New ethics guidance on tuberculosis (TB) was launched by the World Health Organisation (WHO) in preparation for World TB Day on 24 March.
TB is the world’s top infectious disease killer, killing 5,000 per day. The WHO’s new guidelines seek to protect the communities hit hardest, which are often subject to other socio-economic challenges.
These challenges might include refugees, prisoners, ethnic minorities, miners, working and living in risk-prone settings, and marginalised women, children and older people.
Director-general of the WHO Dr Margaret Chan said: ‘TB strikes some of the world’s poorest people hardest. 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.’
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 of people with TB (4.3 million) go undiagnosed or unreported, some receiving no care at all and others access care of questionable quality.
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.
Its five key obligations for health workers 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,
- enable “key populations” to access same standard of care offered to other citizens,
- ensure all health workers operate in a safe environment, and
- rapidly share evidence from research to inform national and global TB policy updates.