Rethinking TB: an examination into the socio-economic determinants underlying the disease and the ethical issues they raise

TDR news item
9 May 2011

The June issue of the International Journal of Tuberculosis and Lung Disease will feature a special supplement devoted to examining how social and economic factors impact tuberculosis (TB). The issue1, entitled “Ethics and social determinants: key elements of tuberculosis prevention, care and control” contains 12 articles that look at ways of understanding these non-medical determinants and how best to deal with them. TDR’s Dr Andrew Ramsay was one of the issue’s guest editors. “Quite often, good intentions have replaced policies and professional practice based on solid ethics grounds”, said Ramsay, who specializes in TB diagnostics and health systems research.

While it has long been acknowledged that social and economic factors are some of the most important determinants of health and disease, not enough attention has been devoted to understanding how these determinants impact TB, and what to do about it. These socio-economic factors raise many ethical quandaries for researchers that have not been well addressed in the ethical literature on TB control, which has mostly been limited in the past to addressing issues around direct observation of treatment, said Ramsay.

The articles include an examination into the human rights issues that arise in TB control programs in low-income countries; an operation assessment of the Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) project; and a review of the impact of microfinance and cash transfer schemes in TB control. The editors hope that the articles in the supplement will promote further research and debate in order to foster a more comprehensive response to the TB epidemic.

For more information contact Dr Andrew Ramsay,

1 IJTLD Supplement, June 2011 (Vol 15; 6 (Suppl 2): S1-S70)