Finding the right frame: What is the problem represented to be in a national tuberculosis strategy

Abstract

This paper examines how a problem representation that targets specific populations impacted the formulation of a national tuberculosis strategy in Canada. Globally, one third of the world population is infected with tuberculosis (1). Tuberculosis has garnered increased international attention with the emergence of multi-drug resistant TB. International standards endorse that low incidence countries enact TB policies that address the most vulnerable and hard to reach groups (2). In Canada, a low incidence country, two groups are disproportionately affected by TB: the Aboriginal and foreign-born populations (3).

In 2014, Health Canada and the Public Health Agency of Canada released a national strategy for TB (3). This analysis of the “Framework for Action” policy document will focus on problem framing using Bacchi’s theory of “What’s the problem represented to be?” (4)

The choice of a problem frame reduces the complexity of tuberculosis and its political and social connections. Specifically, problem frames containing target populations are influenced by the social constructs of that population. This paper will argue that narrowing the frame of tuberculosis to a development issue in the Aboriginal population and a security issue for the foreign-born population has implications at the domestic and international level.