Being a Press Release by
Afrihealth Optonet Association (AHOA)
INTRODUCTION AND BACKGROUND
Afrihealth Optonet Association (AHOA) is a global-level and community-focused Network/Think-tank of civil society organizations (CSOs) and non-state actors (NSA) on Health, Human Welfare/Rights, Climate Change, Biodiversity Conservation, Food Security and Sustainable Development Goals (SDGs). Its mission is to engender sustainable interventions in the health, capacity, survival, empowerment, life, development, and standard of living of youth, low-income individuals and communities, women, infants, adolescents, the poorest of the poor, the elderly, rural and marginalized Indigenous people, sick and vulnerable groups, especially in Africa; by promoting evidence-based credible actions, and supporting measures needed to achieve and safeguard them. Established in 1997, AHOA has teams/chapters in the FCT and 36 States of Nigeria; 3,000 organizations from 120 countries as its members, and a Google Group of over 44,000 members globally, AHOA has become a third-sector global player, partner, project/programme developer, implementer, monitor and reporter on the measures needed to achieve and safeguard them.
THE INTERNATIONAL COLLOQUIUM ON TUBERCULOSIS OR ‘TB’
At the international colloquium jointly organized on 21st March 2025 by Afrihealth Optonet Association (AHOA) and the World TB Day Planning Team of the Federal Ministry of Health (FMOH) Nigeria, participants from several countries including Nigeria, India, United States of America, Cote D’Ivoire, Kenya, Nepal, Zambia, Colombia; the governments, businesses and civil society actors; and institutions including the World Health Organization (WHO); participants generally identified TB stigma and discrimination as the most single element that mostly stacks against the efforts to stop TB, and end/eliminate the disease; impacting treatment adherence, care-seeking behaviors, and overall health outcomes.
SIGNIFICANT BARRIERS TO ENDING ‘TB’
Tuberculosis (TB) remains a global health and development crisis, with an estimated 10.8 million people falling ill with the disease in 2023, resulting in 1.25 million deaths. In 2023, eight countries accounted for more than two-thirds of global TB cases: India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and the Democratic Republic of the Congo (DRC).
Tuberculosis (TB) stigma and discrimination are significant barriers to effective TB control in Africa, Asia, and other developing countries which bear the largest brunt of TB morbidities and mortalities in the world. Tuberculosis (TB) stigma and discrimination hinder diagnosis, impede treatment adherence, and overall health outcomes, impacting individuals and communities negatively. Stemming from misconceptions about contagiousness and the perceived “tainted” status of those infected with tuberculosis, leading to social isolation and discrimination.
Tuberculosis (TB) stigma and discrimination mostly affect women and those with limited resources; significantly hindering TB control efforts in affected countries, further leading to delayed diagnosis and social isolation, adversely impacting individuals and communities, and for global efforts to eliminate the disease.
‘TB’ STIGMA AND DISCRIMINATION AS MAJOR BARRIERS
Stigma and discrimination impact Health-Seeking Behaviors as the fear of both leads people to delay seeking medical care, avoid testing, and delay treatment, thus hindering effective TB control. Their social consequences lead to social isolation, loss of employment, and rejection by loved ones, and further exacerbate the challenges faced by those affected. These further reinforce stigma and discrimination within healthcare settings, policies, and regulations, impacting healthcare workers and patients. As critical social determinants of health, stigma, and discrimination are shaped by community norms, interpersonal relations, and health institutions’ culture, and lead to unfair labeling and castigation of those affected by TB, their families, and communities.
IT’S TIME TO END ‘TB’ STIGMA AND DISCRIMINATION EVERYWHERE
The dangers of stigma and discrimination against persons, families, and communities affected by TB are self-evident. TB stigma and discrimination violate the rights and dignity of individuals affected by the disease, and ending them is crucial for achieving the global goal of ending the TB epidemic. Ending stigma and discrimination will improve access to care, increase treatment adherence, and ultimately lead to better health outcomes for people with TB. About the Topic of the AHOA’s international colloquium ‘Yes! We Can End TB: Commit, Invest, Deliver TB Interventions by Meaningfully Involving Indigenous Peoples, Marginalized Communities, and Vulnerable Populations’; TB disproportionately affects the poorest and most vulnerable populations; including women, youths/adolescents, males who have sex with males, sex workers, injecting drug users, and prisoners, poorest of the poor, women, children, elderly, homeless, destitute, hungry, and the sick. Addressing and ending stigma and discrimination against them is even more important to ensure equitable access to care.
