Social mobilization from the perspective of tuberculosis surveillance in Brazil: a critical assessment

Abstract Tuberculosis, a global problem related to the population’s living conditions, is a historically complex problem. In recent years, social mobilization has become a fundamental component of disease surveillance. In this article, the concepts of social mobilization for tuberculosis surveillance and control, present in the National Tuberculosis Control Program (2006), in the Strategic Plan for Tuberculosis Control (2007-2015), are critically analyzed in the document description of the implementation of the Global Fund to Fight AIDS, Malaria and Tuberculosis Program in Brazil and in six Brazilian scientific productions, from 2007 to 2016, that address the theme. Specifically, the study aims to understand these concepts, as well as discuss the relationships between them. All were examined through content analysis. Although favorable to social mobilization, the texts refer to some theoretical and epistemological contradictions. Social mobilization is presented according to a functionalist and utilitarist conception (positivist paradigm of science), with regulatory rather than emancipatory intent. It seems to be a social mobilization in the service of the domestication of society, which disregards the life experiences of the population and the complex structure of production and social reproduction of the disease.

摘要：结核病是与民众生存境况紧密相关的全球性公共卫生难题，亦是兼具历史复杂性的议题。近年来，社会动员已成为疾病监测的核心构成要素。本文针对《国家结核病控制规划（National Tuberculosis Control Program）（2006）》与《结核病控制战略规划（Strategic Plan for Tuberculosis Control）（2007-2015）》中提出的结核病监测与防控社会动员理念，结合巴西实施全球抗击艾滋病、疟疾和结核病基金项目（Global Fund to Fight AIDS, Malaria and Tuberculosis Program）的文件描述，以及2007至2016年间6篇围绕该主题的巴西学术成果，展开批判性分析。本研究旨在厘清上述理念，并探讨其间的内在关联。所有分析均通过内容分析法（content analysis）完成。尽管相关文本均对社会动员持支持态度，但其中仍存在若干理论与认识论层面的矛盾。社会动员的阐释遵循功能主义与功利主义理念，契合科学实证主义范式（positivist paradigm of science），其核心意图偏向规制而非赋权。此类社会动员似乎沦为服务于社会驯化的工具，忽视了民众的生活体验，以及疾病的复杂生产与社会再生产结构。