The World Health Organization (WHO) states that there are new tuberculosis ethics guidelines launched on March 22, 2017. The WHO aims to “ensure that countries implementing the End TB Strategy” (End Tuberculosis Strategy) continue to hold fast to standards of ethics
End TB Strategy adhere to sound ethical standards to protect the rights of all those affected.
Tuberculosis kills 5,000 people each day. Some of the most affected communities are those that come from socioeconomic disadvantage. For instance, these can include ethnic minorities, miners, refugees, migrants, and many, many others.
These people come at intersections of sanitation, income, nutritional, and housing or home problems. These people come at increased risk of alcohol use and diabetes, HIV and other things. And about one-third of tuberculosis cases go unreported or undiagnosed.
Indeed, this means many individuals with tuberculosis go without any adequate care. That’s why the WHO ethics guidance or guidelines are important. As part of the protection of human rights, the ethics around appropriate tuberculosis treatment is important.
There will be an upcoming conference that will then inform the United Nations General assembly high-level meeting on tuberculosis, which will be held for deliberation in 2018.
The WHO director-general, 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.”
The five key ethical obligations or responsibilities listed for care providers, governments, health workers, researchers, and NGOs are as follows:
- provide patients with the social support they need to fulfil their responsibilities
- refrain from isolating TB patients before exhausting all options to enable treatment adherence and only under very specific conditions
- enable “key populations” to access same standard of care offered to other citizens
- ensure all health workers operate in a safe environment
- rapidly share evidence from research to inform national and global TB policy updates.
The implementation of these ethical obligations has been said to be difficult by the WHO news release. The current tuberculosis is multidrug-resistant. That is, if one form of tuberculosis is resistant to a specific form of drug, then giving multiple drugs increases the odds of non-resistance.
For example, if the odds of a disease being resistant to one drug is 1 in a 100, and if you want to increase the probability of a cure or immunity with the shot, and if the odds of the same disease being resistant to another drug is 1 in 20, then the odds of the drug being resistant to both used at the same time in the multidrug mix is 1 in 100 times 1 in 20, or 1 in 2,000.
However, the current multidrug-resistant TB (MDR-TB) is creating a “crisis and the health security threat.”
“Only when evidence-based, effective interventions are informed by a sound ethical framework, and respect for human rights, will we be successful in reaching our ambitious goals of ending the TB epidemic and achieving universal health coverage,” director of the WHO Global TB Programme, Dr. Mario Raviglione said. He also claimed that, “The SDG aspiration of leaving no one behind is centred on this.”
The conference to be held will be the Global Ministerial Conference in November of this year in Moscow. That will be the basis for informing the high-level UN meeting in 2018.