Achieving universal social protection for people with TB

Fuady, A., Hutanamon, T., Herlinda, O., Luntungan, N. and Wingfield, T., 2024. Achieving universal social protection for people with tuberculosis. The Lancet Public Health, 9(5), pp.e339-e344.

  • Global tuberculosis strategies focus more on biomedical approaches, with little emphasis on poverty alleviation and socioeconomic support, despite the recognized importance of social protection.
  • Advocacy still favors biomedical investment, risking that commitments to social protection remain rhetorical due to underinvestment.
  • Universal health coverage (UHC) lacks provisions to protect individuals from the socioeconomic impacts of tuberculosis, such as income loss, unemployment, and associated costs like transportation and accommodation.
  • UHC also neglects broader social determinants like stigma and discrimination related to tuberculosis, focusing mainly on health-care access.
  • There is a need for universal health and social coverage (UHSC), which integrates health and social care policies, governance, staffing, and budgets, particularly for poverty-related diseases like tuberculosis.
  • National tuberculosis programs should allocate dedicated resources for social protection interventions, ensuring comprehensive support beyond basic health care.
  • Addressing catastrophic costs, defined as tuberculosis-related expenses exceeding 20% of a household’s annual income, and providing consistent non-financial support like nutritional aid, are essential but currently inadequate.
  • Reducing undernutrition, which contributes to 15% of global tuberculosis cases, through broader programs could significantly decrease tuberculosis incidence and prevalence.

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