Prominent tuberculosis (
TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TBtechnologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TBtechnology D&I.
The fundamental ethical issue facing
TBtechnological D&I is a failure within and beyond the TBcommunity to stand in solidarity with persons with TBin addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TBelimination.
We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new
TBtechnologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action.