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Lancet. 2015 Dec 5;386(10010):2354-62. doi: 10.1016/S0140-6736(15)00324-4. Epub 2015 Oct 26.

Stopping tuberculosis: a biosocial model for sustainable development.

Author information

1
Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
2
Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA; Wellcome Trust Africa Centre for Health and Population Studies, Mtubatuba, South Africa.
3
Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA. Electronic address: ratun@hsph.harvard.edu.

Abstract

Tuberculosis transmission and progression are largely driven by social factors such as poor living conditions and poor nutrition. Increased standards of living and social approaches helped to decrease the burden of tuberculosis before the introduction of chemotherapy in the 1940s. Since then, management of tuberculosis has been largely biomedical. More funding for tuberculosis since 2000, coinciding with the Millennium Development Goals, has yielded progress in tuberculosis mortality but smaller reductions in incidence, which continues to pose a risk to sustainable development, especially in poor and susceptible populations. These at-risk populations need accelerated progress to end tuberculosis as resolved by the World Health Assembly in 2015. Effectively addressing the worldwide tuberculosis burden will need not only enhancement of biomedical approaches but also rebuilding of the social approaches of the past. To combine a biosocial approach, underpinned by social, economic, and environmental actions, with new treatments, new diagnostics, and universal health coverage, will need multisectoral coordination and action involving the health and other governmental sectors, as well as participation of the civil society, and especially the poor and susceptible populations. A biosocial approach to stopping tuberculosis will not only target morbidity and mortality from disease but would also contribute substantially to poverty alleviation and sustainable development that promises to meet the needs of the present, especially the poor, and provide them and subsequent generations an opportunity for a better future.

PMID:
26515678
DOI:
10.1016/S0140-6736(15)00324-4
[Indexed for MEDLINE]

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