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Prevention and Treatment of Tuberculosis in Low- and Middle-Income Countries: Ethical Challenges

Although tuberculosis (TB) affects people worldwide, particularly those of lower socioeconomic status, the vast majority of the burden is felt in low- and middle-income countries (LMICs). In turn, the ethical challenges posed by TB care and control are especially salient in LMICs faced with acute and chronic resource constraints. For some of these challenges, there is broad agreement about what ought to be done. TB prevention among close contacts of contagious patients, for example, is essential. Other challenges, however, are either new or refractory and require greater consideration. This chapter discusses three such key ethical challenges posed by TB care and control, particularly within the context of LMICs: isolation and involuntary isolation, third-party notification, and the introduction of new antitubercular drugs.