In this article, James Deane explores how the Stop Tuberculosis (TB) Partnership has adopted a communication approach that blends behaviour and social change communication strategies, social mobilisation and advocacy into a single coherent framework of action and explains why this approach is critical.

According to the article, in the most recent World Economic Summit in Davos, Switzerland saw a number of world leaders pledge financial commitments to combating TB. However, at the same time behind the headlines, the Stop TB Partnership was bringing together a broad range of disciplines and sectors to develop what is considered to be an unprecedented, ambitious and coherent 10-year strategy for TB control. The role of advocacy, communication and social mobilisation was recognised as having an integral part of that strategy. According to the article, the TB control strategy is designed to fulfill one of the key Millennium Development Goals set by the United Nations, namely to have “halted by 2015 and begun to reverse the incidence of tuberculosis.” Deane argues that this will be achieved only with effective communication strategies, including communication strategies to help empower people with TB.

The article explains that a critical component of any TB strategy is finding and encouraging people with the disease to come forward for treatment. This is a particular challenge because TB disproportionately affects the poor, who have less access to TB services, less capacity and time to take advantage of such services and, crucially, often a lack of knowledge of the symptoms and risks of TB. A major component of any communication strategy on TB is a relatively traditional behavioural one of encouraging those who have a cough for two weeks to seek treatment and to encourage those taking treatment to adhere to it.

The article also explains that stigma is harmful, both in itself, since it can lead to feelings of shame, guilt and isolation of people with TB and also because it may result in not making the best health choices. Stigma may result in people not accessing, or being denied, health services. Stigma results in part from misinformation or a lack of information and also from deep-seated social beliefs. Advocacy, communication and social mobilisation programmes are essential in empowering people with, or affected by, TB to take community action to confront stigma, and to educate broader communities to reduce stigma. The 10-year plan recognises explicitly that any communication strategy designed to combat TB needs to support both a process of social change in society to tackle stigma and marginalisation of people with TB, together with a process of behaviour change to persuade people to seek treatment.

The article further explains that communication strategies can offer opportunities for inclusion of people affected by TB in planning, and implementing strategies both in terms of advocacy interventions and how different communication actions/programmes can enable people with, and affected by, TB to have their voices heard in the public domain. Contemporary health communication, and particularly communication for social change strategies, are increasingly concerned with providing spaces and channels where people affected by health issues can make their voices heard, engage in dialogue and debate and achieve increased visibility as people with important perspectives that deserve attention.

Lack of political will is cited as hampering TB-control policies and the successful implementation of TB policies at the central, district and local levels. Even when good TB policies exist, there is often a gap between the policies and the programmes on the ground. Advocacy, both at the national and global level, is a growing element of the overall global TB strategy at the global and national level.

The article concludes that "the role of communication for development in general, and communication for social change in particular, has become increasingly recognised as a mainstream, central pillar of effective interventions in some of the most pressing health and development issues of our time. Clearly, the role of communication in TB is this most recent - and particularly compelling - example of that trend."