ARASA launches activist guide on human rights and TB

On December 4, 2015: ARASA launched a guide for activists called: Close the Gap: TB and Human Rights at the 46th Union World Conference on Lung Health  in Cape Town. With initial results from the STREAM randomised controlled trial showing 80% success rate in using a 9-month treatment option for MDR-TB, compared with 24-month treatment standard – the theme of this year’s Lung conference, “A New Agenda” articulates the long awaited biomedical advancements in tuberculosis treatment. What remains lagging behind are the ‘people’ who are meant to be accessing the treatment. Key populations who are most vulnerable to TB are being missed because of lack of enabling legal, social and policy environments.

This document serves as a framework for activists in Southern and East Africa working on HIV, TB and human rights issues in the region. The guide is divided into the five key topics identified as needing urgent attention in the region: A rights-based approach to TB, Criminalisation of TB, Unequal access to TB care and treatment, TB and gender, and people most affected by TB.

For each topic, the guide provides background to the issue and case studies from partner countries in the region, to provide best practice examples of how civil society has been able to undertake advocacy efforts to promote rights-based responses regarding the topic. A framework for a way forward for TB activists in the region regarding each topic is outlined, including policy advocacy where there are no rights-based approaches in country’s national TB strategies and documentation of case studies to gather evidence of violations of human rights.

This is a living document, which aims to provide a starting point for activist to identify the key advocacy priorities relating to TB and human rights in their own countries and is not intended to be prescriptive. As articulated by the Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Dr. Mark Dybul, “TB is fundamentally a disease of poverty – it is a disease of social injustice’.

Calls to action:

More details can be found within the Call to Action of each section within the guide.

TB and Human Rights:

• Conduct law and policy review and reform to ensure that human rights principles are upheld
• Monitor and evaluate proposed interventions using human rights principles
• Advocate for the provision of legal services for people affected by TB and 
vulnerable groups
• Advocate for and implement programmes to reduce stigma and discrimination

Criminalisation of TB:

• Document cases of human rights violations regarding the criminalisation of TB
• Advocate for increased accessibility, availability, acceptability and quality of 
community-based treatment and care of TB, especially in the case of drug- 
resistant TB.
• Advocate for the integration of drug-resistant TB into community-based work

Access to TB prevention, treatment and care:

• Monitor funding made available for TB and HIV interventions and advocate for 
increased funding (including global and domestic funding)
• Monitor and advocate for the implementation of TB prevention and care methods 
for people living with HIV
• Advocate for countries to use compulsory licensing to increase the production of 
generic TB vaccines, diagnostics and treatment

TB and Gender:

• Advocate for commitment to address gender and TB
• Advocate for better data collection regarding women
• Advocate for women-centered research and development

People most affected by TB:

• Advocate for meaningful participatory planning and engagement of key populations in addressing TB in these groups
• Advocate for health services that are tailored to the needs of Key Populations
• Advocate for measures to address TB in migrants to be taken at country-level
• Advocate for the TB needs of HCW and miners to be addressed
• Advocate for the TB needs of prisoners to be addressed