This study examines tuberculosis discourse in order to understand the ideological
factors surrounding the disease. It reveals that a dominant focus on biomedical issues
and HIV/AIDS has undermined existing perceptions of the social causes of
tuberculosis disease. The effect is an individualising of tuberculosis and its removal
from a social context. This together with a hegemonic neo-liberal paradigm of
development and state spending dictates that the biomedical reductionist treatment for
certain diseases – like tuberculosis – is most “cost-effective” and thus is advocated for
disease control. Consequently, the state is required to merely provide health-care in a
manner that ignores the social context of disease. The responsibility for the outcome
of health care (i.e. health) is therefore deferred to the individual. The unintended
consequence is that as private organisations (both for- and not-for-profit) take up the
state’s responsibility, citizens become disempowered by their limited ability to hold
the state accountable, or to engage in meaningful ways that bring about structural
change. As such, an environment that further disenfranchises the poor and defeats the
purposes of health care in general is perpetuated and diseases like tuberculosis
continue their deadly campaign.
© University of Pretoria 2007
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