Stigma: A major hurdle in the fight against TB

Join us for a 60-minute Twitter chat to share your views about Stigma and it’s impact on TB using the hashtag #TBproof. All stakeholders including community health workers, healthcare professionals, patients, NGO’s, policymakers, payers, journalists, educators, nurses and researchers locally and globally are welcome. The public transcript will be recorded by Symplur.

Date: Wednesday, 24 March 2021
Time: 19:00 – 20:00 SAST
Hashtag: #TBproof
Moderator: @TBproof

NPO website:

T1: In what ways do you think stigma has contributed to TB incidence and mortality?
T2: What is the possible impact of COVID-19 on the already existing TB Stigma?
T3: What are the plans of the global community towards mitigating against the impact of COVID-19 on the stigma related commitments of the UNHLM?
T4: What should be included in ‘patient centered care’ that could improve treatment adherence?
T5: What role do you think awareness and sensitization could play in reducing TB stigma and discrimination?
CT: (Closing Thoughts): Is there anything you feel is important to add to this conversation?

Start your answers with T1, T2, T3, T4, T5 or CT for transcript purposes
Answer only after the moderator prompts. Questions will be prompted every 8-10 minutes, but keep answers coming using the relevant T and number. Introduce yourself if you are joining. Use the #TBproof hashtag in all tweets so you are visible to others in the chat as well as on the Symplur transcript afterwards.

Stigma: A major hurdle in the fight against TB
According to the Global Tuberculosis Report 2020, an estimated 10 million people fell ill with tuberculosis (TB) worldwide in 2019 and 1.4 million people died from TB. TB is one of the top 10 causes of death and the leading cause of death from a single infectious agent, worldwide. 

Stigmatized people are often discredited, seen as a disgrace, perceived to have less value or worth, or even seen as a danger’ (Stop TB Partnership, 2019).  TB is a stigmatised disease because it is often associated with Human Immunodeficiency Virus (HIV), poverty, drug and alcohol misuse, homelessness, being imprisoned or a  refugee. Some people believe that only a ‘certain kind of person can get TB’, when the truth is anyone that breathes can get TB as it is a bacteria that spreads through the air. 

Stigma is a barrier to accessing care which prevents people with TB symptoms being screened for TB or completing TB treatment (Cramm et al 2010; Datiko, Jerene & Suarez, 2020; Furin et al., 2020). By delaying seeking medical treatment, symptoms may worsen, making treatment more difficult, and the TB infection continues to spread in the community. Health workers can play an important role in treating people diagnosed with TB with compassion and respect, and avoid using stigmatizing language (for example calling someone a TB suspect or defaulter). “Stigma continues to be a major barrier to providing high quality person-centred TB care” – Phumeza Tisile, TB Proof member and XDR-TB survivor.

The Stop TB Partnership’s Global Plan to End TB 2018-2022 calls for a paradigm shift to accelerate the scale up of TB care and prevention with the goal of leaving no-one behind (Stop TB Partnership, 2019). Ending TB stigma is a global priority, as demonstrated through the political declaration signed by global leaders at the United Nations (UN) High-Level Meeting (HLM) on TB where commitments included “to promote and support an end to stigma and all forms of discrimination”. Addressing TB stigma, human rights- and gender-related barriers to accessing TB care are also national priorities for South Africa. The revised South African National Strategic Plan (NSP) emphasises the importance of reducing drop-offs throughout the care cascade (Department of Health (DoH), 2017) and grounding the TB response in human rights’ principles to reduce stigma among people living with HIV and TB by at least 50%. These approaches may include reducing stigma through community education and revitalising community-based support groups to address internalised stigma. The NSP further emphasises the need to consider social and structural factors such as poverty and gender inequality that increases one’s vulnerability to HIV, TB and STIs. Therefore, special consideration to remove human rights- and gender-related barriers to accessing high quality services is critical.  

In order to reach our dream of a TB-free world, we all need to help reduce the harmful effect of TB stigma in our communities by taking part in activities that break down false and unfair attitudes towards people with TB. 

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  1. Chats are public. Even if you use a platform like, they still show on your timeline. Think before you tweet! Read more about maintaining a good digital footprint here.
  2. Tweets are limited to 280 characters and 140 on some tweetchat platforms, so keep answers as simple as possible. Answer one question as many times as you like.
  3. Respect other members of the community and show courtesy at all times.
    Refer to the Twitter Terms and Conditions of use. Disrespectful behavior can be reported.
  4. Don’t be afraid to lurk although participation is encouraged.
  5. Visit to check out the analytics and transcript for #TBproof after the chat.
  6. If you don’t understand a question from the moderator speak up and ask for clarity.
  7. Use this opportunity to network with other stakeholders and follow them.
  8. When entering the Twitter chat, first introduce yourself and tell other members what you do so they get to know you.
  9. If you agree with someone’s perspective retweet (RT) them to show support.
  10. The chat runs for 60 minutes but you can join at any time.
  11. Start answers with the relevant T and number.
  12. Answer each question after the moderator prompts but keep answers coming even if we move onto the next question. We don’t want to miss out on your views.
  13. Both panel experts and attendees are invited to participate because everyone’s perspective counts.
  14. Use the hashtag #TBproof in all of your tweets or you won’t be visible to others as well as on the transcript recording.
  15. Have fun, and invite others to support the session!
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