R.J. Cokera,, S. Mounier-Jacka, R. Martinb
Summary Background: Tuberculosis control is an important public health challenge
in many European countries. Law is an important tool that policy-makers can
draw upon to support control efforts and, according to the World Health
Organization, represents a tangible expression of political commitment and will.
Despite this, little national research, and even less cross-national comparative
research, has been conducted to describe and analyse legislative approaches to
tuberculosis control.
Methods: We conducted a survey of 14 European countries to identify, describe,
map and analyse legislative tools used to support tuberculosis control.
Results: We found a wide range of legislative models. Legal measures available to
nation states, such as compulsory examination, compulsory screening, compulsory
detention, compulsory treatment and compulsory vaccination, vary widely in both
scope and number. We identified a typology of legal frameworks, from the most
authoritarian to the least restrictive. It seems likely that the application of some
laws might not withstand scrutiny under the European Convention for the Protection
of Human Rights and Fundamental Freedoms.
Conclusions: Harmonization of legislative response to infectious diseases, based
upon sound evidence, may be necessary if collaborative efforts in support of
infectious disease control, as envisaged in the new International Health Regulations,
are to be most effective and are to reflect more appropriately a globalized 21st
century world.
Public health law and tuberculosis control in Europe
