Indigenous people experience disproportionate levels of disease; a new NGO at Simon Fraser University aims to change that.
Many people think of tuberculosis (TB) as a thing of the past, but for many Indigenous communities in Canada, it is still a prevalent and pressing concern. That’s why a trio of Simon Fraser University (SFU) students are teaming up to address the issue.
According to master of public health student at SFU, Jeannine Ho, this is a way of upholding the Declaration on the Rights of Indigenous Peoples Act (DRIPA). That’s why she founded the Partners in Health (PIH) non-governmental organization (NGO) chapter at SFU with fellow students Angel Bhinder and Kamryn Di Salvo.
“Our fundamental belief is that health care is a human right, no matter where you are in the world,” Ho told The Squamish Chief.
“PIH works on TB and other health issues around the world, but our SFU team has decided to specifically focus on Indigenous communities in this country.”
Alarming numbers
TB is a bacterial infection that primarily affects the lungs, though it can spread to other parts of the body. It is often exacerbated by crowded living situations, as well as risk factors such as smoking and poor nutrition.
“It is clear that TB is a disease rooted in social inequities with a colonial past. In Canada, we are starting to view health through a psychosocial lens instead of just a biomedical one. As such, many prevention-focused health initiatives are focusing on a holistic view of the issue, including TB,” said Di Salvo.
“According to the most recent data from Statistics Canada (2023), First Nations People are three times more likely, and Inuit People are 37 times more likely, to contract the disease than the general Canadian population. These numbers are incredibly alarming, since these groups only make up around 3% and 0.2% of the overall population.”
Those numbers are shocking.
“No one should be living at risk of such a disease. But it begs the question, why are such small segments of the population at the most risk of TB? Why don’t we hear much about action taken to address this issue?”
Systemic change
According to the SFU team, these numbers are a direct reflection of the racism and colonialism the communities have experienced, which lead to inadequate housing and lack of access to health care.
According to Bhinder, the only solution is systemic change, “which can best be accomplished through respectful and meaningful collaborations with First Nations, Inuit, and Métis partners,” she said.
“To support these collaborations, it is crucial to allocate sufficient funding towards screening for high-risk populations, interventions to address social determinants of health, improved access to essential medication currently not licensed in Canada, and modernized data systems.”
Without proper funding, Canada will not be able to meet its commitment to eliminate TB by 2035, nor ensure health equity for its most impacted populations.
“In 2023, Canada reaffirmed its commitment to addressing TB rates. One of Canada’s targets was to reduce the incidence of TB by 50% by 2025, compared to 2016 rates, among Inuit and Inuit Nunangat,” Bhinder said.
“Unfortunately, the incidence of active TB in Canada has remained unchanged over the last decade. High incidence rates among Indigenous communities highlight deep roots of racism and colonialism, and the lack of culturally safe practices in our healthcare system. This further implies that Canada is failing to fulfil the actions outlined in the DRIPA action plan, specifically actions 3.1, 3.5, 3.7 and 4.8.”
The Government of Canada has introduced a tuberculosis response in 2025, which is a positive step forward, as it recognizes that much work remains to address the lasting effects of colonialism that continue to create inequities among Indigenous communities. The response aims to advance reconciliation efforts, foster meaningful collaboration with affected populations, and employ a culturally relevant approach.
“To successfully eliminate TB in Canada, it will be crucial for the Government of Canada to maintain these commitments and regularly assess its progress,” said Bhinder.
Indigenous sovereignty
Tuberculosis is only one part of the problem—colonialism is the other. According to Ho, you can’t really discuss one without acknowledging the other.
“Forceful imposition of colonialist laws has violated Indigenous sovereignty and right to self-determination. These health disparities truly cannot be understood outside the context of racism and colonization, which has been widely documented as a key determinant of health for Indigenous Peoples,” she said.
“Indigenous health is fundamentally linked to historic and ongoing processes of structural and systemic inequalities that stem from this forced assimilation into Euro-Canadian ways of life. Cultural alienation from residential schools, removal of children during the 60s scoop, and ongoing child welfare policies have contributed to the loss of community, identity, and unequal access to health care.”
