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Year : 2022  |  Volume : 15  |  Issue : 6  |  Page : 954-955  

To END TB, we need a paradigm shift in the way we refer to stakeholders

Hon Secretary and Technical Adviser, The Maharashtra State Anti TB Association, Mumbai, Maharashtra, India

Date of Submission02-Nov-2021
Date of Decision24-Nov-2021
Date of Acceptance25-Nov-2021
Date of Web Publication28-Jan-2022

Correspondence Address:
Dr. Yatin Dholakia
2B Saurabh, 24E Sarojini Road, Santacruz West, Mumbai - 400 054, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_866_21

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How to cite this article:
Dholakia Y. To END TB, we need a paradigm shift in the way we refer to stakeholders. Med J DY Patil Vidyapeeth 2022;15:954-5

How to cite this URL:
Dholakia Y. To END TB, we need a paradigm shift in the way we refer to stakeholders. Med J DY Patil Vidyapeeth [serial online] 2022 [cited 2023 Jan 30];15:954-5. Available from: https://www.mjdrdypv.org/text.asp?2022/15/6/954/336715

Dear Sir,

The private health sector has a major role to play in the plan to eliminate tuberculosis. Globally, tuberculosis programs are striving to engage the vast private sector in many countries through various interventions.

Public health experts and researchers alike have often referred to the private sector as “unregulated,” “for profit,” “chaotic,” “substandard,” “profit driven,” and “arbitrary.”[1] One World Health Organization report has referred to allopathic practitioners as “unqualified.”[2] Such disparaging terms do not augur well for healthy collaboration and only widens the gap among the stakeholders. Media, both print and electronic, pick up these terms and use these widely in their reporting of health issues many a time leading to violence against doctors and health-care providers.

A large group of international experts[3] advocated for the tuberculosis program to shift the onus of completion of treatment from patients to the health system. The patient-centered approach is the norm and the formerly used terms to describe individuals likely to be suffering from the disease (suspects), not taking regular treatment (defaulters), and many others have been systematically changed to more positive ones.[4] It is strange that the same group of experts failed to consider and have so far been unconcerned about their own professional colleagues being subject to such disrespect.

Researchers do not leave any opportunity to malign the private sector. Even when they collaborate with the private sector and publish findings from interventions carried out in public-private initiatives,[5] they use such irreverent terms as “unregulated” for their description of the private sector – the very sector in collaboration with whom they carry out these interventions. Published literature is replete with such communication, whereas only a few articles such as private sector's compliant practices[6] or attempts to explain their treatment practices[1],[7] get reported. Such articles many a time rarely get pass the first editorial scrutiny and fail to see the light of the day (author's personal experience).

Attitudes have strong relation to the way we use words in our communication. Good communication can be enabling, can empower people, and create healthy work environments and partnerships. Pejorative language, on the other hand, can have detrimental effects. It can be devastating and can ruin relations.

Time is running out in the race to END TB. Mutual respect and positive communication are very much the need of the hour if we want to achieve our goal. In the words of Woodrow Wilson, ”We cannot be separated in interest or divided in purpose; we stand together until the END;” and END TB we MUST.

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Conflicts of interest

There are no conflicts of interest.

  References Top

McDowell A. Dr. Zahir's dilemma: Money and morals in India's private medical networks. BioSocieties 2021;16:363-86.  Back to cited text no. 1
World Health Organization. In: Anand S, Fan V, editors. The Health Workforce in India. 2016: World Health Organization; Geneva.  Back to cited text no. 2
Zachariah R, Harries AD, Srinath S, Ram S, Viney K, Singogo E, et al. Language in tuberculosis services: Can we change to patient-centred terminology and stop the paradigm of blaming the patients? Int J Tuberc Lung Dis 2012;16:714-7.  Back to cited text no. 3
United to END TB. Every Word Counts. Suggested Language and Usage for Tuberculosis Communications. First Edition. Available from: http://www.stoptb.org/assets/documents/resources/publications/acsm/LanguageGuide_ForWeb20131110.pdf. [Last accessed on 2021 Sep 09].  Back to cited text no. 4
Huddart S, Ingawale P, Edwin J, Jondhale V, Pai M, Benedetti A, et al. TB case fatality and recurrence in a private sector cohort in Mumbai, India. Int J Tuberc Lung Dis 2021;25:738-46.  Back to cited text no. 5
Dholakia Y, Quazi Z, Mistry N. Drug-resistant tuberculosis: Study of clinical practices of chest physicians, Maharashtra, India. Lung India 2012;29:30-4.  Back to cited text no. 6
  [Full text]  
Dholakia Y, Mistry N, Lobo E, Rangan S. Use of standardised patients to assess quality of tuberculosis care. Lancet Infect Dis 2016;16:23.  Back to cited text no. 7


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