On World TB Day, a reminder of why treatment needs to be responsive to gender

A couple of years ago, in a meeting, a colleague asked me why we need to consider gender or sexuality in tuberculosis care. “TB can happen to anyone who breathes,” this person said. “Aren’t we all equally vulnerable?”

Yes, TB is an airborne illness and we are all vulnerable. But equally vulnerable? Four countries account for over half the global burden of drug-resistant TB – a form of TB that is resistant to first-line medication and requires stronger medicines. Among them, India leads the tally, accounting for 32% of global cases of drug resistant-TB.

While we are all vulnerable to TB and drug-resistant TB, the extent of vulnerability differs. Socioeconomic determinants such as the lack of access to well-ventilated houses, food insecurity and cultural barriers to healthcare access put some people at a higher risk for TB than their socioeconomically privileged counterparts.

Further, vulnerability to TB varies by gender, sexuality and related cultural barriers in accessing care.

Gender inequities

Women in rural areas hesitate to seek care where female health providers are unavailable. Women in traditional settings may not be allowed to travel without a male companion, and are dependent on others for healthcare access. Their default role as family caregiver often means that they tend to themselves last, in the best-case scenario, and...

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