Fighting Stigma and Discrimination

Stigma and discrimination are recognized as the most identified human rights-related barriers to
ending the TB epidemic, limiting access to TB services and negatively impacting quality of life. As
such and as part of the required human rights-based approach to TB it is essential that countries
understand the levels and dimensions of TB stigma and develop strategies and actions based on
evidence to address it in order to reduce peoples’ vulnerability to TB infection, increase peoples’
access to TB services and improve TB treatment outcomes.

Why invest in assessing TB stigma?
As a direct result of the political declaration of the high-level meeting of the United Nations General Assembly on the fight against tuberculosis (TB) in September 2018 and in order to meet the targets set forth in the Global Plan to End TB1 and End TB Strategy, there is now an explicit and prominent articulation of national governments’ desire and commitment to end TB stigma and all forms of discrimination, including formally linking the right to health within the TB agenda.
Countries cannot fully support the right to the highest attainable standard of physical and mental
health without assessing and addressing TB stigma as a root cause of discrimination and other human right violations.

Kuboresha -Africa Limited has strarted a program known as CATAS (Community Awareness on TB and Aids Stigma with Objectives that include:

1. To understand the level and dimensions of anticipated stigma, self-stigma, enacted stigma
   (stigma directly experienced) and observed stigma among people diagnosed with TB:
   a. To understand how and the extent to which self-stigma manifests among people
   diagnosed with TB.
   b. To understand the settings and stages of care in which TB stigma is being
   experienced and observed by people diagnosed with TB.
2. To understand the level and dimensions of secondary TB stigma, stigma directly
   experienced, and stigma observed by family members / primary carers of people diagnosed
   with TB:
   a. To understand how and the extent to which secondary stigma manifests among
   family members / primary carers of people diagnosed with TB.
   b. To understand the settings and stages of care in which secondary TB stigma is being
   experienced and observed by family members / primary carers of people diagnosed
   with TB.
3. To understand the level of perceived TB stigma against people diagnosed with TB in
   communities, and the ways in which stigma is observed by the community:
   a. To understand how and the extent to which stigma against people diagnosed with
   TB takes place in communities.
   b. To understand the settings and stages of care in which TB stigma against people
   diagnosed with TB is being observed by community members.
4. To understand the level and dimensions of perceived TB stigma against people diagnosed
   with TB in health care settings and stigma against health care workers:
   a. To understand how and the extent to which perceived stigma against people
   diagnosed with TB manifests in health care facilities.
   b. To understand the settings in which TB stigma is experienced by TB health care
   workers.
   c. To understand the settings in which TB stigma against health care workers is
   observed by other TB health care workers.
5. To understand the extent to which structural stigma (any existing laws/policies, the
   enforcement of those laws/policies and the corresponding media coverage) could harm or
   protect people diagnosed with TB.
6. To support the development of recommendations to address TB stigma in order to reduce
   peoples’ vulnerability to TB infection, increase peoples’ access to TB services and improve
   treatment outcome.

Kuboresha-Africa is mobilizing financial resources to engage the 700 CBOs in the 70 Districts of the KAL Network to mitigate the risks of stigma that has impacted negatively on the TB and HIV/AIDS response.