Stigma & Discrimination

While in western countries such as Germany tuberculosis is a notifiable disease, i.e., physicians, microbiology laboratories and pathologists are required to report all diagnosed tuberculosis cases to the Health Department, this type of measure may not yet have been implemented in many developing countries. Although on the one hand such legislation in the developed world makes sense, it may be a larger problem in developing countries, where low levels of disease literacy are prevalent and a cure is not guaranteed for various reasons such as poor quality or inadequate supply of drugs, inappropriate treatments, etc. As a result, patients face discrimination, ostracizing and abandonment by society and even loved ones, driving them deeper into hiding to continue the uninhibited spread of the disease.

Due to the lack of understanding about the disease, it is often met with high levels of stigma and discrimination. People who become ill with tuberculosis are often cast out from their community and even from their families. In India, for example, 100,000 women each year are disowned due to TB. Hence, early detection and continuous spread of the disease is further helped by the very patients themselves when they delay seeking care for fear of stigma and discrimination.

Thus it is expected that making TB a notifiable disease could hurt these vulnerable patients and their standing in society even more. However, fortunately, more and more governments aware of the danger of the spread of the disease. In India for example, the country with the largest number of TB victims annually, in May 2012, this law was finally enacted.

As a result, our society seeks to support interventions and projects that are based on an active detection of patients. We also support those projects that carry out Information, Education and Communication (IEC) activities in order to strengthen the education and general literacy about health and tuberculosis (see picture on the left). Another advantage of disease education and the resulting reduction of discrimination is the possible reduction of the dreaded discontinuation of treatment, which has led in recent decades to the creation of man-made super-bacteria. Read more about this threat in the next section.

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