The Patients' Charter of the Tuberculosis Community (2)
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from Leslie London <ll@cormack.uct.ac.za>
I think the idea of a Patients' Charter of the TB Community is
interesting and valuable.
I have two general comments to make about the idea, and then
have made specific comments about the specific rights and re-
sponsibilities details below.
1. The Charter doesn't really speak to any issues of Health Sys-
tems. For example, people with TB should also have rights that
extend beyond the provider-patient relationship - they should
expect that services for them are not constrained by global ine-
qualities that limit the availability of drugs for TB, and ine-
qualities in investment in drug development. So, rights around
investment in drugs for common diseases should appear in the
Charter.
2. There is also an absence of any discussion around prevention
and factors that increase risks for TB. Patients with TB often
have risk factors that will predispose to a range of other ill-
nesses if not repeat episodes or to treatment failure. I think
people with TB can expect interventions to address the social
and economic determinants of their illness. Isn't that why the
WHO established the Commission?
Lastly, I notice that the Charter is framed as one for the "Tu-
berculosis Community." I may have missed previous discussion,
but it's not clear to me who is the community, or how homogenous
it is. Patients? Families? Providers? Researchers? Lots of peo-
ple have vested interests in TB, but these are not necessarily
consonant. Others have vested interests in keeping TB a hidden
issue.
--
Leslie London
mailto:ll@cormack.uct.ac.za