Global Indigenous STOP TB Initiative

1
Global Indigenous STOP TB Initiative Dr Kim
Barker, Public Health Advisor, Assembly of First
Nations, Canada
2
Overview

• Who are the indigenous?
• What makes them vulnerable? Case in point
  examples
• Why focus on Tuberculosis?
• Options going forward

3
Who are the Indigenous Peoples?

• 370 million people identify as indigenous in over
  70 countries
• 5 of the worlds population
• 15 of the worlds poor
• 30 of the worlds extreme poor in rural people

4
Historical Context
5
Current Day Realities Global Examples

• Bolivia infant mortality rate among the
  indigenous populations is close to 75 of 1,000,
  compared to 50 of 1,000 for the non-indigenous
  populations
• Guatemala 53.5 of indigenous youth have not
  completed primary school compared to 32.2 of
  non-indigenous Guatemalans
• Canada rates of TB in Aboriginal communities
  are 20-30 times higher than non-aboriginal born
  Canadians

6
Case in Point Oral Childrens Health

• 95of FN Children in the Sioux Lookout Zone
  require general anaesthetic intervention for
  Early Childhood Caries
• DMFT Index Toronto1.1
• DMFT Index non-First Nations2.5-2.8
• DMFT Index First Nations Southern
  Ontario3.5-4.8
• DMFT Index First Nations SLZ Ontario10-13.7

7
Case in Point Food Security

• Food insecurity driven by highly inflated food
  prices with no subsidies
• Milk is 12 for 4L, alcohol is regulated
• Loss of traditional ways and access to the land
• Environmental contaminants and climate change are
  additional threats

8
Why focus on TB?

• At the turn of the century extensive public
  health systems were created to improve living
  conditions and hygiene
• When effective medication became available the
  number of tuberculosis cases dropped
  dramatically.
• As the numbers dropped, officials and the public
  became complacent. Despite high rates of
  tuberculosis that persisted in the poorest
  communities and countries, there was a belief
  that modern medicine had defeated this ancient
  enemy. Funding was slashed and tuberculosis
  control declined. Clinics were disbanded and
  hospital beds for tuberculosis patients were
  eliminated.
• After decades of decline, tuberculosis rates
  have sky rocketed due to increasing homelessness,
  greater poverty, over-crowding and the emergence
  of HIV-AIDS

9
How invisible can 370 million people be?
10
UNPFII potential role

• The United Nations Permanent Forum on Indigenous
  Issues was created by the United Nations Economic
  and Social Council (ECOSOC) in July 2000),
  through resolution 2000/22 with the mandate to
  provide expertise and recommendations on
  indigenous issues to the United Nations through
  ECOSOC. The forums role includes promotion and
  coordination of activities, as well as, the
  preparation and dissemination of information
  specific to indigenous issues.
• Across all hemispheres and latitudes there is one
  common health issue facing all Indigenous groups
  globally higher rather of TB than the
  non-indigenous citizens
• UNPFII requests countries to report back on
  targets annually why not TB?

11
WHO-STOP TB Initiative in Partnership with the
AFN and ITK

• As a result of tabling a resolution at the most
  recent UNPFII, the Canadian Government, together
  with PHAC and WHO sponsored a meeting of global
  TB experts and Indigenous leaders November 13-14
  in Toronto.

12
Purpose of the Meeting

• to develop a strategic plan that will aim to
  include indigenous groups globally in National TB
  programs, encourage the collection of
  disaggregated data and promote the implementation
  of culturally appropriate best practises.

13
Potential Next Steps

• Creation of a Secretariat?
• Assurance of the Global community commitment to
  including Indigenous groups in their policy and
  program development as it relates to TB?
• Other?

14
Thanks!

• kbarker_at_afn.ca