Table of Contents
Why Is a Curable Disease Like Tuberculosis Still Killing Millions of People?
Discover how the history of tuberculosis was shaped by prejudice and why the cure, which has been available for decades, is often withheld by corporate greed and systemic injustice. Learn how activism and solidarity are providing the ultimate cure. To understand the full story of how deep-seated injustice determines who survives tuberculosis, continue reading to uncover the hidden architecture of global healthcare inequality and the virtuous cycle of people fighting back.
Genres
Science, Health, Nutrition, History
Learn how colonial health policies still kill millions today.
Everything Is Tuberculosis (2025) reveals how humanity’s deadliest infection is not just a biological problem but a story of profound injustice. Through the unforgettable journey of a young Sierra Leonean man named Henry Reider, you’ll discover how the disease was shaped by prejudice, why a cure that has existed for decades is withheld by corporate greed, and what it takes to fight back. It’s an urgent call to understand that the true cause of tuberculosis is injustice, and therefore, the cure must be justice.
You walk into a pharmacy and pick up antibiotics without a second thought. Your child gets vaccinated on schedule. When illness strikes, you trust that medicine will be there, affordable and accessible. But for millions around the world, this basic security doesn’t exist. The same diseases we’ve conquered continue to kill, not because we lack the science, but because of choices – choices about who deserves care, whose suffering matters, and what a life is worth.
In this summary, you’ll learn how tuberculosis – a curable disease – continues to devastate communities through a toxic combination of corporate greed, systemic racism, and global indifference. You’ll explore how the stories we tell about illness shape who lives and who dies, and how profit-driven healthcare creates the very superbugs it claims to fight.
By understanding this hidden architecture of medical injustice, you’ll gain insight into why healthcare inequality persists in an age of medical miracles – and more importantly, how ordinary people have successfully fought back, transforming a system designed to abandon them into one that serves them.
A story of two plagues
The stories we tell about illness can be just as powerful as the illness itself. When a society frames a disease as a mark of creative genius or moral failure, that framing profoundly shapes who suffers and who receives compassion. This is the story of one disease with two deeply different identities, and a history that shows how our ideas about illness become matters of life and death.
In the 18th and 19th centuries, Europe was haunted by a plague known as consumption, what we now call tuberculosis. Though it was the leading cause of death, it carried an extraordinary romanticism that’s difficult to imagine today. The disease marked the sensitive and brilliant, a “flattering malady” that refined the body and elevated the soul. Its physical symptoms became beauty standards. Pale skin, rosy cheeks from fever, wide luminous eyes – these signs of consumptive patients were celebrated as “consumptive chic.”
Women used cosmetics to mimic the look. Men like Lord Byron mused that dying of consumption would be desirable, because then women would say, “See that poor Byron – how interesting he looks in dying!” This romanticized illness was considered a “White Man’s Plague,” evidence of the so-called master race’s delicate and superior constitution.
Then in 1882, everything changed.
A German doctor named Robert Koch proved consumption was caused by a bacterium. The romantic narrative instantly collapsed, replaced by fear. The same disease, now clinically named tuberculosis, was completely rebranded. Gone was the flattering malady of the elite. In its place: a contagious illness of filth, poverty, and depravity.
This new story was immediately weaponized. The same white medical establishment that had claimed the disease as proof of superiority now used it as a tool of oppression. Doctors argued that high tuberculosis rates among Black Americans and Indigenous peoples stemmed from racial weaknesses rather than racism, poor housing, and malnutrition.
This lie had deadly consequences. In Canada, Indigenous children forced into residential schools died from TB at rates of 8,000 per 100,000 – almost unprecedented in human history – due to deliberate neglect and mistreatment. The story society told about tuberculosis had become a form of violence.
This legacy of stigma and neglect has a human face. You can find it today at Lakka Government Hospital in Sierra Leone, a former leprosy isolation facility where patients are housed in rooms resembling prison cells. There you might meet Henry Reider. He is seventeen, but years of tuberculosis and malnutrition have so stunted his growth that he looks like a small boy. He has the very physical traits a 19th-century European might have found beautiful – visible cheekbones, wide eyes.
But he is living no romantic poem. He is living the brutal, present-tense reality of tuberculosis, an illness that society decided long ago was a plague for the poor and forgotten. His story begins where the romantic myth ends: with a curable disease in a world that has chosen to leave him uncured.
