By Antonia Chan
Public health officials from California’s San Diego and Imperial counties have signed a deal with the Mexican state of Baja California, as well as the nonprofits International Community Foundation and Puentes de Esperanza Contra Tuberculosis, formalizing a joint effort to combat TB along the border. The Times of San Diego reports that “participants will receive referrals, lend technical support, accept lab specimens, and assist with investigations.”
The move comes at a critical time: in 2014, the Health and Human Services Agency (HHSA) of San Diego reported 220 cases of TB—almost twice the national average despite the region’s annual number of cases having halved over the past two decades. San Diego’s HHSA also noted that almost a third of San Diego County’s TB patients had ties to Baja California, reinforcing the need for a cross-national approach to tackling the disease’s spread.
While TB’s impact is epidemic and global in scale—in 2013, approximately 9 million people were infected by the disease and 1.5 million died from it—low- and middle-income countries account for 95% of all TB deaths. The disparity between wealthy and poor is just as alarming within countries: a recent Demographic and Health study revealed that members of the poorest quintile in India had a 5.5-fold higher risk of self-reported prevalent TB compared to those in the wealthiest quintile.
Compared to the emphasis put on strictly public health-oriented strategies, human rights remain an underutilized but important tool to improving access to testing and treatment for TB. A rights-based approach focuses on the underlying social and economic determinants of the disease, articulating the rights of people living with and vulnerable to the disease, and encouraging people to claim these rights. The universal right to health in particular establishes a legal obligation between governments and non-state actors, such as drug manufacturers and health providers, to halt the spread of TB and ensure that quality testing/treatment are accessible for all.
“We live in a border region where thousands of people cross back and forth on a daily basis,” San Diego public health officer Dr. Wilma Wooten told the Times of San Diego. “In order to prevent and control the spread of tuberculosis, we must address this issue together.” Although the agreement between California and Mexico does not explicitly outline human rights-based approaches to halting TB, it does establish a state obligation to protect the right to health of those most vulnerable, through prevention measures, diagnosis, and treatment. HHR’s June 2016 issue on TB and the Right to Health will seek to expand on this topic as well as others, including:
- The role of human rights in promoting the availability, accessibility and acceptability of good quality testing and treatment for TB.
- The impact of stigma and discrimination in the lives of people living with and vulnerable to TB.
- The situation of key affected populations.
- The State’s duty to protect against violations of human rights by non-state actors, such as pharmaceutical companies and private health providers.
More HHR Papers on Tuberculosis and the Right to Health
(Guest Editors from the University of Chicago: Brian Citro, Tyler Cerami, Mihir Mankad, Reilly Paul, Kiran Pandey, Evan Lyon. From the FXB Center for Health and Human Rights: Camila Gianella.)