Reclaiming the Breath: A Decolonial Lens on Tuberculosis Control in the Global South

Abstract

Background: Tuberculosis (TB) remains a leading cause of death in the Global South, where the burden of disease is compounded by structural inequalities. Despite decades of biomedical interventions, TB control efforts have often failed to address the deeper socio-political and historical factors that sustain the epidemic. Aim: This literature review aims to examine how colonial legacies continue to shape TB control and to explore how decolonial frameworks can reimagine TB care by centering indigenous knowledge, community agency, and health sovereignty. Methods: A narrative literature review was conducted using interdisciplinary sources from public health, global health governance, medical anthropology, and decolonial theory. Key themes were identified through a review of peer-reviewed articles, reports, and grey literature related to TB, colonialism, indigenous knowledge, and community participation. Discussion: Findings highlight enduring power asymmetries in global TB governance, with institutions based in the Global North often dictating priorities that may not align with community needs. The marginalization of indigenous epistemologies further weakens the cultural relevance of TB interventions. However, documented examples of community-led initiatives and integrated traditional practices demonstrate alternative models rooted in relational, participatory approaches. These approaches underscore the importance of ethical collaboration, epistemic pluralism, and local leadership. Conclusion: Decolonising TB control means more than changing tools; it means changing relationships. By centering indigenous knowledge, dismantling power hierarchies, and fostering true community leadership, TB strategies can become more just and effective. In reclaiming the breath, we restore the right to heal on one’s own terms.