Question

Global Health

Consider a disease, other than HIV/AIDS, such as tuberculosis. How might public health efforts with respect to this disease raise human rights concerns?

Answer 1

While working with control of communicable diseases such as tuberculosis, it should be noted that the activities should be ethically sound and ensure provision of adequate human rights .The main areas where the human rights can be subjected to violation are

1)Discrimination or social stigma

Human society always have an aversion to communicable diseases. In earlier days,it was seen with patients suffering from leprosy, but now it is seen with other communicable diseases such as tuberculosis also.

2)Privacy and confidentiality

Privacy and confidentiality should be strictly enforced.Screening and interventions should be done in a physical setting which will not differentiate between those with positive and negative results. This is actually a difficult issue to address in public health measures for control of communicable diseases.The issue of confidentiality is a major concern in contact tracing also.The identity of the individual should be protected to the maximum extend possible, and any breach in confidentiality show be clearly explained on the basis of threat to the safety of the individual.

3)Enforced compliance

Legally, the responsibility of public health worker in communicable disease prevention includes the police power to enforce strict compliance to medications and to restrict the activity of the patient for the welfare of others.Restrictions to ensure compliance is justifiable if the measures are demonstrably effective and ethical. In case of tuberculosis control program, it is seen that the restrictions to enforce compliance has given good results.

4)Health care access

Access to health care means the people who need the service should find them available, acceptable ,appropriate with no barriers to use.It is seen that there is inequality existing with respect to certain population subgroups when health care access is concerned. However,the tuberculosis control program ensures that no such inequality exists, for provision of treatment.

Though there exist matters that raise human right concerns in public health measures to control communicable diseases, revised national tuberculosis control program works with an integrated human rights based approach.Protection of human rights is one of the objectives of WHO's stop TB strategy.The health workers are trained on non discrimination, confidentiality, informed consent and duty to treat.Health education is given to the community to avoid social stigma.There are patient support initiatives such as patient support peer groups and 'know your rights' campaigns.Case finding and treatment is community based.