Table 1: TB and Right to Non-discrimination and Equality

Examples of Human Rights Violations

  • Persons with TB are refused medical treatment or given a lower standard of care
  • Persons with TB are prohibited from participating in the local market
Human Rights Standards Treaty Body Interpretation
ICERD 2(1) States Parties condemn racial discrimination and undertake to pursue by all appropriate means and without delay a policy of eliminating racial discrimination in all its forms and promoting understanding among all races.

ICERD 2(2) States Parties shall, when the circumstances so warrant, take, in the social, economic, cultural and other fields, special and concrete measures to ensure the adequate development and protection of certain racial groups or individuals belonging to them, for the purpose of guaranteeing them the full and equal enjoyment of human rights and fundamental freedoms.

ICERD 5(e)(iv) States Parties undertake to prohibit and to eliminate racial discrimination in the right to public health, medical care, social security and social services.

CERD: Expressing concern to India about “reports that members of scheduled castes and scheduled and other tribes are disproportionately affected by … tuberculosis … and that health care facilities are either unavailable in tribal areas or substantially worse than in non-tribal areas” and recommending that the State ensure adequate health care facilities for members of scheduled castes and scheduled and other tribes and “to increase the number of doctors and of functioning and properly equipped primary health centres and health sub-centres in tribal and rural areas.” CERD/C/IND/CO/19 (2007).

Other Interpretations 

WHO Guidance on ethics of tuberculosis prevention, care and control (WHO, 2010):

Overarching goals and objectives. …[A]ll persons with TB should be treated the same way…. TB patients have the right to receive advice and treatment that meets international quality standards, be free of stigmatization and discrimination, establish and join peer support networks, and benefit from accountable representation.

The obligation to provide access to TB Services. TB programmes should take into account the needs of all patients, and in particular, the special needs of socially vulnerable groups for whom tailored interventions should be proactively developed…. Such groups include, but are not limited  to, people living in extreme poverty, indigenous populations, refugees, asylum seekers, migrants, mine workers, prisoners, substance users (including alcohol), and homeless people. In addition, the needs of women, children, and people coinfected with HIV warrant special consideration.

Resolution WHA 62.15, Prevention and control of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis (WHO, 2009):  

Para. 1(j). Undertake “effective advocacy, communication and social mobilization, avoiding stigmatization and discrimination, and spreading community awareness about policies and plans for prevention and control of tuberculosis including multidrug-resistant and extensively drug-resistant tuberculosis”. Resolution WHA 62.15.

Beijing Call for Action on Tuberculosis control and patient care: together addressing the global MDR-TB and XDR-TB
epidemic
(WHO, 2009):

Para. 1(c). Ensuring a comprehensive framework for management and care of M/XDR-TB is developed, including community-based care, and identifying the groups most vulnerable to, and at risk of, drug-resistant TB and its impact, including people living with HIV, prisoners, mine workers, mobile populations, drug users, alcohol dependents, the poor and other vulnerable groups; and ensuring that services to prevent and treat drug-resistant TB are targeted to their needs”.

Recommendations to ensure the diagnosis and treatment of tuberculosis in undocumented migrants (Int’l Union
Against Tuberculosis and Lung Disease, 2008):

Recommendation 1. Health authorities and/or health staff should: a) ensure easy access to low-threshold facilities where undocumented migrants who are tuberculosis suspects can be diagnosed and treated without giving their names and without fear of being reported to the police or migration officials, b) remind health staff that they have an obligation to respect confidentiality,

Recommendation 2. Each country should ensure that undocumented migrants with tuberculosis are not deported until completion of treatment, and

Recommendation 3. Authorities and the non-governmental sectors should raise awareness among undocumented
migrants about tuberculosis, emphasising that diagnosis and treatment should be free of charge and wholly independent of migratory status.

Berlin Declaration on Tuberculosis (WHO European Ministerial Forum, 2007)

Para. 5(2). We will adopt the Stop TB Strategy in all its components, thereby… empowering people with TB and their communities, and removing stigma…. EUR/07/5061622/5 (2007).

Patients’ Charter for Tuberculosis Care (World Care Council, 2006): 

Care. The right to free and equitable access to tuberculosis care, from diagnosis through treatment completion, regardless of resources, race, gender, age, language, legal status, religious beliefs, sexual orientation, culture, or having another illness.

Dignity. The right to be treated with respect and dignity, including the delivery of services without stigma, prejudice, or discrimination by health providers and authorities. The right to quality healthcare in a dignified environment, with moral support from family, friends, and the community.

Abuja Call for Accelerated Action Towards Universal Access to HIV/AIDS, Tuberculosis and Malaria Services in Africa
(African Union, 2006):

Protection of Human Rights. Adapting national legislation to take cognizance of HIV and AIDS and TB issues specifically
discrimination and stigmatization… Sp/Assembly/ATM/2 (I) Rev.3 (2006).

Security. The right to job security after diagnosis or appropriate rehabilitation upon completion of treatment.

Abuja Call for Accelerated Action Towards Universal Access to HIV/AIDS, Tuberculosis and Malaria Services in Africa (African Union, 2006):

Protection of Human Rights. Adapting national legislation to take cognizance of HIV and AIDS and TB issues specifically discrimination and stigmatization… Sp/Assembly/ATM/2 (I) Rev.3 (2006).