Ahead of International Day of Social Justice, the Stop TB Partnership and partners today called on high burden countries for tuberculosis (TB) to invest in interventions that overcome the prevalent human rights barriers that currently diminish the effectiveness of national TB control efforts and ensure social justice equality for all.
This call came at the virtual event organized with the Global Fund Communities Delegation and the O’Neill Institute for Global and National Health Law. International global health representatives ,and human rights academic and justice leaders came together to discuss the findings of the recent publication of the peer-reviewed study a first of its kind for TB, demonstrating that stigma and discrimination against people affected by TB are the leading human rights barriers impeding access to TB prevention, diagnosis, treatment, care and support. The paper, published in the Health and Human Rights Journal, summarizes the findings of Community, Rights and Gender (CRG) assessments carried out in 20 countries.
Between 2018 and 2021, 20 countries across four regions—Africa, South Asia, Southeast Asia, and Eastern Europe and Central Asia—carried out CRG assessments, and these reports were reviewed, analyzed and summarized in the study published in late December 2021. The paper, developed with the support of the Stop TB Partnership and with funding from USAID and the Global Fund to Fight AIDS, Tuberculosis and Malaria (“Global Fund”), analyzed the assessment findings using seven dimensions of the normative right to health framework: availability, accessibility, and quality; nondiscrimination and equal treatment; health-related freedoms; gender perspective; vulnerable and marginalized groups; participation; and remedies and accountability.
To focus the TB response on communities, rights and gender, the Stop TB Partnership recently launched round 11 of its Challenge Facility for Civil Society (CFCS). With US$9 million available for grants, it is the largest round yet. Over the past 15 years, the CFCS has grown from $700,000 to $9 million in yearly funding to help TB-affected communities and civil society organizations promote and protect human rights and gender equality. Despite the steady increase in funding still, only a quarter of the funding needs are met.
Out of the 90 countries with either high burdens of TB, TB/HIV coinfection or multidrug/rifampicin-resistant TB, more than 30 have yet to conduct a CRG assessment. Today the Stop TB Partnership and partners also called on all countries to complete such assessments and then develop and fund national Action Plans to mitigate, overcome and eliminate human rights and gender-related barriers to TB services—including stigma and discrimination.
Panelists at today's event: Brian Citro, Human Rights Lawyer, USA; Lawrence Gostin, O'Neill Institute for National and Global Health Law, USA; Ai Herna Saro, Rekat, Indonesia; Justice Zione Ntaba, Justice, High-Court, Malawi; Dr.Tereza Kasaeva, Director of WHO’s Global TB Programme; Eric Fleutelot, Expertise France and Peter Sands, Executive Director of the Global Fund.
“At the 2018 UN High-Level Meeting on TB, world leaders made pioneering commitments to prioritize communities, human rights and gender in the TB response,” said Dr. Lucica Ditiu, Executive Director, Stop TB Partnership. “The review of recent Community, Rights and Gender assessment findings from 20 countries mean that we now, for the first time, have the evidence of the most prevalent social justice and human rights barriers at country level.”
“I am a TB survivor, and my story is the story of my life and my family. But also the story of my TB family, with whose support I know I am never alone in the fight for the gender and human rights for people affected by TB,” added Ani Herna Sari, TB Survivor and Executive Director, Rekat Indonesia. “Attention to TB and human rights, including stigma and discrimination, is essential. But beyond attention, we need elevated financial resources. Without a fully funded TB response, this airborne disease will continue to kill more than 4100 people every day—and everyone should feel accountable for this. I call on the Global Fund to step up investment in the new funding cycle and increase funding with the new catalytic investment.”
Justice Zione Ntaba, Justice, High-Court, Malawi, reminded us of the intersectionality between different legal actors - the law, lawyers, lawmakers, law enforcement and judiciaries. Without their meaningful engagement and sensitization, we will struggle to effectively realize human rights-based health responses. “We need to have laws that are not vague, laws that promote and protect human rights. We need to have laws that are non-discriminative. Lawyers are also central. It’s them that can bring to court cases that clearly describe the rights violations and the consequences for the people – losing work, not getting the right treatment and the big impact of discrimination on their families,” Justice Zione Ntaba added.
“Human rights and huge inequalities are the biggest issues in the TB response, and all the other issues we face are based on this central problem. In the 21st century, despite better tools, more than half of people don’t have access to new diagnostic tools and treatment. This is unacceptable. Every stakeholder needs to be accountable for reaching the targets agreed at the 2018 UNHLM on TB,” Dr. Tereza Kasaeva, Director of WHO’s Global TB Programme.
“We need more investment and more money flowing in the TB response and especially the community-based organizations who are pragmatic and know exactly how to approach the issues that preoccupy people affected by TB in their community. How we will address challenges ahead of us is also related to our appetite for risk and how far are we ready to go to get on the road to end TB,” said Eric Fleutelot, Expertise France.
“The Global Fund has come a long way in investing in TB-related human rights programs – from a negligible 0.8% part of TB grants to attaining a 2% in the current funding round. Even if we made a lot of progress, we know we have a long way to go. Building on the lessons learned, we are committed to further scaling up support to countries and working with communities and partners to ensure an evidence-based, comprehensive human rights response as an integral part of national TB responses," said Peter Sands, Executive Director of the Global Fund.