SSHIFTB and Several Collaborators Sponsor Fiery Debate on TB Stigma in Africa
Details
SSHIFTB, along with several collaborators, sponsored a fiery debate at the South African TB Conference this summer. The debate focused on addressing TB stigma in Africa, weighing the merits of scaled-up counseling and education against social and economic protections. The conference was held at the Durban Inkosi Albert Luthuli International Convention Centre from June 4th to 6th.
Panelists from diverse backgrounds brought varied perspectives to the debate, including:
– Andrew Medina Marino, Principal Investigator at the Desmond Tutu Health Foundation, focused on men’s health in TB and HIV.
– Phumeza Tisile, Advocacy Officer at TB Proof and Drug-Resistant TB Survivor.
– Boitumelo (Tumi) Seepamore, Researcher at the University of KwaZulu-Natal with a background in public health social work.
– Kavindhran (Kavi) Velen, Senior Scientist at FIND, trained in epidemiology and microbiology.
The debate was co-facilitated by Jeremiah Chikovore (Human Sciences Research Council – South Africa, and SSHITB) and Alanna Bergman (John Hopkins School of Nursing, and SSHIFTB).
Tumi began the debate by arguing for structural economic protections. She made a compelling case for non-contributory social security and other social justice factors driving determinants of TB health. Kavi rebutted, suggesting that counseling and education could address TB stigma by improving understanding and awareness, facilitating behavioral change and health-seeking behavior, and fostering social and emotional support through empowerment. Phumeza provided a rebuttal to each perspective, infusing the debate with her lived experience as a community representative.
Andrew discussed the limited information available on the acceptability of either approach, particularly regarding gender. His current research supports existing literature indicating differences in manifestations and experiences of stigma by gender. This led to a larger and animated conversation involving the audience about the need for gender-specific and more broadly differentiated interventions based on identity. We would also like to acknowledge Goodman Makanda (TB survivor and advocate) for his insights, dovetailing with Phumeza to highlight the real-world manifestations of TB stigma and the perspective of the community.
As a group, we came to a consensus that stigma reduction requires a holistic and multi-faceted approach to combat the intersectional nature of stigma.
We were fortunate to have incredible audience engagement from TB advocates, clinicians, academia, and civil society. The debate was well attended, with many audience members acknowledging the lack of social science at scientific conferences despite the clear relationship between social factors and TB transmission, care access, and treatment completion. The audience emphasized that they would like to see more of such conversations, preferably in longer sessions, and featuring health workers as well as policymakers, at future conferences.
Thank you to all the wonderful panelists and attendees for your time, attention, and dedication to this topic. We look forward to expanding this conversation as we aim to leverage meaningful interventions towards stigma reduction.
