Tuberculosis, ethics and human rights
“Protecting human rights, ethics and equity” is one of the 4 key principles of the WHO End TB Strategy. This is especially relevant for tuberculosis (TB), which is widespread among the most vulnerable and marginalized populations. This approach is fully aligned with the 2030 Agenda for Sustainable Development and its focus on human rights, ethics and equity, which is summarized in the motto “leave no one behind”.
Stigma linked to TB (infectiousness, long treatment, possible HIV co-infection) and the social conditions that are often related to it (poverty, imprisonment, migration, etc.) are important causes of lower access to services and further social discrimination. In the WHO European Region, the high levels of multidrug-resistant TB (MDR-TB) make the protection of ethics, values, and human rights a special challenge, particularly in relation to:
- diagnosis (in the absence of effective treatment);
- treatment (isolation and involuntary treatment of patients; support for patients’ adherence; compassionate use and expanded access to TB drugs; palliative and end-of-life care; research; health workers’ rights and responsibilities); and
- interventions within specific groups (children, prisoners, migrants).
Human rights are mainly concerned with the relationship between the individual and the state, but also include responsibilities for private, non-state actors. Governmental obligations with regard to human rights broadly fall under the principles of respect, protect and fulfil. The right to health – articulated as the highest attainable standard of physical and mental health – is enshrined in the WHO Constitution, the Universal Declaration of Human Rights (Article 25) and the International Covenant on Economic, Social and Cultural Rights (Article 12).
WHO/Europe assists Member States in protecting and promoting human rights, ethics and equity for TB patients by reviewing current legislation and practices and advising for their alignment with ethics and human rights principles.