Mr. Speaker, when we look at the frequency and the situation of the disease, we must consider not only where we are but also where we have come from and where our strategy to reduce the frequency of this disease should take us.
In the 1930s we were faced with death rates, not incidence rates but death rates, of 700 per 100,000 population among Canadian Indians.
An extensive program to discover and treat active cases of TB was begun in 1938. In the late 1940s the necessary funding and expertise were provided, new sanitoria and nursing stations were built and aggressive case finding, extensive vaccination and new treatment regimes were begun.
These early efforts bore fruit and today the mortality rate is almost negligible while the incidence of TB has been dramatically reduced. In 1992 the rate was 60 per 100,000 population using official population figures for the First Nations communities.
The reason we were allocating additional funds to implement a national strategy for the elimination of aboriginal tuberculosis was because the decrease in rates had stalled. There remains a number of active TB cases in older people who continue to harbour tuberculosis and who become infectious as they get older and suffer from other diseases and debilitating conditions.
The government has been spending $1 million per year to address this problem and has allocated an additional $2.8 million over the next three years.
While the spread of TB to other people is facilitated by overcrowding and other personal and environmental conditions, the main way to eliminate the disease from the population is to find active cases at an early stage and treat them before the bacterium is spread to contacts, particularly young children who are especially susceptible.
The strategy which this department in partnership with First Nations communities is putting in place aims to reduce the incidence of TB to less than 20 per 100,000 by the year 2000 and to eliminate the disease by the year 2010.