Thanks very much. I'm going to deviate from my prepared remarks to try to summarize their essence.
It's fantastic that this issue is being addressed by this committee. Congratulations. It is a blot on the conscience of Canadians that the disparity is as profound as it is.
TB control requires a very standard, globalized approach that you've heard about. You find the cases, you cure the cases. You find the contacts, you prevent them, and you do so on an urgent basis for the reasons already described. There's no question about it.
Canada has those standards, but we do not have performance indicators at the regional level to determine whether the standards are being met. These should be measured on an annual basis, and we either pass or fail. We deliver that program in order to save lives, prevent transmission, and to reach elimination strategies.
There is no question that we can do it, because we did it in the fifties when rates were 2,000 to 3,000 per 100,000 people. Now the rate is four per 100,000. But in the north, where a determined Canadian program or policy was put in place—I'm sure at great expense—the rates fell faster than they did anywhere else in the world. They hit their nadir, the bottom, about the mid-eighties.
Since then, they've been rising, because our attention has shifted. We failed to sustain what we were required to do to ensure that we reached the elimination point, and the rates have gone up and up and up in every region of this country, but especially in Nunavut among the Inuit. The rates have gone down in one province, which happens to be Alberta.
I hesitate to brag, but I want to tell you how that program is described. It's described as “pigheaded”, because we are determined to do it. The program works because there is collaboration between the federal and provincial authorities and there are performance indicators measured annually. People talk to each other, and when a case occurs, it is considered an emergency and urgent action emanates as a result. I suggest this happen everywhere.