Activating Law and Human Rights to End Tuberculosis: An Empirical Assessment of Ten Countries' Fulfillment of United Nations Commitments

Abstract

The United Nations General Assembly held the first-ever High-Level Meeting on Tuberculosis in 2018 (the TB UNLHM). In the Political Declaration that followed, Heads of State made ambitious pledges to end TB and drug resistant TB by 2030. Among these were pioneering legal and human rights commitments on the right to health, non-discrimination, and access to medicines. In 2020 and 2023, the UN Secretary-General and World Health Organization released reports examining countries’ progress toward the UN pledges. The reports discuss some human rights initiatives and contain data for key targets, such as reductions in TB incidence and deaths, but they do not empirically evaluate progress toward the legal and human rights commitments. This paper fills this gap by reviewing law and policy in ten countries with high burdens of drug-resistant TB. It develops the TB UNHLM Legal Rights Index modeled on the Human Development Index, comprising quantitative indicators for the legal and human rights pledges. Using this empirical framework, this paper evaluates over 150 legal instruments from the ten countries and finds that each has failed to meet all three commitments. The results nonetheless demonstrate significant variation among the countries and highlight challenges and opportunities as they work to fulfill their pledges in the new Political Declaration from the second TB UNHLM held in September 2023.