Tu­ber­cu­lo­sis, of­ten ab­bre­vi­at­ed as TB, is a con­ta­gious in­fec­tion caused by the bac­te­ria My­cobac­teri­um tu­ber­cu­lo­sis. It main­ly at­tacks the lungs, but it can al­so harm oth­er parts of the body like the brain, spine and kid­neys.

Left un­treat­ed, the mor­tal­i­ty rate for TB is around 50 per cent, far high­er than the 0.2 to 0.5 per cent death rate of COVID-19. Both Covid-19 and TB can be trans­mit­ted via droplets in a cough; how­ev­er COVID is a virus, and TB is a bac­teri­um treat­ed with an­tibi­otics.

Around 1.23 mil­lion peo­ple died from tu­ber­cu­lo­sis glob­al­ly in 2024, ac­cord­ing to the World Health Or­gan­i­sa­tion. TB is ar­guably the lead­ing cause of death from a sin­gle in­fec­tion glob­al­ly; de­spite this, I find it dis­con­cert­ing that there is so lit­tle pub­lic aware­ness about this dis­ease.

While TB is treat­able, it re­quires a six-month course of an­tibi­otics and hun­dreds of tablets, which cost the tax­pay­er a sig­nif­i­cant amount of mon­ey.

Drug-re­sis­tant strains of TB do ex­ist, and they cause 150,000 deaths world­wide per year, ac­cord­ing to the WHO. In my opin­ion, the spread of drug-re­sis­tant TB is a pub­lic health cri­sis that should be treat­ed with more care and at­ten­tion, giv­en how much more dead­ly it is when com­pared to COVID-19.

This dis­ease is very much a re­gion­al and lo­cal is­sue. In Feb­ru­ary 2026, Joanne Clark, writ­ing for Caribbean News Week­ly, wrote: “Grena­da’s Min­istry of Health is in­ves­ti­gat­ing sev­er­al con­firmed cas­es of tu­ber­cu­lo­sis (TB), in­clud­ing in­fec­tions among chil­dren, as of­fi­cials mon­i­tor an in­crease above the coun­try’s typ­i­cal year­ly av­er­age.

“Health au­thor­i­ties said three ac­tive cas­es have al­ready been con­firmed so far this year, com­pared with the usu­al two to three cas­es record­ed an­nu­al­ly. The af­fect­ed in­di­vid­u­als are cur­rent­ly in iso­la­tion and re­ceiv­ing the nec­es­sary treat­ment.”

Er­i­ca Virtue, writ­ing for the Ja­maican Glean­er in May 2026, un­der the head­line “Grave con­cern - Tu­ber­cu­lo­sis cas­es raise hu­man rights, health wor­ries in de­ten­tion cen­tres.”

And the ar­ti­cle in the Glean­er reads: “Tu­ber­cu­lo­sis has been linked to the deaths of two in­mates at the Hunts Bay Po­lice Sta­tion lock­up in St An­drew be­tween Au­gust 2024 and April 2026. Over the same pe­ri­od, more than 30 oth­er cas­es were reg­is­tered in state de­ten­tion fa­cil­i­ties.”

I had planned to ap­proach lo­cal doc­tors who treat TB to dis­cuss ru­mours I heard of ris­ing TB in­fec­tion rates in Trinidad and To­ba­go. How­ev­er, this in­for­ma­tion is best dealt with by an of­fi­cial press re­lease from the Min­istry of Health, as da­ta col­lec­tion for the whole coun­try re­quires in­ter-agency co­op­er­a­tion.

This col­umn now fo­cus­es on the need for up­dat­ed leg­is­la­tion to con­trol TB in T&T, as the ex­ist­ing act has not been amend­ed since 1980.

TB leg­is­la­tion

The Tu­ber­cu­lo­sis Con­trol Act, Chap. 28:51, grants a clin­i­cian the pow­er in Sec­tion 3 to ad­mit and de­tain pa­tients “for such time as in the opin­ion of the hos­pi­tal di­rec­tor is nec­es­sary for the care and su­per­vi­sion of the pa­tient ei­ther for his own pro­tec­tion or for the pro­tec­tion of oth­ers.”

Giv­en that the pub­lic health dan­ger of spread­ing TB is ar­guably greater than that of spread­ing COVID-19, it is rea­son­able to give hos­pi­tal di­rec­tors the pow­er to de­tain pa­tients against their will “for their own pro­tec­tion,” as un­treat­ed TB has a 50 per cent chance of killing a pa­tient, and spread­ing TB will cause a strain on the pub­lic hos­pi­tal sys­tem, as more pa­tients have to be ad­mit­ted and quar­an­tined.

How­ev­er, Sec­tion 3 is draft­ed in a vague man­ner with­out checks and bal­ances, which may not be in keep­ing with our con­sti­tu­tion­al frame­work. Giv­en that the law was passed in 1961, it is ar­guably cov­ered by the Sav­ings Law Clause found in Sec­tion 6 of the Con­sti­tu­tion. There is, how­ev­er, room for a ma­li­cious ac­tor to abuse this law to de­tain some­one against their will.

Giv­en that the 1961 law was reen­act­ed in Act No. 31 of 1980 af­ter the pass­ing of the 1976 Re­pub­li­can Con­sti­tu­tion, it may no longer be cov­ered by the Sav­ings Law Clause and be sub­ject to a le­gal chal­lenge.

Sec­tion 13 of the TB Con­trol Act is the most in need of an amend­ment. It pro­vides for a penal­ty for breach­es of the Act as fol­lows: “13. Any per­son who con­tra­venes a pro­vi­sion of any reg­u­la­tion, the con­tra­ven­tion of which is spec­i­fied in the Reg­u­la­tions as con­sti­tut­ing an of­fence against this Act, is li­able on sum­ma­ry con­vic­tion to a penal­ty of one thou­sand five hun­dred dol­lars.”

Giv­en the ex­treme risk to pub­lic health pre­sent­ed by TB, a mere $1,500 fine is not a suf­fi­cient de­ter­rent. A more re­al­is­tic fine would be $100,000, which is jus­ti­fi­able, as the spread of TB can drain the state’s re­sources, and even cause death, as drug-re­sis­tant TB strains do ex­ist and claim the lives of peo­ple all over the world.

Tu­ber­cu­lo­sis kills more than any oth­er in­fec­tion, yet com­mands lit­tle at­ten­tion. With cas­es ris­ing re­gion­al­ly, T&T should look to up­dat­ing leg­is­la­tion and re­sourc­ing the clin­ics re­spon­si­ble for treat­ing this dis­ease.