Social protection for tuberculosis—how can we make it universal?

Tuberculosis is strongly associated with social determinants such as undernutrition, poor housing, and poor access to health care. Moreover, tuberculosis rates declined in high-income countries well before the advent of effective antibiotics, largely due to improvements in socioeconomic conditions.

Despite this knowledge, the global tuberculosis strategy has largely relied on a biomedical paradigm, centered on diagnosis and treatment of individuals once they develop tuberculosis. However, thanks to a steady accumulation of evidence, there is growing awareness about the need to address social determinants through social protection. According to WHO, social protection refers to the set of policies and corresponding programmes designed to prevent and reduce poverty, vulnerability, and social exclusion throughout the life course. Universal social protection is a precondition for social development, and is crucial for accelerating progress towards the Sustainable Development Goals (SDGs).