Thank you, Madam Chair and members of the committee. I'm pleased to be here on behalf of the Canadian Lung Association, and I wish to thank the committee for recognizing that this is a serious issue that deserves the attention of Parliament.
Rather than repeat a lot of the information that you've already heard this morning, I want to reinforce two points from the lung association's point of view. These are that we do need improved treatment of tuberculosis, and secondly, that we also need to be addressing the social determinants of health.
But there are a couple of other points I'd like to raise. The third point has to do with the nature of the support that's required for tuberculosis. It has to be long-term and sustainable support, and one of the reasons for that is due to the disease itself. Some diseases are dangerous because they grow very quickly and rapidly, but tuberculosis is dangerous because tuberculosis germs grow very slowly. In a society where we appreciate speed, that might be hard to comprehend, but it takes six months or more of taking combinations of drugs to cure a case of tuberculosis. Without intervention, a tuberculosis epidemic can take 200 to 300 years to run its course.
The lung association has been fighting tuberculosis for 110 years; we are here for the long term. Solutions to TB problems in first nations, Métis, and Inuit communities will require long-term programs, with long-term indicators for success, and long-term, sustainable funding. One of the things to consider in looking at these indicators is that if you start improving TB control programs, initially you're probably going to find more tuberculosis. Rates of tuberculosis might even experience an initial increase, and that shouldn't be a reason that one would yank the funding. You have to look at this in the long term.
If we look at where rates are among the aboriginal population right now, it's been about 30 years since rates were that high in the non-aboriginal component of the population. It took 30 years to bring that rate down below one per 100,000. We have better tools now. As Dr. Long has said, a lot of the high risk and high rates of tuberculosis are located in geographically confined communities. We can achieve a faster decline of rates of TB in the aboriginal population, but we still need to build capacity and work with first nations and Métis and Inuit community leaders and champions to make effective TB control a reality.
A couple of programs have worked. The SCRAP-TB program, which was developed in B.C., and the World Health Organization's PAL program appear to have some promise. Both of these programs are based on the notion that there's not one size that fits all.