Low- to Middle-income Countries

From Tuberculosis Wiki

Low- to middle-income countries (LMICs), also referred to as low- and middle-income countries, is a term used to refer to countries with economies classified as low-income and middle-income by the World Bank.[1] All 30 of the countries with the highest burdens of tuberculosis (which together account for 87% of tuberculosis cases globally), are classified as LMICs.[2] Overuse and misuse of income classifications and the term 'LMIC', has been criticized as a form of "othering," or a way to convey an inferior status, and attach assumptions and ideas to countries without evidence.[3]

LMIC Classification[edit | edit source]

The World Bank classifies economies into 4 categories annually, based on their final yearly income divided by the amount of citizens, or gross national income (GNI) per capita.[4] LMIC covers the three lower-income categories: low-income, lower middle-income, and upper middle-income countries, not including high-income countries. In 2024, LMICs were countries with a maximum GNI per capita of US $13,846.[1]

Tuberculosis Burden of LMICs[edit | edit source]

There is a significant correlation between a country having a lower annual income and higher rates of tuberculosis (TB) disease. Factors which may contribute to this include undernourishment (which is also seen to raise risks of TB), and less access to TB diagnostics and treatment.[2] Newer, less toxic drugs, and faster, more accurate diagnostic tool are often too expensive for those in need of them, because of high cost barriers. About 49% of people with TB face catastrophic total costs (total costs above 20% of annual household income).[2]

Criticism of LMIC Misuse[edit | edit source]

While the literal use of 'LMIC' is simply as an economic category, it has been pointed out that overuse and misuse of the term can lead to it being used to convey harmful and misleading ideas surrounding countries whose economies fall into that category. When terms like LMIC are used where an idea isn't reflective of a common truth across these income categories, it can contribute to harmful myths about countries that aren't classified as high-income.[3] Myths such as the idea that scientific development only takes place in high-income countries (which are seen to be untrue with examples such as TrueNat, which was developed and manufactured in India, a lower middle-income country), can be further perpetuated by use of economic classifications where something is not conclusively tied to a country's economy. When 'LMIC' is used as a form of othering it can be seen as a continuation of the colonial connotations and ideas that many other terms are avoided for being rooted in.[3]

References[edit | edit source]

  1. ^ a b "World Bank Country and Lending Groups". World Bank Data Help Desk. World Bank. Retrieved 28 January 2024.
  2. ^ a b c Global Tuberculosis Report 2023 (Report). World Health Organization. 2023. ISBN 9789240083851.
  3. ^ a b c Lencucha R, Neupane S (June 2022). "The use, misuse and overuse of the 'low-income and middle-income countries' category". BMJ Glob Health. 7 (6). doi:10.1136/bmjgh-2022-009067. PMC 9185671. PMID 35672116.
  4. ^ "Gross national income per capita (Atlas method)". World Health Organization. Retrieved 28 January 2024.