A cure built on control
You might be asking yourself – if Henry’s disease has been curable for decades, why is he wasting away in that hospital ward? The answer lies in a story of breathtaking scientific triumph followed by an agonizing failure of human empathy. We discovered the cure for tuberculosis. Yet the way we chose to deliver it to the world’s most vulnerable people was built on a foundation of control rather than care.
For most of history, a diagnosis of active tuberculosis meant death. In the 1940s, even in the best sanatoria, only about a quarter of patients could expect to recover. The majority would either live as invalids or die from the disease.
Then, almost overnight, everything changed.
The discovery of antibiotics in the 1940s and 50s led to a powerful cocktail of drugs – streptomycin, isoniazid, and others – that could reliably kill the bacteria. The impact was miraculous. In wealthy countries, sanatoria overflowing with the sick and dying began to empty out. Humanity seemed on the verge of defeating its oldest and deadliest infectious enemy.
This miracle was never shared equally. For millions in the newly independent nations of Africa and Asia, it was as if the cure had never been invented. As one doctor observed, the drugs existed where the disease wasn’t, and the disease raged where the drugs couldn’t reach.
To solve this injustice, the global health community developed a strategy in the 1970s called DOTS, or Directly Observed Therapy, Short-course. The goal was to deliver a standardized, cost-effective cure to the world’s poorest places.
It relied on smear microscopy for diagnosis – a cheap method from the 1880s that misses about half of all TB cases. Every patient received the same standardized regimen of drugs, regardless of their individual circumstances.
The system’s core feature was in its name: Directly Observed.
It required that a healthcare worker physically watch every patient swallow every single pill, every single day, for months. This was about enforcing “compliance.” The system was founded on a deep, paternalistic distrust of the poor, treating them as untrustworthy subjects rather than partners in their own healing. It treated systemic issues – like lack of food to take pills with, or transport costs – as individual moral failures.
This system of control first failed Henry Reider as a young boy. After his initial diagnosis, he was enrolled in a DOTS program in Sierra Leone. Within this rigid framework, his father saw his son suffering from side effects without improving.
He lost faith in the medicine and in a system that treated his son like a case file rather than a child to be cared for.
He pulled Henry from treatment, a decision that likely allowed the surviving bacteria in Henry’s body to multiply and develop resistance to the only drugs available. A program created to prevent drug resistance through control had, through its own lack of humanity, created the very superbug that would one day threaten to kill him.
The price of a life
Having failed to cure Henry with its cheap, one-size-fits-all approach, the healthcare system now faced a much deadlier challenge: a strain of tuberculosis that was resistant to the standard drugs. To save his life would require more advanced tools and newer medicines. But in global health, “advanced” often means “expensive,” and Henry was about to discover that his life was caught in a battle against both a bacterium and a balance sheet.
The first barrier was information. To fight a drug-resistant infection, you have to know which drugs the infection resists. A modern medical wonder called the GeneXpert machine can do exactly that, identifying TB and its specific resistances within hours.
But the company that makes it, Cepheid, uses a razor-blade business model. They sell the machine at a small profit and then charge huge markups on the single-use test cartridges required to run it. The price of a single cartridge can be more than half of what Sierra Leone spends on a person’s entire healthcare for a year.
This profit-driven scarcity meant Henry was never properly tested as a child. He was treated for years with the wrong drugs, a pointless ordeal that allowed the infection to fester, spread to his lymph nodes, and become even stronger.
Now, hospitalized at Lakka, he needed a different kind of cure. A newer, safer, and more effective drug called bedaquiline existed. It could be taken as a simple pill and offered him his best chance at survival.
But Henry couldn’t have it.
The drug was owned and patented by Johnson & Johnson, which used its monopoly to charge a price far out of reach for Henry’s country. So instead of a safe pill, Henry was put on a toxic cocktail of older drugs known as “the injectables.” One of them, kanamycin, is notorious for causing irreversible hearing loss.
Soon enough, the inevitable happened. Henry woke up one morning unable to hear out of his left ear, a permanent disability he would carry for the rest of his life. This was a preventable injury inflicted by a corporate patent.
