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Shame re­mains a ma­jor prob­lem fac­ing doc­tors and health ser­vices try­ing to com­bat TB. “It works both at an in­di­vid­ual level and at a na­tional level,” said Marc Lip­man, of Uni­ver­sity Col­lege Lon­don.

“My clinic re­cently di­ag­nosed a lady from In­dia as hav­ing TB. She was aghast, not be­cause she had con­tracted such a se­ri­ous con­di­tion but be­cause she felt it re­flected on her way of life. ‘How can I have TB? I keep a clean house,’ she told us.”

In the past, peo­ple of­ten did not re­veal that a death in their fam­ily had been caused by TB. It would have im­plied lack of clean­li­ness, or poverty. Cru­cially, that trend is mir­rored at a na­tional level. Coun­tries of­ten hide the dis­ease’s preva­lence within their bor­ders. “Man­agers who run a na­tion’s health ser­vice are un­likely to ac­knowl­edge at an in­ter­na­tional con­fer­ence that TB is an is­sue in their coun­try be­cause of its as­so­ci­a­tions with poverty,” said Lip­man. “They could lose their jobs if they ad­mit­ted that. How­ever, if you get heads of state at a con­fer­ence then they can ac­knowl­edge that all is not well in their coun­try.”

This was one of the main rea­sons that the UN sum­mit on TB was set up – as an event at which world lead­ers could come clean about the cri­sis. “Once that has been achieved, we can start to get things done,” said Lip­man.

Robin McKie

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