Those working on this issue feel it’s impossible to ignore, regardless of what social advancements have been made over the years.
“Whether we want to admit it or not, there is still ongoing racism and colonialism in all our systems and policies, which is why we still see highly disproportionate rates of TB in Indigenous communities.”
That’s why addressing TB is a more complex and multi-layered issue than it seems at first.
“Reducing harms for Indigenous populations is intertwined with reducing the harms of colonialism through Indigenous-specific solutions. By this virtue, policies, programs, and practice must focus on decolonizing,” she said.
“Decolonizing means promoting strategies that are community-based and peer-led, trauma-informed, distinctions-based, and culturally safe, with a reflexive component to ensure that colonization is not re-occurring. There’s also the concept of Indigenizing, which is developing healthcare policies and programs that integrate Traditional Ways of Knowing through teachings, ceremonies, land, and language.”
For those working on this issue, it means a complete reframing of the issue.
“Indigenous Peoples know what is best for them, and we as settlers who hold privileges must use our voices to advocate for the resources and funding required to address these health inequalities,” Ho said.
We must use our own voices and recede space to uplift and center Indigenous voices.”
Looking upstream
It helps to think of it like a river.
When envisioning ways to help communities struggling with TB, you can picture people being swept down a fast-moving river and calling for help. According to Di Salvo, there’s two different ways you can approach reaching those that need your assistance.
“You all throw them flotation devices and try to get them out. However, someone stops to ask: Why are these people falling into the river in the first place? This leads the rest of you to look upstream,” she said.
“We need to address the reasons TB is still persistent in a nation with a universal health-care system—i.e. falling into the river—instead of just treating them and sending them home—throwing them a floatation device.”
“If we can prevent TB in the first place, a lot of suffering can be avoided,” she said.
“Canada needs to work with First Nations, Inuit, and Métis representatives to ensure this elimination strategy is culturally relevant. There is so much that Western medicine doesn’t know about traditional healing and wellness, and this knowledge needs to be incorporated for this group to receive the best care possible.”
According to Ho, there is reason for hope.
“Indigenous Peoples are extremely resilient. Despite facing oppression, Indigenous Peoples have not only survived but have actively revived, reclaimed, and revitalized their culture and traditions through the guidance of their Elders and Ways of Knowing,” she said.
“This call for action is to name the impacts of colonization, address health disparities experienced by Indigenous People, call for equitable and culturally specific solutions, and generate discussions among community members, scholars, researchers, all levels of government, and people with lived experience.”
Working together to end TB
Reached for comment by The Squamish Chief, Nicholas Janveau of Health Canada shared a joint statement from Chief Public Health Officer Dr. Theresa Tam and Chief Medical Officer of Public Health Dr. Tom Wong on the subject of tuberculosis.
“Inuit, First Nations, Métis and people born outside of Canada continue to be disproportionally affected by the disease. Social and systemic factors, such as colonialism, racism, stigma, discrimination, structural inequities and inequitable access to health care, contribute to the ongoing occurrence of TB,” they wrote.
In the statement, they lay out their 2025 “Working Towards TB Elimination” strategy.
“While many challenges remain, the great progress being made in TB-affected communities through Indigenous-led initiatives offers us hope. These include Inuit Tapiriit Kanatami’s leadership in developing an Inuit TB Elimination Framework, and the development and implementation of local action plans in all four Inuit Nunangat regions.”
They believe Canada is on track to end the disease.
“Though we still have more work to do, from improving equitable access to TB medicines to ending stigma and discrimination associated with TB, elimination IS within our reach if we work together. By committing to collective action and supporting community-led initiatives, we can end TB.”
There is also a government webpage that focuses on tuberculosis in Indigenous communities, listing resources and celebrating recent breakthroughs.
•Please note that this story has been corrected since it was first published to say that the stat about First Nations People being three times more likely, and Inuit People are 37 times more likely, to contract the disease than the general Canadian population, is from 2023, not 2003, as first stated. The Squamish Chief apologizes for this typo.
