TB, a human rights concern?<\/p>\n
By Chris W. Green<\/p>\n
JAKARTA (JP): \"Tuberculosis is deeply rooted in populations
\nwhere human rights and dignity are limited. While anyone can
\ncontract TB, the disease thrives on the most vulnerable -- the
\nmarginalized, discriminated against populations, and people
\nliving in poverty.\" This is according a 2001 report by the World
\nHealth Organization.<\/p>\n
If this is true, is it any surprise that Indonesia continues
\nto occupy the third position in the world rankings of countries
\nwith the highest number of new cases of TB, after India and
\nChina?<\/p>\n
Or that the WHO lumps Indonesia together with other countries
\nwith high rates of TB, such as the Russian Federation, as having
\ninadequate TB control, caused mainly by lack of resources devoted
\nto health care?<\/p>\n
As World TB Day of March 24 comes round once again,
\ncommemorating the discovery of the TB bacillus in 1882, it is a
\ngood time to consider what progress we have made in the last 12
\nmonths. And the news is not good.<\/p>\n
The WHO estimates that there were 591,000 new cases of TB
\ninfection in Indonesia in 1998, the last year for which figures
\nare available. This is an increase of one third over the previous
\nyear. Over 140,000 died of the disease. But the WHO-supported
\nanti-TB program identified only a few of the new infectious
\ncases.<\/p>\n
This program, called Directly Observed Treatment, Short-course
\nor DOTS, is intended to provide a complete response, starting
\nfrom political commitment, identification of TB infection, and
\ntreatment of those found to be infected.<\/p>\n
Whereas this program has expanded rapidly, now covering 80
\npercent of the population, it has detected only 12 percent of the
\nnew cases. Even worse, only a little over half of these cases
\ncompleted the six to eight months therapy needed to cure the
\ndisease, compared with 94 percent in the previous year.<\/p>\n
Treatment that is not completed can add to the problem, by
\nincreasing the chances that a strain of TB may evolve which
\ncannot be cured by standard therapy.<\/p>\n
There are many reasons for this failure to make real progress.
\nBut it is clear that inadequate consideration of human rights has
\na major bearing on this.<\/p>\n
Non-discrimination is a principle of human rights -- and
\npublic health -- that is fundamental to the response to TB. TB
\nremains a highly stigmatized disease, little better than the
\nAcquired Immune Deficiency Syndrome or leprosy. Because of the
\nstigma, we prefer not to talk about it, not to understand it, and
\nto ostracize people infected with TB.<\/p>\n
Partly because of this stigma, we neglect the right to
\ninformation. Many people are even unaware that TB can be cured,
\nand with drugs that are relatively inexpensive and that should be
\nwidely available.<\/p>\n
Of course, TB thrives among the most vulnerable sections of
\nsociety -- the poor, women, children, refugees, people in prison,
\ndrug users and people with AIDS.<\/p>\n
Malnutrition, crowding, and poor sanitation all increase the
\nchances of infection with TB. We can only guess at the explosion
\nof TB that is occurring in the refugee camps which are becoming
\nmore common as a result of the ethnic violence which is spreading
\nso rapidly throughout the country. And in the prisons.<\/p>\n
A recent survey in a prison on Bali found that almost 20
\npercent of those tested were infected with HIV. Since HIV and TB
\nso often go hand in hand, we can be sure that TB infection rates
\nare much higher than this throughout the overcrowded prisons of
\nthis country.<\/p>\n
We cannot just leave the response to TB to the doctors, to the
\nMinistry of Health. As Gro Harlem Bruntland, the WHO Director
\nGeneral, puts it, an effective response to TB calls for
\nresources, an informed society and a functioning health system in
\nits widest sense.<\/p>\n
It appears that we in Indonesia are far from addressing any of
\nthese requirements.<\/p>\n
The writer is an AIDS activist in Jakarta.<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/tb-a-human-rights-concern-1447893297", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }