Ahead of the World Tuberculosis Day coming up on Friday, the World Health Organization, WHO, has issued a new ethics guidance to ensure countries implementing its ‘End TB Strategy’ adhere to sound ethical standards to protect the rights of tuberculosis patients and care givers.
Tuberculosis is the world’s most infectious killer disease, claiming about 5,000 lives each day.
According to the WHO, the heaviest burden of the disease is carried by communities which already face socio-economic challenges, such as migrants, refugees, prisoners, ethnic minorities, miners and others working and living in risk-prone settings, marginalised women, children and older people.
Nigeria currently ranks fourth among the top 22 burdened countries in the world.
The new WHO ethics guidance addresses contentious issues, such as the isolation of contagious patients, the rights of TB patients in prison, discriminatory policies against migrants affected by TB, among others.
The code emphasises five key ethical obligations for governments, health workers, care providers, nongovernmental organizations, researchers and other stakeholders.
These are to provide patients with the social support they need to fulfil their responsibilities, refrain from isolating TB patients before exhausting all options to enable treatment adherence and only under very specific conditions, and enable “key populations” to access same standard of care offered to other citizens.
They must also ensure all health workers operate in a safe environment, and rapidly share evidence from research to inform national and global TB policy updates.
Mario Raviglione, Director, WHO Global TB Programme, said it is not easy to apply these principles on the ground, as patients, communities, health workers, policy makers and other stakeholders frequently face conflicts and ethical dilemmas.
He said the current multidrug-resistant TB (MDR-TB) crisis and the health security threat it poses accentuate the situation even further.
“Only when evidence-based, effective interventions are informed by a sound ethical framework, and respect for human rights, will we be successful in reaching our ambitious goals of ending the TB epidemic and achieving universal health coverage.
“The SDG aspiration of leaving no one behind is centred on this”.
“The guidance we have released today aims to identify the ethical predicaments faced in TB care delivery, and highlights key actions that can be taken to address them,” he added.
According to statement by the organisation, WHO launched the ethics guidance so that the world can process guidance to action on TB by protecting human rights, and providing ethics and equity which are the principles underpinning WHO’s End TB Strategy.
Margaret Chan, WHO Director-General, said TB strikes some of the world’s poorest people hardest, stressing that WHO is determined to overcome the stigma, discrimination, and other barriers that prevent so many of these people from obtaining the services they so badly need.
She said poverty, malnutrition, poor housing and sanitation, compounded by other risk factors such as HIV, tobacco, alcohol use and diabetes, can put people at heightened risk of TB and make it harder for them to access care.
“More than a third (4.3 million) of people with TB go undiagnosed or unreported, some receive no care at all and others access care of questionable quality”, she said.
The WHO’s End TB Strategy is part of the organisation’s programme for the World TB Day and an opportunity to mobilise political and social commitment for further progress in efforts to end Tuberculosis.
This year, the World TB Day to be celebrated on March 24 signals new momentum at the highest levels with the announcement of the first ever Global Ministerial Conference on Ending TB, which will be held in Moscow in November 2017.
Ren Minghui, Assistant Director-General HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases, said the Global Ministerial Conference will highlight the need for an accelerated multisectoral response to TB in the context of the Sustainable Development Goals.
“It will emphasise that global action against antimicrobial resistance must include optimized care, surveillance and research to address MDR-TB urgently”.
The conference is expected to inform the UN General Assembly high-level meeting on TB which will be held in 2018.