Managing tuberculosis in people who use and inject illicit drugs

Getahun, Haileyesus; Baddeley, Annabel; Raviglione, Mario

doi:10.2471/blt.13.117267

Cited by 28 publications

(29 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…151 Not only do punitive laws drive PWUDs away from health services, they may also contribute to stigmatising or disrespectful treatment in health services. 151 For these reasons, in its 2014 guidance on HIV services for “key populations” including PWUD, WHO recommended decriminalisation of drug use as well as training and protections for health workers to reduce fear of treating PWID. 152 …”

Section: Drug Policy and Infectious Diseasesmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

View full text Add to dashboard Cite

Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Johns Hopkins-Lancet Commission is concerned that drug policies are often colored by ideas about drug use and drug dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug abuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, found it important to emphasize that “[d]rug use is neither a medical condition nor does it necessarily lead to drug dependence.” The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, alcohol for which the goal of social policy is to reduce potential harms. Health impact of drug policy based on enforcement of prohibition The pursuit of drug prohibition has generated a parallel economy run by criminal networks. Both these networks, which resort to violence to protect their markets, and the police and sometimes military ...

show abstract

Section: Drug Policy and Infectious Diseasesmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Furthermore, the inherent behaviour of PWUIDs in tribal populations such as these often deters them from accessing care for their clinical condition. 6 Thus, innovative community-based interventions that include the involvement of IDU network groups should be considered to improve adherence among similar patients during anti-tuberculosis treatment. 10 Whenever possible, a vertical approach to the management of infectious diseases should be avoided in PWUIDs; the diagnosis and management of infections should instead be available at the primary health care level.…”

Section: Public Health Action Tb Outcomes In Substance Abusers 181mentioning

confidence: 99%

“…First, the group should be routinely screened for TB symptoms, as they are known to be at high risk of developing active TB disease. 6 The Standards of TB Care in India (STCI) recommend the screening of TB in high-risk groups such as HIV-infected individuals, patients suffering from diabetes/malnourishment, miners and health care workers, but overlook PWUIDs. 8 Second, as TB diagnosis can be more complicated in this vulnerable group (a quarter of the cohort had smear-negative TB), access to more sensitive molecular diagnostic testing, such as Xpert, is important as it can avoid delays in diagnosis and treatment.…”

Section: Public Health Action Tb Outcomes In Substance Abusers 181mentioning

confidence: 99%

“…National TB programmes should devise separate diagnostic and treatment algorithms that take into account policies aimed at curbing illicit drug abuse, plus criminalisation legislature related to PWUIDs, 3 drug substitution therapies, nutritional support 6 and …”

Section: Public Health Action Tb Outcomes In Substance Abusers 181mentioning

confidence: 99%

“…IDUs are highly affected by the HIV epidemic in Nagaland. 5 PWUIDs are also at high risk for TB 6 due to associated factors such as poverty, unemployment, malnutrition, stigma, complex treatment needs and limited access to health care.…”

mentioning

confidence: 99%

See 2 more Smart Citations