FOCUSING ON THE OTHER KEY CHALLENGES TO ENDING ‘TB’
While the above efforts will largely help us to overcome the stigma and discrimination around TB which generally impede TB care-seeking and services access; it is our considered opinion that all the efforts at addressing the following challenges to ending TB must be sustained:
a. Multi-drug-resistant TB (DR-TB) remains a major public health crisis, with limited treatment options and high mortality rates.
b. The COVID-19 pandemic disrupted TB services, leading to a decline in diagnosis and treatment, which has contributed to a resurgence in TB cases.
c. Social Determinants including poverty, malnutrition, and overcrowding continue to contribute to the spread of TB, especially in high-burden countries.
d. Access to Care and quality TB diagnosis and treatment remains a significant challenge, particularly in remote and underserved areas.
e. Early Detection and Treatment of TB are crucial to prevent the spread of the disease and reduce mortality.
f. TB preventive treatment can reduce the risk of developing active TB in people at high risk, such as those living with HIV or who have been exposed to TB.
g. Strengthening Health Systems is essential to improve TB prevention, diagnosis, and treatment. These must incorporate a Health workforce that is responsive, fair, efficient, competent and productive; an efficient and effective finance system that ensures sustainability and cost-effective interventions; a universal health care (UHC) paradigm that ensures that everyone has access to quality health services without financial hardship; a Primary care system delivering high-quality primary care and essential public health functions; self-evident Quality of care which ensures that health care and services are of high quality; Access to essential medicines, vaccines, biologicals, and medical devices for all; Health governance that ensures that the healthcare system is responsive to the health needs of all members of society, including patient-centered care, community participation, intersectoral coordination, appropriate technologies, and support mechanisms.
h. Multisectoral Action and Global Collaboration addressing the social determinants of TB, such as poverty and malnutrition, and promoting the international collaboration essential to share knowledge, mobilize and deploy the resources to combat TB globally.
WHAT WE MUST DO, AND URGENTLY TOO! A CLARION CALL
To end TB stigma and discrimination, and get the full benefits of all the resources and efforts being daily deployed to eliminate the disease, we have a ‘state of emergency’ and must:
1. Promote TB education and awareness to increase public awareness about TB, its transmission, and the importance of seeking treatment;
2. Foster empathy, respect, and understanding for individuals, families, and communities affected by TB everywhere on earth;
3. Ensure access to quality care that makes TB services accessible, affordable, and free from stigma and discrimination;
4. Advocate for policies that protect the human rights and dignity of people with TB, including confidentiality, non-discrimination, and access to social support;
5. Involve TB survivors and affected communities in the development and implementation of TB stigma reduction strategies;
6. Address stigma and discrimination in healthcare settings, provide compassionate and respectful care to people affected by TB, and ensure that healthcare providers and facilitators do the same within their practices;
7. Collaborate with other sectors including education, social services, and the private sector, to address the social determinants of TB and reduce stigma and discrimination;
8. Monitor and Evaluate TB interventions regularly to ensure their effectiveness and make necessary adjustments, using SMART performance indicators; and
9. Learn from HIV/AIDS by building on its experience, and resourcefully applying lessons learned from how HIV/AIDS has almost completely overcome stigma and discrimination.
CONCLUSION
The Afrihealth Optonet Association (AHOA) acknowledges and commends all the efforts made by governments, institutions, corporations, organizations, communities, TB survivors and individuals in the match to end TB worldwide. Among other actions and interventions, we must actively continue to combat TB stigma and discrimination by promoting education, care, support, sustained treatment, diligent contact-tracing and follow-ups, empathy, and respect for individuals and communities affected by TB, ensuring access to quality care, and advocating for policies that protect human rights and dignity. We are aware that this requires a multi-pronged approach, including education, community engagement, and policies that deliberately promote respect and understanding. In our collective efforts to achieve the above, community-based education, awareness campaigns, and supportive healthcare environments for improved TB outcomes, remain our low-hanging fruits.
Signed:
Dr. Uzodinma Adirieje CEO/Programmes Director Afrihealth Optonet Association (AHOA) Abuja, Nigeria 22nd March 2025 <https://druzoadiriejefoundation.blogspot.com/2024/07/cv-of-dr-uzodinma-adirieje-february-2024.html> Afrihealth Optonet Association (AHOA) <https://afrihealthcsos.blogspot.com/2024/03/about-afrihealth-optonet-association_15.html> National Coordinator, Civil Society Partnership for Sustainable Development Goals in Nigeria (CSP-SDGs Nigeria) WhatsApp: +2348034725905 Email: ceo@afrihealthcsos.org Website: http://www.afrihealthcsos.org