A prominent health researcher says Inuit newborns are at risk of serious illness and even death because the Nunavut government won't distribute a drug to all infants in remote communities.
In a recent article for the Canadian Polar Commission, Dr. Anna Banerji says the preventative antibody palivizumab would save dozens of babies from a serious respiratory illness that often forces them to be airlifted from their homes and treated in intensive care.
Banerji suggests the treatment would save money for the territory by reducing medical evacuations now that the peak season for respiratory syncytial virus, or RSV, is at hand.
"There's really no justification not to give it," said Banerji, a pediatric infectious disease specialist at the University of Toronto.
The Canadian Pediatric Society agrees with her conclusions, but Nunavut's medical health officer says the territory will stick to its policy of reserving the antibody for premature or otherwise weakened newborns.
"We're very sensitive to what (the society) has said, but when looking at our program, we feel it's been quite successful," said Dr. Isaac Sobol from Iqaluit.
Inuit babies in Nunavut suffer from the world's highest rates of respiratory infections, mostly from RSV. In 2002, the rate of infected newborns on Baffin Island was 16 times the Canadian average.
The infection is serious. Banerji's study found one in four infected infants wound up on life support, and the disease often has long-lasting health effects.
The impact is worst in Nunavut's remote communities where overcrowding and poverty are high. In some Baffin Island communities in 2002, more than one-third of babies less than a year old were infected.
Banerji said that palivizumab is 80 per cent effective against RSV and there's no reason not to give it to every child born in high-risk hamlets.
"If this happened in the rest of Canada, there would be a lawsuit."
In October, the pediatric society recommended that "consideration should be given" to administering the antibody to all full-term Inuit infants younger than six months of age at the onset of the RSV season in northern remote communities.
And even though the treatment costs about $6,500 per infant, that's still cheaper - and less traumatic - than flying babies to Iqaluit, Ottawa, Yellowknife or Edmonton, Banerji said.
Sobol said Banerji's conclusions are based on only one year of data. Public health programs have reduced infection rates, which fell 28 per cent between 2004 and 2006, he noted. Hospitalization has also been reduced.
"That's our first priority, to protect children. We're not convinced that following the Canadian Pediatric Society's recommendations would result in significant changes to current trends."
Sobol also disputed Banerji's assertion that giving palivizumab to all babies is cheaper than airlifting the ones who get sick. RSV can be fatal, but he pointed out no babies have died from it in recent years.
Banerji maintains that this RSV season, which begins in January and lasts until spring, is likely to be worse than usual because of the H1N1 virus.
And a lowered infection rate in Nunavut is still many times that of southern Canada, she argues. Banerji said northerners shouldn't have to accept that when an effective solution exists.
"People say, 'Well, this is the way it is in the Arctic. We always have RSV season and the kids get hospitalized and some of them get chronic lung disease.'
"But when we have an alternative and now we've shown that its usage can actually save money, there's zero justification for not using this antibody.
"Do we have to wait for kids to die?"
