Tuberculosis discourse in South Africa : a case study

Abstract

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.