Anchored in human rights (TB patients and surveillance techniques)

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Anchored in human rights (TB patients and surveillance techniques)

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• A leading killer in global south: Because the disease called tuberculosis (TB) was neglected for long, it is a big killer in southern hemisphere now, killing approx. 20 lakh each year. Shocking fact : TB is curable and preventable!
• UN Declaration, Sept. 2018: The UN declaration indicated its mission to end TB, and many governments reaffirmed their 2030 commitment.
• Disturbing new facts: There is a plan in India to install microchips in people to track them to ensure they complete their TB treatment! This is shocking for many policy makers.
• DOTS goes tech, and intrusive: The Directly Observed Treatment course (DOTS) is now being made technical. Till now, patients report to a health authority who watches them take medicines, but soon video / tablet / phones / drones are to be used!
• Disease management through gadgets? This new obsession with technology, for a disease that can be eliminated through simple human-rights based methods, is strange. Those humans are patients, not "suspects to be tracked and targeted, and never trusted".
• World Human Rights day, December 10: It is a reminder that elimination of TB must be through human rights based methods. Trust, partnership and dignity are basic elements. Patients are assumed to have the intelligence that motivates them to cure themselves. Control and coercion is to be avoided.

• Three ways to do it right (3 interventions):

1. New treatment: There are only 2 new TB drugs to have come in 50 years - bedaquiline and delamanid. These are effective against drug-resistant TB compared to existing toxic drugs and injections, that often fail, causing disability and psychosis. Sadly, only 30,000 people have got these new drugs, while 5 lakh contract drug-resistant TB each year. Companies like Johnson and Johnson and Otsuka must be forced to drop prices (upto a dollar a day) to that people access those medicine.Focus on new drugs, not gadgets!
2. Human touch: We need to use community health-care workers, far more than we do today. If they are trained well, they can reach out to the patients furthest from the reach of health-care systems. Millions will get new employment too.
3. Accountability: We have to hold the health-care systems to account. For that, we need the right structures. That would be  community based structures like "clinic committees". Grassroot civil society is indispensable.

• Stop watching over: The govt. must stop trying to watch over the TB patients, but hear their problems. The shine of surveillance technologies is a big distraction. Avoid it.
• Summary - India may be making a big mistake in adopting technology-based surveillance for TB eradication; it should go for new drugs and community-based work instead.

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