IHR Clinic Fellow Earns Delhi Center Grant

Meredith Heagney
Law School Office of Communications
April 16, 2014

Clinic Fellow Brian Citro has been awarded a $30,000 grant from the newly opened University of Chicago Center in Delhi to help fight tuberculosis in India. Citro, who works in the Law School’s International Human Rights Clinic, is part of an interdisciplinary team that will develop a rights-based approach to prevent and treat tuberculosis, a global epidemic among the world’s poor.

The project will explore how human rights, and particularly the right to health, can be used as tools to increase access to testing and treatment of tuberculosis in India. They will work to articulate the rights of people with the disease, and those at risk of contracting it, as well as the obligations of government and the private sector in providing treatment and prevention. Finally, they will develop methods to bring a rights-based approach to the fight against tuberculosis that can be used in India and other developing nations.

The project, which will begin this summer, will include a research trip to India and a conference in Delhi this fall. International Human Rights Clinic students will work alongside Citro.

“India has the highest TB burden in the world. More than 1,000 people on average die a day from TB in India,” Citro said. “But the disease is easily curable and at a low cost. Social and economic factors, including poverty, poor sanitation, and lack of access to appropriate testing and treatment, drive the epidemic.”

Citro, a 2010 graduate of the Law School, worked in Delhi for two years as senior research officer to the United Nations special rapporteur on the right to health. He was also project manager of the Global Health and Human Rights Database, a project of the HIV/AIDS Unit of the Lawyers Collective, a nongovernmental organization in India. He worked on right-to-health issues with the United Nations, including efforts studying tuberculosis in Azerbaijan and Tajikistan.

His co-organizers include two University of Chicago doctors, Assistant Professor of Medicine Evan Lyon and Research Fellow Kiran Raj Pandey, and attorney Mihir Mankad, health policy advisor for Save the Children United Kingdom, which promotes children’s rights around the world. The team is currently developing partnerships in India, including with the Public Health Foundation of India, Jindal Global Law School, and the Lawyers Collective.

The University of Chicago Center in Delhi, which opened March 29, is an interdisciplinary center for research in India and southeast Asia. The University also has centers in Paris and Beijing.

In the grant proposal, Citro and his fellow researchers described the scope of the tuberculosis epidemic. They pointed out that in 2012, there were approximately 8.6 million new cases of tuberculosis and 1.3 million deaths. That same year, more than a quarter of all global incidences of tuberculosis occurred in India, they said.

Tuberculosis is relatively easy to prevent and treat. But for the poor and marginalized, the disease is devastating. These patients face many barriers to treatment, and even when treatment is begun, it often isn’t finished for financial or other reasons. As a result, difficult to treat drug-resistant strains of tuberculosis have developed.

The researchers want to develop methods for reducing the devastation of tuberculosis that prioritize human rights and personal autonomy. They aim to mimic similar initiatives that made progress in the global effort to lessen the impact of HIV. Such an effort requires participation from the government, private health care providers, and pharmaceutical companies.

“A rights-based approach has been effective in the global movement to fight HIV/AIDS in increasing access to life-saving medicines, protecting the rights of people living with HIV, and reducing stigma associated with the disease. A similar approach, using the courts, policy advocacy, and grassroots activism, can be just as successful in the fight against TB,” Citro said.

The tuberculosis project is not the International Human Rights Clinic’s only work in India. Over Spring Break, Citro and Clinical Professor Sital Kalantry, who directs the clinic, took three students to Delhi to study housing policy. They developed litigation and policy strategies to improve the living conditions of slum dwellers and presented their work to The Law Commission of India, which is considering drafting a national housing rights bill.