Thailand - Stop TB Partnership

the political agenda, not only of the health ministry, but also of the ministries of finance
and planning.” 11
The marginality of the Declaration at the country level is symptomatic of a broader
issue: insufficient public awareness of the scope and seriousness of the TB epidemic. Global
incidence of TB has increased over the past 10 years. 12 TB kills approximately 2 million
people a year 13 and is a leading cause of death by infectious disease for people living with
HIV/AIDS. Yet when contrasted with the extent of social mobilization around health issues
such as HIV/AIDS, the general lack of awareness that TB is a serious health threat is striking.
Lack of awareness
There is nothing more than a poster on the wall in health facilities to
promote awareness.
—Ezio T. Santos Filho, Public Health Watch researcher, Brazil 14
Public Health Watch researchers from all five countries identified lack of awareness about
TB at all levels as a critical issue—one that has multiple adverse consequences and implications
for the effectiveness of TB control efforts.
In the high-burden countries under study, many people do not know the basic
facts about TB: how the disease is transmitted; that it can be treated and cured; and where
to access free treatment. In Bangladesh, where over half of the population is infected with
the TB bacillus, a recent study found that some women believed they could get TB by wearing
torn slippers. 15 According to one Nigerian doctor, “most people [in Imo State] still think
that TB patients have been poisoned. Some think it is a curse from the gods—especially
when many family members get infected—and go to fortune tellers and prayer houses for
deliverance.” 16 Even groups at an elevated risk of TB infection, including people living with
HIV/AIDS, appear to lack information about TB. For example, a recent series of social mobilization
workshops among HIV/AIDS activists in Brazil—where TB is one of the leading
causes of death by infectious disease for people with HIV/AIDS—revealed that few participants
knew even the basic facts about TB transmission and treatment. 17
Lack of information can lead to delays in accessing treatment, increasing the potential
for transmission of the disease. One recent study in Tanzania found that only 42 percent
of TB patients visited a health facility within three months of the onset of symptoms; the
median duration between onset of TB symptoms and visiting a health facility was about
eight months. 18
The low level of awareness extends to high-level political officials as well. The leader
of one faith-based organization in Thailand remarked that “the general perception among
political leaders as well as in Thai society is that TB has been completely eradicated.” 19
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TB POLICY IN THAILAND