Around one third of the world population is estimated to be infected with the TB bacterium and is at risk of developing the disease. There were 8.8 million new cases of TB in 2010 and the disease killed a staggering 1.4 million people. Many more struggle with the disease which, apart from causing human suffering, slows down economic growth. The situation is said to be serious in Europe, alarming in Africa and worrisome in parts of Asia. And yet, the current TB drug treatment regimen is just too old, grossly inadequate, and unable to control the epidemic. There is just one vaccine available, which was discovered almost 100 years ago, and which provides limited protection.
Not only is there a dearth of effective and patient friendly medicines, there are discriminatory policies too in many countries, either by law or by society, which reduce access to healthcare services for the affected populations due to fear and mistrust. From the public health point of view, the consequences are catastrophic ? lower case detection, increased infection rate, and more of drug resistant TB. The vulnerable tuberculosis population consists of women and girls (who account for more than 50% of our planet?s population and are still discriminated), injecting drug users in congregated settings, migrants/ immigrants, poor or malnourished people particularly children, among others. We all know that it is unethical to discriminate against TB patients or for that matter those suffering from any disease. This prevents access to healthcare and helps in spreading the disease rather than curbing it.
Dr Gilles Cesari, Regional Director at the International Union Against Tuberculosis and Lung Disease (The Union)?s office in Singapore, spoke to CNS at the recently concluded 42nd Union World Conference on Lung Health, Lille, France. Dr Cesari informs that ?Transgenders, female sex workers and people living with HIV are refused access to care in some TB DOTS Centers in Bangladesh; 63 countries have some form of HIV (or TB) specific restriction to entry, stay and residence of immigrants; and 28 countries deport people once HIV+/TB status is known.?
Dr Cesari feels that at the grassroots level, a lot has to be done to enable vulnerable populations to access proper TB treatment. He cites the example of ?Singapore, which I thought was an ideal place to live in. But then I saw the sorry state of its discriminatory laws in public health. It heavily discriminates against migrants (who are legally staying in the country) as far as TB is concerned. As soon as they are diagnosed with TB, which they contracted in Singapore, they are immediately deported to their home country. This is not only sad from human rights point of view; it is catastrophic from a public health perspective too. These people obviously are afraid to go the healthcare centres for fear of reprisal. So they knowingly do not access treatment spreading the disease in their community. All this could be prevented only if they had a fearless access to standard treatment and care. Deportment does not solve the problem. In fact it increases it manifold. They end up infecting many more people before succumbing to the disease themselves. There is no way we can stop a disease by deporting patients.?
What could be the reason for this sorry state of affairs? Well one important factor could be lack of active community participation. It was only a strong community involvement that forced governments, stakeholders, researchers to change the scenario in the field of HIV/AIDS during the last 25 years. There have been new drugs, new tools, and new guidelines/protocols to combat this once dreaded disease?all because of intense lobbying by the community. This is somehow missing in the field of TB. We do have the Patients? Charter for Tuberculosis Care
Source: http://elitestv.com/pub/2011/11/weakest-link-in-war-against-tb-community-participation
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