chief of the Assembly of First Nations Statement on Tuberculosis
This featured chapter is a welcome addition to the Canadian TB Standards, as it sheds light on the historical relationship and ongoing struggle First Nations have with TB. Shortly after the establishment of the reserve system, implemented through the Indian Act, First Nations have suffered destructive consequences of TB. This continued when our children were removed from their families and sent to institutions of assimilation and genocide — residential schools. In 1907, Dr. Peter Bryce, an early medical whistleblower documented the horrific conditions that facilitated the spread of TB. The number of TB casualties during the era of residential schools was inhumane and unprecedented. Though First Nations’ TB rates fell significantly toward the end of the 20th century, TB rates remain higher than non-Indigenous Canadians — particularly in northern and remote communities. Substantial progress toward national and global TB eradication by the year 2030 will occur once all determinants of TB are addressed. Equitable healthcare at the First Nation community level, with capacity to manage the total transfer of health services supported by sustainable investments and complete jurisdiction, will be strong indicators of progress.
Giannakakos!
Wishing you Peace beyond all understanding,

President of Métis National Council’s Statement on Tuberculosis
The history of TB in Inuit Nunangat is one of colonization and loss, but also of resiliency in the face of hardship. The story of eliminating TB from Inuit regions will be told in terms of solidarity and self-determination. Our strength in unity, resilience in the face of hardship, and a strong grip on our traditions have sustained us during challenging periods marked by colonization and disrespect for our human rights. We have our language, our culture and our food. We have the way that we raise our children. We have a love for not only the land but all things that live within it. We know how to hold each other up to persevere through difficult times. We are alive today because of Inuit unity and resilience. These characteristics are still very evident in our communities. Unfortunately, we have no shortage of challenges upon which to unleash this potential today. The high rates of TB in Inuit regions are a symptom of social inequities that enable the spread of TB, diminishing the health and wellbeing of too many of our people. It is vital that everyone from government leaders to policy-makers to frontline workers understand the conditions contributing to the exceedingly high rates of TB in Inuit communities. Recognizing that TB is directly linked to poverty, insufficient access to healthcare, and overcrowded housing conditions is crucial as we continue to work together to eliminate this disease. All of those who provide health care in Inuit regions have a part in helping Inuit eliminate TB from their communities. TB elimination will be an incredible feat of cooperation and collaboration. We need to work together to ensure TB care for Inuit is evidence-based in design and is Inuit-specific in delivery.
Natan Obed
President
President of Métis National Council’s Statement on Tuberculosis
The Canadian Tuberculosis Standards represent a significant step forward in tackling TB within the Métis Nation, and we thank all who contributed to this important work. TB continues to have serious impacts on the health and well-being of Métis Nation individuals, families and communities. Strong and sustained efforts are needed at all levels of government to reduce its harms and to eliminate TB in our population. Increasingly, policy and decision makers and health care workers alike recognize and understand that the Métis Nation is a distinct Indigenous people with unique health challenges and needs. This recognition is essential in ensuring culturally relevant, culturally safe and effective TB prevention, treatment and care for the Métis Nation. Along with the profound and persistent, negative impacts of colonialism, past failed health policies, and the negative impacts of the social determinants of health, ongoing jurisdictional disputes around responsibility for Métis Nation health continue to hamper efforts to reduce TB within the Métis Nation. While Métis Nation citizens have access to mainstream provincial services, these services often do not meet the specific resourcing, cultural, and geographical needs of Métis Nation individuals and families, especially those living in more rural and isolated areas. Federal systems established to address the health needs of Indigenous people in Canada to this day remain exclusive of the Métis Nation, further exacerbating these health disparities. Neither do current data systems have the capacity to accurately assess or track TB in the Métis Nation, and Métis Nation-specific research and data remain limited and inadequate to the task. It is clear that there is much work to be done to understand and effectively address TB within the Métis Nation. The distinctions-based approach adopted in the development of the new Canadian Tuberculosis Standards makes an import- ant contribution in this collective, ongoing effort.
President Cassidy Caron
Métis National Council
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