PHA-Exchange> TB Charter 3

[claudio at hcmc.netnam.vn]

--from Leslie London <ll at 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 responsibilities details 
below.

1. The Charter doesn't really speak to any issues of Health Systems.
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 inequalities that limit the availability of 
drugs for TB, and inequalities 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 illnesses 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 "Tuberculosis 
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 people have vested interests in TB, but 
these are not neccessarily consonant. Others have vested interests in 
keeping TB a hidden issue. 


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