Social determinants: Critical to TB elimination

SINCE the discovery of microbial causes of Tuberculosis in 1882, the world has witnessed this devastating disease claiming nearly 1.4 million lives annually in its wake across the globe despite the availability of effective treatment for the past 6 decades.

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Over the last 30 months, the unprecedented COVID-19 pandemic has disrupted health services globally and has adversely impacted on gains being made in the global endeavour to eliminate TB.

It is imperative to understand the linkage of social and environmental factors with both TB and COVID-19.

The WHO defines social determinants of health as all those material, psychological and behavioural circumstances linked to health and generally indicated as a risk factor. “Global anti TB strategy has long been driven by a biomedical approach rather than a socio-economic response to the epidemic, A deeper assessment suggests that a more holistic approach is required to eliminate TB.

Besides appropriate biomedical responses, determinants like stigma, poverty, food insecurity, environmental conditions, malnutrition, hygiene and sanitation, proximal dwelling spaces, poor housing, migration, alcohol consumption, drug consumption, smoking and co-morbidities like HIV and mental disease also need to be addressed on a war footing,” says Dr Dalbir Singh, President, Global Coalition Against TB. He adds that in India, poverty certainly has been a key driver of this disease besides being a barrier of lack of access to healthcare.