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.