Congenital Syphilis in Newborns

"In high-income countries you see it in pockets of disadvantaged populations."

"It's a marker of inequality Its a marker of low-quality prenatal care."

Teodora Elvira Wi,World Health Organization HIV, Hepatitis and sexually transmitted infection program

"It's just the whole system, and all the things that we've done in bad was no to support Indigenous communities."

"We probably need a million tests to get out there around the country. The solution's right in front of us."

Sean Rourke, scientist with the Li Ka Shing Knowledge Institute, St.Michael's Hospital, Toronto

 

"All of the social circumstances that contributed to this have just gotten worse over the [time and diversion of health-care attention] pandemic."

Ameeta Singh, infectious diseases specialist, HIV/STI practice, Edmonton, Alberta 

Syphilis has made a resurgence globally in the last five years, and in that time, Canada has the distinction of being far ahead of other wealthy, developed nations in the steep rise of the sexually-transmitted disease that has resulted in much larger numbers of Canadian children born with syphilis than its counterparts proportionally throughout Europe. 

According to Health Canada, the incidence of babies born with syphilis has reached 26 per 100,000 live births in 2021, an increase from 2 in 2017. Expectations are that the increase will continue, in accord with preliminary government data. Congenital syphilis places babies at higher risk of low birth weight, bone malformations and sensory difficulties, outlines the World Health Organization. It is the second-leading cause of stillbirth worldwide.

It is, on the other hand, a condition readily preventable should an infected woman have access to penicillin throughout a pregnancy. Only the United States reported a higher incidence of syphilis at birth, logging in at 74 per 100,000 live births in 2021, triple 2017's numbers as revealed by the U.S. Centers for Disease Control and Prevention. In a population of 332 million, 2,677 cases of congenital syphilis emerged, reflecting preliminary CDC data, while Canada had 96 cases for a population of 38 million.

It is Canada's Indigenous population that experiences a disproportionate number of these births, often having poor access to health and social services, that sets Canada apart, leading to these high numbers. According to Jared Bullard, a Manitoba pediatrician researching babies born with syphilis since 2021in a longitudinal study for the Public Health Agency of Canada. "It's pointing at multiple failures along the path".

Canada's three prairie provinces, Manitoba, Saskatchewan and Alberta see the concentrated rise in babies born with syphilis. They also experience higher crystal meth use, have remote populations where Indigenous populations may find it difficult accessing health care. The highest rate of such births are recorded in Manitoba, with some 371 cases per 100,000 live births in 2021.

A public awareness campaign urging people to practise safe sex and to get tested has been launched in Saskatchewan A study revealed that at least two-thirds of babies born with syphilis were born to women reporting a history of substance abuse. 45 percent of the women identified as Indigenous, another 40 percent no ethnicity recorded in a reality where Indigenous people represent about five percent of the Canadian population.

 

Doctors and outreach workers are hopeful wider use of a new rapid test for syphilis could help slow the spread of the dangerous sexually transmitted infection.   CBC

"[Research into syphilis is complicated by the fact that the] bacterium is very difficult to work with,"

"We really don't understand how it works, how it infects a person or ways to appropriately combat it, or prevent that infection."

"We are starting to get more philanthropic organizations who are providing funding for research and we're starting to see more people join the field, which is what is really needed in order to get those innovative research programs going,"

Caroline Cameron, professor, department of biochemistry and microbiology, University of Victoria

Pitting Diminished GHS Against Food Production

"So, let's review: A policy of cutting fertilizer use in Canada, a country that leads the world in prudent fertilizer use already, will hurt farmers, cut production, starve the poor, raise food prices for everyone, benefit other grain growing countries and ... increase GHGs."

"Farmers are stoic people. We have to be. We deal with an impossible Canadian climate, prices that are set globally, already high taxation and regulations."

"We've already borne the brunt of carbon taxes on fuel. But now, we are looking at a fertilizer reduction policy that not only will hurt us, but hurt everyone. Especially the poor."

"With no net global benefit."

Gunter Jochum president, Western Canadian Wheat Growers

Canada's Liberal-led government with Prime Minister Justin Trudeau at the helm has decided it makes eminently good sense to increase the price of food staples. It is in the process of consultation around a policy mandating a 30 percent nitrogen fertilizer reduction. A move that would have the effect of disproportionately affecting Prairie farmers where grain is the major crop. Grain just happens to require greater amounts of fertilizer to cultivate and extract larger crops from rolling plains of wheat.

 

This Trudeau government is fixated on the environmental impacts of climate change. Inflicting carbon taxes on the nation that also impacts more detrimentally on those living in rural areas, and even more so, farmers, keeping their farm machinery running and trucking out their crops.  Greater operational costs and less use of fertilizer leads to a diminished food supply. Which effectively counters the government's own goals on agricultural exports. The most basic staples in Canada and worldwide would see a rise in growing and production costs.

Fertilizer just happens to be the most expensive investment in crop farming. Farmers are accustomed to using just enough fertilizer and no more, in reflection of the cost involved; in other words there is full consciousness of conservation of resources at play without government intervention. Wth a 30 percent cut in fertilizer-based emissions, the outcome will be less food producing, greater strain on the supply chain and higher prices for basic foodstuffs. And Canada is a major exporter of grains.

 

Harvested wheat fields near Cremona, Alta.. In Manitoba, which is facing tens of millions of dollars in damages as a result of flooding and wet weather this spring, some farmers haven't even been able to get out onto their land yet. (Jeff McIntosh/The Canadian Press)

 

There is a vicious cycle at play here where inputs into grain production becoming more expensive results in fallen production. With scarcer products available, prices increase. Those most affected are always the poor wherever they are, in Canada itself and internationally as well. Government policy highlights the need to see that Canada's abundant crop yields help feed the world at large. A goal not possible to reach while reducing the fertilizer supply. 

Calculating a 30 percent cut in the use of nitrogen fertilizer reflects the StatsCan data of Canada producing 1.5 percent of global Greenhouse Gas emissions. This is a reflection of the entire agricultural sector; grains, livestock and every aspect of agricultural production, producing 10 percent of Canada's GHG. Under half of the Canadian total of GHGs is produced by nitrogen fertilizer, the remainder represent burning fuel and cow burps. Should Canada's fertilizer emissions be cut by 30 percent, global GHGs would fall, but by a mere negligible 0.02 percent.

Reduced export crops to the global community resulting from a mandated 30 percent reduction in fertilizer will leave a gap that will be swiftly filled by other grain growing and exporting countries such as China and India, both of which countries use greater amounts of fertilizer more intensively than Canadian grain farmers; effectively shifting production to countries with higher GHG production. Badly thought-out environmental plans that serve to diminish the effective potential of good farming.