Multinational corporations and infectious disease: Embracing human rights management techniques

Background:Global health institutions have called for governments,international organisations and health practitioners to employ a human rights-based approach to infectious diseases.The motivation for a human rights approach is clear:poverty and inequality create conditions for infectious diseases to thrive,and the diseases,in turn,interact with social-ecological systems to promulgate poverty,inequity and indignity.Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases,as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights.These social determinants and economic outcomes associated with infectious diseases should interest multinational companies,partly because they have bearing on corporate productivity and,increasingly,because new global norms impose on companies a responsibility to respect human rights,including the right to health.Methods:We reviewed historical and recent developments at the interface of infectious diseases,human rights and multinational corporations.Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases,which embraced rights-based disease control strategies.Results:Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations.Indeed,in an increasingly globalised and interconnected world,multinational corporations have an interest,and an important role to play,in advancing rights-based control strategies for infectious diseases.Conclusions:There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies.Guidance offered by the United Nations in 2011 that is widely embraced by companies,governments and civil society provides a roadmap for engaging business enterprises in rights-based disease management strategies to mitigate disease transmission rates and improve human welfare outcomes.

Socio-cultural determinants of timely and delayed treatment of Buruli ulcer: implications for disease control

Introduction:Public health programmes recommend timely medical treatment for Buruli ulcer(BU)infection to prevent pre-ulcer conditions from progressing to ulcers,to minimise surgery,disabilities and the socio-economic impact of BU.Clarifying the role of socio-cultural determinants of timely medical treatment may assist in guiding public health programmes to improve treatment outcomes.This study clarified the role of socio-cultural determinants and health system factors affecting timely medical treatment for BU in an endemic area in Ghana.Methods:A semi-structured explanatory model interview based on the explanatory model interview catalogue(EMIC)was administered to 178 BU-affected persons.Based on research evidence,respondents were classified as timely treatment(use of medical treatment 3 months from awareness of disease)and delayed treatment(medical treatment 3 months after onset of disease and failure to use medical treatment).The outcome variable,timely treatment was analysed with cultural epidemiological variables for categories of distress,perceived causes of BU,outside-help and reasons for medical treatment in logistic regression models.The median time for the onset of symptoms to treatment was computed in days.Qualitative phenomenological analysis of respondents’narratives clarified the meaning,context and dynamic features of the relationship of explanatory variables with timely medical treatment.Results:The median time for initiating treatment was 25 days for pre-ulcers,and 204 days for ulcers.Income loss and use of herbalists showed significantly negative associations with timely treatment.Respondents’use of herbalists was often motivated by the desire for quick recovery in order to continue with work and because herbalists were relatives and easily accessible.However,drinking unclean water was significantly associated with timely treatment and access to health services encouraged timely treatment(OR 8.5,p=0.012).Findings show that health system factors of access are responsible for non-compliance to treatment regimes.Conclusions:Findings highlight the importance of an integrated approach to BU control and management considering the social and economic features that influence delayed treatment and factors that encourage timely medical treatment.This approach should consider periodic screening for early case-detection,collaboration with private practitioners and traditional healers,use of mobile services to improve access,adherence and treatment outcomes.