ABSTRACT
Many consider tuberculosis (TB) to be the archetypal disease of poverty. It particularly affects those who are marginalised or are economically and socially excluded. What does this mean for the way in which we, as clinicians, manage people with TB? The simplest answer is to say that it is not our field; that poverty should be tackled by politicians and economists and not by health professionals. Attractive though this answer may be to clinicians who are hard-pressed to provide day-to-day clinical service, it is the wrong answer. Ignoring the deprived socio-economic circumstances of the majority of patients with tuberculosis in the way we design, deliver and develop clinical services sets us on the path to failing patients as well as their families and our wider communities. This chapter analyses the relationship between poverty and TB and suggests how an explicit recognition of the importance of poverty can be a guiding principle in our individual and collective clinical and public health responses to TB.
