The dual resistance of slow disease in Mekelle (Ethiopia)

The application of universal strategies for the prevention, control and treatment of MDR-TB hinders the realization of local policies and strategies that are contextualized to a socio-cultural level. This generalization leads to a critical reflection, as such strategies influence the adherence process to the prescribed therapies. Tuberculosis and MDR-TB pharmaceutical treatment transforms the present existence in view of a possible, but not certain, future improvement. So the “slow disease” shows itself as a plague of the double resistance. In addition to the resistance of the biological body - that is the acquired ability to antagonize the effects of a chemotherapeutic agent - we have a "holistic" resistance, implemented by patients through negotiation and reshaping strategies in everyday life to get a re-establishment of themselves free and independent from the biomedical drugs, their side effects, inside and outside of the body. The importance given by WHO to the DOT strategy (Direct Observed Therapy), as an essential component and more effective programs for the control of tuberculosis, leads us to consider how the application of a strictly biomedical approach to prevention and treatment of the disease reflects neoliberal ideologies and principles which place emphasis on the superiority of the knowledge of Western biomedicine as a panacea of human misery. Therefore, those who are not closely adapted to biomedicine are severely attacked and the reasons for those who are looking for a cure that follows different paths within the pluralistic medical system are neglected. In fact, patients develop strategies to negotiate a continuous medicalization of life that flows in isolation and daily control, as they use - simultaneously or alternately - traditional and religious therapeutic resources, which instead constitute real social therapies.