TB's Impact on Women

By on .

Women face a severe burden when it comes to tuberculosis. In fact, the latest WHO report on TB states that women are likely to wait longer than men before they seek medical attention, in part because of the social stigma attached to TB.  TB is the biggest infectious disease killer of women of child-bearing age.

I had a chance to explore this issue with an expert from India while I was attending last month’s TB Forum in Rio De Janiero, Brazil. I met with Blessi Kumar, whose organization, Rahein, a health and development consultancy and technical support group, has partnered with the Treatment Action Group.

One key point she makes is that, “We have spent our energy on HIV/AIDS and now we need to show the same commitment to TB especially with TB in women. If change is to come, it will happen with women raising their voices loud and clear. So, to the women of the United States I would say you are in a relatively more empowered state, and you probably have more opportunity to talk about this, so do raise your voice loud and clear, demand more access to health and resources for tuberculosis.”

Interview with Blessi Kumar, MISBAH, India
at the Stop TB Forum in Rio De Janiero, Brazil
March 25, 2009

David Bryden, Center on Global Health Policy, IDSA:
It’s a pleasure to hear about your work with women and communities in India.

Ms Kumar:
Yes, I have a health and development services and support NGO in India. This organization basically builds the capacity of smaller NGOs and societal organizations. So, I am very interested in the issues that surround women especially.

David Bryden:
How have you seen the impact of tuberculosis in the communities where you have been working?

Ms Kumar:
India is one of the top 22 countries with a high burden of TB, so TB is a very big problem. And, also with the very closed community that we are in India, we tend to hide things and not discuss. It was the same with HIV a few years ago, but it’s the same with TB. There’s a lot of stigma and discrimination so people do not want to come out with the problem.

David Bryden:
How does tuberculosis connect to the broader issue of poverty?

Ms Kumar:
The social determinates of tuberculosis are very clear. Poverty is one of the biggest problems and housing. The impact on women is quite serious because they are at the bottom of everything whether it comes to health services or economic empowerment and whether it is access to food and nutrition. Women are really in the bottom strata of the society, and, coupled with that is the effect of gender discrimination against women. There is no equal opportunity, so it affects a lot of women. Access to health is a big problem for women.

So, tuberculosis is complicated by all of these things and while, yes, it does affect everyone in the society, women tend to suffer a lot more just because their access to healthcare is so low, and it is so difficult for them. In fact, the health-seeking behavior of women is very poor in the communities that I work with, and part of the empowerment process is to help them put their health first and to make them understand that their own health is important. They must begin to put their own health first rather then putting their family first and neglecting their own health. It’s the same as reproductive health.

David Bryden:
And in India how do you see the government’s commitment to take action on these issues?  Has there been any improvement?

Ms Kumar:
Yes, I think there has been some change, but these policies and other changes which are printed in policy papers and books remain policies until they are demonstrated with actions at the ground level. Yes, we have come a long way from 50 years ago when the situation was very different, but what has happened is that efforts need to be accelerated really fast. We cannot sit back and say yes change will come. Because of this whole feminization of HIV/AIDS a few years ago we were losing lives, so we really needed to pull up our socks and work really hard to address that, and now that same commitment needs to be shown in the TB world as well, which unfortunately is not there.

David Bryden:
We don’t see as strong of a movement in the case of TB, compared to HIV?

Ms Kumar:
That’s true.

David Bryden:
Turning to the Global Fund, what is your view of the Fund and do you feel that the money has made a contribution?

Ms Kumar:
It has, but it’s not very equitable. If you see the pie chart of the funding you see a very small amount for TB. Especially for malaria in the last few years, the share has increased, but with TB it has remained more or less the same. So I think putting resources towards TB is extremely important and to look at vulnerable populations and women would really top that list.

David Bryden:
So, do you see health in general as a feminist issue?

Ms Kumar:
Well, when there is gender inequality that is so obvious in every sector, health does become a big gender issue, so when we talk about equality we are talking about a society in which everyone has the same right to access health, to have economic independence, to have rights to education, which all women don’t have still.

David Bryden:
If you could say one thing to advocates and activists in the United States what would you like to tell them?

Ms Kumar:
With regards to TB, I would like to say that TB is a big problem and time is short. We have spent our energy on HIV/AIDS and now we need to show the same commitment to TB especially with TB in women. If change is to come, it will happen with women raising their voices loud and clear. So, to the women of the United States I would say you are in a relatively more empowered state, and you probably have more opportunity to talk about this, so do raise your voice loud and clear, demand more access to health and treatment and medications and resources for tuberculosis.

Leave a Comment

Your email address will not be published. Required fields are marked *