Anchored in human rights -Allan Maleche, Blessina Kumar & John Stephens
Instead of surveillance technologies, help TB patients by providing rights-based interventions
Decades of global neglect have resulted in tuberculosis (TB) becoming the leading cause of adult deaths in most of the global south — it kills nearly two million people a year. This is shocking given that TB is curable and preventable. But there are signs of change as the spotlight shines on TB; including the United Nations Declaration of September 2018 titled “United to End Tuberculosis: An Urgent Global Response to a Global Epidemic”, where heads of state and government have “reaffirmed their commitment to end the global TB epidemic by 2030”.
But not all attention is good. An emergent and disturbing arsenal of surveillance technologies has caught the attention of international and domestic policy makers and threatens to detract from an effective response to TB that is anchored in human rights and has a human touch. For example, a plan in India is to implant microchips in people in order to track them and ensure they complete TB treatment. There are also seemingly endless technological tweaks to the Directly Observed Treatment, short course (DOTS) strategy, which requires patients to report every day to a health authority, who watches them swallow their tablets. Now, governments use, or plan to soon use, a strategy of video, tablets, phones and drones to carry the old DOTS strategy into the technology era.
An obsession with new gadgets in disease management — in the context of a disease that could be eliminated in a relatively inexpensive way through human-rights based interventions — is strange. This thinking envisions a TB response that is not with and for people who have TB but rather against suspects who must be targeted, tracked, traced and, above all, never trusted.
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