The silence that kills. How your voice can end tuberculosis

_________________

OPINION

By Deborah Aujo

What if ending Tuberculosis (TB) starts with you? It begins not in a clinic, but with a conversation. It grows with a simple act of courage: talk about TB without shame. Support those who are sick. Do not shun them. Choose compassion over fear. Get tested not just for yourself, but for your community.

We have the medicines to cure it. What we lack is openness. Tuberculosis thrives in silence, but it is defeated with solidarity.

Nelson Mandela once called TB “a disease of poverty and inequality”.  Today, it is a disease of stigma; a silence that spreads faster than the bacteria themselves. We can test for TB. We can treat it. We can prevent TB. Yet many people remain undiagnosed, not because services are unavailable, but because of judgment.

Consider the boda boda rider who has been coughing for 2 weeks but avoids testing for fear of losing his source of income. The market vendor in Kisenyi, who hides her cough, is terrified of gossip. The fisherman at Kasenyi landing site, who would rather suffer in silence than be labelled “dirty.” These are not just stories; they are realities that fuel an epidemic hiding in plain sight.

The numbers tell a devastating story. In 2023 alone, tuberculosis infected 10.8 million people worldwide. It claimed 1.25 million lives - mothers, fathers, children - each one a preventable tragedy. Here in Uganda, our health workers screened 22,699 people last year, and uncovered 673 new cases - that's 673 people saved from prolonged illness and prevented from unknowingly spreading the disease to their families and communities. Yet for every case we find, how many more remain hidden not because they are invisible but because they are afraid.

We live in an era of medical miracles, yet TB, a disease we've known for centuries, still ravages our communities. Why? Because fear silences people. Shame delays testing. Stigma kills.

Portable digital X-ray machines and shorter TB treatment regimens mean nothing if those most affected are too afraid to come forward. We must create spaces where conversations about TB are met with empathy, not judgment. Where a cough is met with concern, not contempt.

This is not just the work of health workers and policymakers.  This is your work. It is my work. It is our work. Let us talk openly about TB. Tuberculosis isn’t a "dirty disease." It’s a preventable, treatable infection. Support, don’t stigmatise those affected. Get tested early, spread facts, not fear about TB. Shaming sufferers only drives it underground.

TB isn’t waiting. Why should we?

The time to act is NOW.

The writer is a field epidemiology fellow in the Uganda Public Health Fellowship Program, hosted at the National Tuberculosis Leprosy Program, Ministry of Health