2.2.6 Protection from stigmatization, discrimination and harm

Discrimination based on gender, sexuality, ethnicity or caste or against populations such as sex workers and people who use or inject drugs, can severely limit access to treatment, which may be reinforced by the lack of a framework for protecting human rights. The existing frameworks for protecting human rights and the extent to which they are enforced must be reviewed before systematic screening is implemented.

Possible stigmatization of and discrimination against people screened for TB and people with diagnosed TB can create risks for people undergoing screening. For example, people with diagnosed TB may lose their jobs temporarily or permanently or be expelled from school or forced to divorce. The legal protection of the rights to care and to maintain employment must be considered. The legal status of migrants should be carefully considered when designing a screening plan, with regard to both their access to health services and their risk of expatriation if they are diagnosed with TB. If lack of protection of rights or other social risks affect people and communities that are at high risk of TB, measures must be taken to mitigate those risks as part of any systematic screening programme, and informed consent must be sought. While informed consent for TB screening is ethically required in all cases, it is especially important for populations who may face repercussions from a TB diagnosis.

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