The dollars and sense of fighting homophobia, a call for culture change in the west and better words for TB talk . . . We’re reading the health benefits of changing attitudes

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NewWWRAt the World Bank, turning finance ministers into gay rights advocates – Discriminating against gay people and other sexual minorities is not only nasty, it’s expensive. That’s the message the World Bank began to gather the data to support, and then deliver in a report showing how homophobic discrimination leads to a cycle of poverty that undermines economies. While critics quoted in this article about the approach say the World Bank could do more, including introducing concepts of “decency” and “dignity” into discourse, they concede the value of an approach that introduces an apparently difficult concept in practical terms. Now, if only similar arguments based on science and public health could be made to policy makers in a country’s losing their fight against HIV, for example, Uganda.

Fighting Ebola requires a culture change in the west as well as west Africa – Although the worst of the Ebola crisis appears to be over, it continues, and the way it has been perceived continues to pose threats to future timely and effective public health responses, this article by former UNAIDS head and Ebola co-discoverer Peter Piot and International Rescue Committee David Millibrand says. The article looks at the impacts of low health worker salaries in weakening defenses against the outbreak, and of community leaders and organizers in turning the tide of the crisis. It reminds readers also  that the work is not done, nor have billions of dollars in pledged funds been delivered. Essential to future success, they argue, will be an examination of assumptions about why the outbreak exploded as it did. At the same time, this New York Times article about Liberia President Ellen Johnson Sirleaf’s evaluation of her own errors in initial responses to the outbreak can serve as an inspiration.

Retiring stigmatizing and criminalizing language form the global TB discourse – Think about the terms “defaulter” for a person on TB treatment who was lost to follow-up, “suspect” for a person who might have TB and should be evaluated, and “TB control” to express the concepts of disease prevention and care. The Community Research Advisors Group – CRAG — and other community-based organizations did, and sent an open letter to the organizer of the world’s largest TB conference and publisher of the TB field’s most prominent publication, suggesting consideration of words used to express challenges the disease presents. They  urge getting rid of words that imply judgement and replacing them with ones that better describe circumstances and the actions needed them. They include a link to a draft copy of the Stop TB Partnership’s tuberculosis terminology guide, which also draws attention to terms like “cocktail” to describe a combination of drugs (sounds like fun, but isn’t) and “case” (use sparingly — patients prefer to be regarded as people).

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