Public health measures to control tuberculosis in low-income countries: Ethics and human rights considerations

John D. Kraemer, O. A. Cabrera, J. A. Singh, T. B. Depp, L. O. Gostin

Research output: Contribution to journalArticle

Abstract

In low-income countries, tuberculosis (TB) control measures should be guided by ethical concerns and human rights obligations. Control programs should consider the principles of necessity, reasonableness and effectiveness of means, proportionality, distributive justice, and transparency. Certain measures - detention, infection control, and treatment to prevent transmission - raise particular concerns. While isolation is appropriate under certain circumstances, quarantine is never an acceptable control measure for TB, and any detention must be limited by necessity and conducted humanely. States have a duty to implement hospital infection control to the extent of their available resources and to provide treatment to health care workers (HCWs) infected on the job. HCWs, in turn, have an obligation to provide care unless conditions are unreasonably and unforeseeably unsafe. Finally, states have an obligation to provide adequate access to treatment, as a means of preventing transmission, as broadly as possible and in a non-discriminatory fashion. Along with treatment, states should provide support to increase treatment adherence and retention with respect for patient privacy and autonomy. Compulsory treatment is almost never acceptable. Governments should take care to respect human rights and ethical obligations as they execute TB control programs.

Original languageEnglish (US)
JournalInternational Journal of Tuberculosis and Lung Disease
Volume15
Issue numberSUPPL. 2
DOIs
StatePublished - Jun 2011

Fingerprint

Ethics
Tuberculosis
Public Health
Infection Control
Therapeutics
Delivery of Health Care
Quarantine
Privacy
Social Justice
Cross Infection

Keywords

  • Ethics
  • Human rights
  • Public health
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Public health measures to control tuberculosis in low-income countries : Ethics and human rights considerations. / Kraemer, John D.; Cabrera, O. A.; Singh, J. A.; Depp, T. B.; Gostin, L. O.

In: International Journal of Tuberculosis and Lung Disease, Vol. 15, No. SUPPL. 2, 06.2011.

Research output: Contribution to journalArticle

Kraemer, John D. ; Cabrera, O. A. ; Singh, J. A. ; Depp, T. B. ; Gostin, L. O. / Public health measures to control tuberculosis in low-income countries : Ethics and human rights considerations. In: International Journal of Tuberculosis and Lung Disease. 2011 ; Vol. 15, No. SUPPL. 2.
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