TB and the right to health Nelson Otwoma National Coordinator- NEPHAK

TB, Health and Human rights Human Rights are: Universal and inalienable Interdependent and indivisible The right to health calls access to quality health services, immediate and targeted steps to ensure that health services, goods and facilities are available, accessible, acceptable and of good quality.

Background on TB TB is a major public health problem caused by a mycobacterium tuberculose TB is the 3 rd leading cause of death among women aged years of age TB is transmissible through the air when one is infected and a person with TB can infect people in a year if not detected Drug resistant TB is on the increase and requires urgent attention

The Stop TB Strategy VISION: A TB-free world GOAL: To dramatically reduce the global burden of TB by 2015 in line with the MDGs and the Stop TB Partnership targets OBJECTIVES: Achieve universal access to high-quality care for all people with TB Reduce the human suffering and socioeconomic burden associated with TB Protect vulnerable populations from TB, TB/HIV and drug-resistant TB Support development of new tools and enable their timely and effective use Protect and promote human rights in TB prevention, care and control

TB and human Rights TB is deeply rooted in poverty. Poverty, low socio economic status, legal,social and structural barriers are barriers to the achievement of Universal access targets. Promotion of human rights is critical in addressing this barriers,diminish peoples vulnerability and ensuring a targeted response to TB control globally

Human rights approach to TB Put the individual at the centre of any health policy, providing the individual and groups with the tools to participate and claim specific rights Identify and support the most marginalized and vulnerable, ensuring that TB prevention, treatment and care is accessible to all – Pulmonary TB, extra pulmonary TB and drug resistant TB Address the socio-economic determinants of TB Address the human rights implications of TB policy, legislation and programme implementation –Practice of Isolation of TB patients Overcome institutional constraints and capacity gaps that prevent individuals and groups from fulfilling their rights related to TB Support an integrated response to TB

Human rights approach to TB Support an integrated response to TB Provide a platform for documenting and sharing best practices, supporting advocacy and social mobilization around human rights relevant to TB Rolling out of the TB Patients Charter that spells out the rights and responsibilities of TB pateints Provide accountability tools for governments, the international community and civil society

TB Patients Charter Rights Right to equitable and accessible care Right to be treated with dignity Right to Information Right to choice Right to Justice Right to confidence /privacy Right to organization Responsibilities Share Information Follow Treatment Contribute to Community Health Show solidarity

Squabbling while Rome Burns- Letting TB happen Woman with MDRTB is counselled before initiating ART in Blue House- Kenya Weakness of TB Control Increase in number of defaulters Criminalization of 6 Kenyan TB patients

Responding to MDRTB while violating rights Warder Keeps Watch Denial of freedom of movement: Nomasonto Shaba, 32, said the situation was “mentally frustrating and suicidal”. “I am on ARVs but these days I do not take them. “I think it is better to die than live like a prisoner,”.

Human Rights Approach for TB will require. 1. Identification of emergency measures: Infection control Case tracing IPT therapy for people, particularly in MDR/XDR high incidence nodes 2. Integration of TB and HIV services as envisaged by the NSP: Proper co-ordination and oversight through by TB and HIV Programmes Massive and co-ordinated information campaign: Isolation of MDR/XDR patients in humane conditions: 3. Social Support for MDRTB Patients Access to facilities, means of proper communication etc 4. Needs-based planning and budgeting for TB: A human resource plan for TB: Based on identification of needs Political leadership

TB/HIV COMMUNITY MOBILIZATION IN AFRICA: Call to ACTION on TB and HIV