Grant: Project Grant

Rates of Tuberculosis (TB) among the Inuit are up to 296 times higher than the Canadian, leading to significantly higher number of cases of disease and morbidity. TB is curable, but providing specialized health care in remote northern communities poses many challenges. In 2018 the Federal government and Inuit Tapiriit Kanatami (National Inuit organization) pledged to eliminate TB in Inuit Nunangat by 2030. A federal investment of $27.5 million over five years to develop plans support this goal was also announced. Presently, Inuit led region specific plans are being developed by the four regions in Inuit Nunangat. The largest of the four regions is Nunavut. We are working working our partners in the government of Nunavut and Nunavut Tunngavik Incorporated to model the potential epidemiological impact and cost-effectiveness of novel community wide TB screening programs. These programs have health professionals go into the communities, providing education around TB, offering TB screening and diagnostic tests to proactively diagnose TB among people who are not yet showing symptoms. By diagnosing patients before they become very sick and present to the health care system we can improve treatment outcomes and hopefully reduce further ongoing transmission in the community. These programs are very expensive and not all approaches can be employed or studied. This modelling study will allow us to answer key questions on the affordability and cost-effectiveness of scaling up and optimizing community wide screening programs that incorporate new tests and treatment approaches. It will help inform evidence-based policy development, allowing decision makers in Nunavut to assess under what conditions community wide screening programs may be scaled up, based on a value for money analysis that reflects local experience and needs.