title: Limitations on human rights: are they justifiable to reduce the burden of TB in the era of MDR- and XDR-TB?
abstract: Tuberculosis, in all its forms, poses a serious, demonstrable threat to the health of countless individuals as well as to health as a public good. MDR-TB and, in particular, the emergence of XDR-TB, have re-opened the debate on the importance, and nature, of treatment supervision for basic TB control and the management of drug-resistant TB. Enforcing compulsory measures regarding TB patients raises questions of respect for human rights. Yet, international law provides for rights-limiting principles, which would justify enforcing compulsory measures against TB patients who refuse to have diagnostic procedures or who refuse to be monitored and treated once disease is confirmed. This article analyzes under what circumstances compulsory measures for TB patients may be enforced under international law. Compulsory measures for TB patients may, in fact, be justified on legal grounds provided that these measures are foreseen in the law, that they are used as a last resort, and that safeguards are in place to protect affected individuals. The deadly nature of the disease, its epidemiology, the high case fatality rate, and the speed at which the disease leads to death when associated with HIV are proven.
authors.affiliation: Department of History and Social Sciences, Bryant University, Smithfield, Rhode Island, USA. boggio@stanfordalumni.org
authors.forename: Andrea
authors.initials: A
authors.lastname: Boggio
authors.forename: Matteo
authors.initials: M
authors.lastname: Zignol
authors.forename: Ernesto
authors.initials: E
authors.lastname: Jaramillo
authors.forename: Paul
authors.initials: P
authors.lastname: Nunn
authors.forename: Geneviève
authors.initials: G
authors.lastname: Pinet
authors.forename: Mario
authors.initials: M
authors.lastname: Raviglione
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006806:Human Rights; D006801:Humans; D011635:Public Health Administration / Q000331:legislation & jurisprudence* / Q000379:methods*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents