One of the world's leading causes of death, tuberculosis (TB) remains a stigmatized and feared disease. Prevention, diagnosis, and adherence to TB treatment remain a challenge for many people, including migrants, those with alcohol and drug dependency, sex workers, people living with
the human immunodeficiency virus, and individuals with disabilities. Low levels of TB treatment literacy and ignorance of transmission risks are common, and—along with inadequate funding for treatment support—contribute to patients' non-adherence to treatment. Recent cases involving
the detention of individuals with TB in Kenyan and Canadian correctional facilities illustrate the circumstances under which individuals interrupt treatment and how health authorities seek restrictive measures to oversee and compel treatment. The legitimacy of restrictive measures is often
defended by international public health authorities in relation to the non-binding Siracusa Principles. Yet in practice, as illustrated by examples from Kenya and Canada, government authorities and local laws sometimes do not fully meet, or entirely disregard, the requirements in the Siracusa
Principles that restrictions on rights in the name of public health be strictly necessary and the least intrusive available to reach their objective. In addition, more specific standards are required at the international level to guide states' development and use of rights-restricting measures
to address TB.
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Document Type: Research Article
Health and Human Rights Division, Human Rights Watch, New York, New York, USA
Public Health Program, Open Society Foundations, New York, New York, USA
Publication date: 21 March 2013
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