Political work in health: tuberculosis in Rio de Janeiro

Abstract

Intervention on tuberculosis in Rio de Janeiro, Brazil, reveals an intensification and extension of the articulations between people, organizations, and institutions involved. To understand this process I mapped the arenas and social worlds present. Social worlds are unities of collective action, defined by the sharing of goals and actions. To achieve those goals they need to interact with other social worlds. The spaces where they interact on themes of their common interest, but on which they hold different perspectives and even different goals, are called arenas. The study revealed that the arena of tuberculosis in Rio de Janeiro has extended in the last decade, with more, and more diverse, social worlds involved, through the “political work” of persons and organizations, at the local, national, and international levels, that is, through the attribution of power to certain entities, based on the ethical valuation of common goals. This political work is implying the intersection with the arenas of HIV-Aids and the National Health System. The extension of the tuberculosis arena redefines the disease and the ways people act on it. Social and economic support to patients, the treatment of co-morbidities, human rights, and other issues that go beyond the biomedical perspective, now integrate the agendas of tuberculosis. In this process, people also redefine the boundaries of action on health.