Abstract
Patients diagnosed with tuberculosis (TB) continue to
experience clinical uncertainty and high mortality and to
bear a high burden of symptoms and other concerns.
Additional concerns may be family support needs and
stigma, particularly the latter, as TB and human
immunodeficiency virus (HIV) coinfection are common.
Human rights covenants, global health policy and the
End TB Strategy all recommend palliative care as an
essential component of care services. As established in
the resolution adopted by the World Health Assembly
(WHA) on ‘‘Strengthening of palliative care as a
component of comprehensive care throughout the life
course’’, there is a ‘‘need for palliative care across disease
groups (non-communicable diseases, and infectious
diseases, including HIV and multidrug-resistant tuberculosis), and across all age groups’’. We address the
ethical imperative to respect the dignity and fundamental rights of people with TB by providing palliative care.
We review the evidence for the need for person-centred
palliative care and highlight novel models that utilise the
skills and training functions of specialist palliative care
to achieve better care. We outline simple recommendations for the delivery of specialist and generalist
palliative care, offer suggestions on how to ensure
optimal coverage by enabling access to appropriate
good-quality palliative care at all points of the health
system, including alongside treatment. Finally, we set
out the current priorities for research and policy to
ensure that quality care is delivered to all who need it
irrespective of treatment outcome, to minimise distress
and to optimise engagement in treatment and care.
