By Shobha Shukla & Bobby Ramakant – CNS
The global health landscape today presents a troubling paradox. Despite repeated global affirmations that “health is a fundamental human right”, we remain alarmingly far from achieving this ideal. Over 70% of all deaths globally are due to non-communicable diseases (NCDs) — many of which are entirely preventable through timely action. Infectious diseases like tuberculosis (TB) and HIV/AIDS, both preventable and treatable, continue to exact a heavy toll, especially in low- and middle-income countries of the Global South.
In 2024 alone, 630,000 people died of AIDS-related illnesses, while 1.3 million new HIV infections were reported, numbers nearly unchanged from the previous year. TB, despite being a curable disease, remains the deadliest infectious disease worldwide. If every life truly matters, then why is “accountability” — the ‘A’ of action — missing from our global health frameworks?
Funding Cuts and Fading Commitments
The health crisis has deepened in 2025 following funding cuts by major donors such as the United States, alongside a global slowdown in health aid. These setbacks have led to disrupted logistics, reduced healthcare workforce, and compromised service quality. According to Dr. Sugata Mukhopadhyay, a global health expert with decades of experience across India, Mozambique, Nepal, Thailand, and Indonesia, we must now achieve more with less by radically improving the quality, efficiency, and reach of healthcare.
Working closely with organizations like Humana People to People India (HPPI), Dr. Mukhopadhyay has been part of efforts that successfully extend public TB services and social support to unreached, high-risk populations. His work provides a critical lesson: unless we prioritise the needs of the most marginalized, true health equity will remain an illusion.
Gandhi’s Talisman: The Moral Compass for Health Equity
Mahatma Gandhi’s timeless guidance offers a blueprint for public health reform. He said:
“Recall the face of the poorest and weakest person you have seen, and ask yourself if the step you contemplate is going to be of any use to them. Will it restore control over their life and destiny?”
This simple but profound principle should be the core ethic of any healthcare system. The services available to the weakest person in society must not only be adequate — they should set the benchmark for everyone else.
Person-Centred Care: Health Beyond Disease
Speaking at a side event during the 13th International AIDS Society (IAS) Conference 2025 and post the 10th Asia Pacific AIDS and Co-Infections Conference (APACC) in Japan, Dr. Mukhopadhyay emphasized the need for person-centred care — a model that places individuals and their lived experiences at the heart of healthcare delivery.
“In person-centred care, everyone — patients, providers, families, and communities — plays an equally important role. It’s not about a hierarchy; it’s about a coordinated partnership,” he said.
Unlike conventional models that treat people as passive recipients of care or “cases,” person-centred care recognizes people as full partners — individuals with preferences, needs, and rights.
Beyond Patients: People, Not Just Numbers
While the term “patient-centred care” focuses on those seeking medical help, person-centred care goes further, recognizing individuals as whole beings, not defined merely by illness or statistics. It advocates for dignity, autonomy, and mutual respect in the healthcare journey — a move from “treatment of disease” to “enhancement of well-being.”
This approach encourages people to be active participants in decision-making, from choosing care pathways to shaping public health policies. It shifts the perspective from “treating” to “empowering.”
Differentiated Service Delivery: One Size Doesn’t Fit All
The differentiated service delivery (DSD) model, already implemented in HIV programmes and now expanding to TB, is a key pillar of the person-centred approach. DSD tailors treatment and care to the unique health and social needs of individuals — ensuring flexibility, responsiveness, and minimized burden on both the system and the recipient.
“It’s not just about curing disease; it’s about restoring functionality, dignity, and social integration,” noted Dr. Mukhopadhyay.
For instance, DSD may offer multi-month drug refills for stable HIV patients or community-based DOTS for TB care — innovations that make treatment accessible and less disruptive to daily life.
Tackling Stigma, Enhancing Support
Addressing health requires more than medicine. According to Dr. Mukhopadhyay, effective care also demands action on stigma, discrimination, gender inequality, and economic vulnerability. To truly uplift those affected by TB and HIV, we must integrate livelihood opportunities, legal protections, social security, and out-of-pocket expenditure reduction into the care system.
“The goal of person-centred TB care is not just to cure but to complete both curative and preventive treatments. For HIV, it means sustained viral suppression and achieving the #UequalsU standard — Undetectable equals Untransmittable.”
The Role of Communities and Civil Society
Achieving these goals requires a collective effort. Dr. Mukhopadhyay commends the vital role of civil society, people living with HIV, TB survivors, and community health workers, whose ground-level engagement makes person-centred care possible. Their voices must be amplified in advocacy for integrated and patient-friendly national health policies, especially in the Global South.
Triple Mantra for TB-HIV Care Reform
Dr. Mukhopadhyay offers a three-pronged strategy to revolutionize care for TB and HIV:
1. Unified TB-HIV Programmes
Instead of fragmented control programmes, we must adopt a merged TB-HIV elimination strategy. Since both diseases disproportionately affect the same vulnerable populations, one programme, one strategy, and one point of care will reduce inefficiencies and improve outcomes.
2. Enhanced Contact Treatment
Index cases (the first identified infected individuals) must trigger a comprehensive response — screening and treating all close contacts. This ensures early detection, reduces transmission, and empowers individuals to demand care for their loved ones as part of their right to health.
3. Capacity Building for Person-Centred Care
At national and sub-national levels, we must invest in training, tools, and digital platforms to support person-centred care. This includes patient charters, stigma measurement tools, and user-friendly applications for self- and community-monitoring, ensuring real-time feedback and accountability.
A Call to Put People Before Profits
As the world strives to meet the United Nations Sustainable Development Goals (SDGs) — particularly SDG 3 (Health and Well-being) and SDG 5 (Gender Equality) — person-centred care must become the guiding principle for all health reforms. Profit-driven models, donor dependency, and disease-centric silos have failed to deliver equity.
Instead, governments must shift focus: from systems to people, from diseases to dignity, and from volume to value.
The truth remains clear: it takes a village to heal a person, just as it takes a rights-based, person-centred system to heal global health.