Thousands of miles away in India, a young activist named Shreya Tripathi was fighting the same battle. She, too, had an extensively drug-resistant form of TB and knew that bedaquiline was what her body needed. She was denied it for the same reason: cost.
But Shreya fought back. She sued the Indian government for her right to access the lifesaving medicine, seeking justice for herself and all who would come after her. In a landmark ruling, she won, forcing a policy change that would eventually help make the drug more available globally.
The victory came too late for her. By the time she received her first dose, her lungs were too scarred and destroyed. The medicine killed the bacteria, but her body had already been lost.
Her story, like Henry’s suffering, makes the injustice terrifyingly clear. In the modern fight against tuberculosis, the deadliest superbug is a system that places a price tag on a human life, and then decides you cannot afford it.
A global system of neglect
You might be wondering how we built a world where a company’s patent can be valued more than a person’s life. The answer lies in a global mindset of neglect, a system that creates self-perpetuating cycles of suffering and then blames the victims for their inability to escape. This is the logic of the vicious cycle.
Tuberculosis is an engine of poverty that runs on poverty. A disease of malnutrition that, by suppressing appetite and draining the body of resources, causes further malnutrition. It preys on weak healthcare systems and then weakens them further by sickening health workers and consuming scarce resources.
In this vicious cycle, the disease travels along the well-worn paths of injustice, deepening and broadening those paths, making them steeper and harder to climb. This self-reinforcing loop of despair results from a global order that has repeatedly chosen to look away.
You can see the devastating effect of this cycle in the collision of two of the deadliest pandemics in history: HIV and tuberculosis.
In the early 1980s, physicians in sub-Saharan Africa began noticing something terrifying. Young patients were dying of TB with a speed they had never seen before – in weeks, rather than months or years. They were witnessing the emergence of HIV, a virus that destroys the immune system, giving latent tuberculosis the perfect opportunity to explode into a swift and deadly active disease.
The two plagues became intertwined, creating a firestorm that led to an explosion of death. In countries like Lesotho, overall life expectancy dropped by a full decade.
The world had the tools to fight back. By the mid-1990s, effective antiretroviral drugs could make HIV a manageable condition. Yet for years, these lifesaving medicines were withheld from the poor countries that needed them most.
The justifications for this inaction were echoes of the old colonial mindset. In 2001, the head of USAID, America’s main international aid agency, argued against providing HIV medications in Africa, claiming that Africans didn’t know what watches and clocks were and only used the sun to tell time.
This racist and breathtakingly ignorant excuse was used to justify a policy of inaction that cost millions of lives. The world decided saving them was “cost-effective,” and this decision was laundered through prejudice. It was the same logic of distrust that built the DOTS program for TB, now scaled up to a global catastrophe.
The tens of millions of people who died during those years were victims of choices – choices to protect patents, to hoard resources, and to believe that some lives are worth less than others.
This is the global system of neglect that created the crisis Henry Reider was born into. His suffering, and Shreya Tripathi’s death, were the predictable, heartbreaking outcomes of a world that has perfected the art of looking away.
The virtuous cycle of solidarity
If the problem of tuberculosis’ survival is a global system of neglect, a vicious cycle that grinds people down, what hope is there for one person? How can anyone, like Henry Reider, ever break free? The answer is that you don’t break the cycle alone. You break it together. This is the story of the virtuous cycle, a powerful alternative built on stubborn, defiant solidarity.
You can see the birth of this cycle in the early 1990s in Peru. At the time, the official policy of the World Health Organization for multidrug-resistant tuberculosis in poor countries was simple: do nothing. Treating it was deemed “too expensive” the chance of a cure “limited.” The standard of care was to put the sick in a hut and wait for them to die.
But a group of doctors and activists with an organization called Partners In Health refused to accept this. They believed that every person deserved the best care possible, regardless of cost.
In an impoverished neighbourhood of Lima, they began treating the very patients the world had written off. They provided the right combination of drugs, plus food, transportation, and daily support from community health workers. The result was astonishing. They achieved cure rates of over 85 percent – as good or better than those in the best-funded hospitals in New York or London.
They proved that treating the poor was possible – the world had simply chosen otherwise.
This single act of defiance created a powerful ripple effect. Their success pressured the WHO to change its guidelines, finally acknowledging that drug-resistant TB could and should be treated everywhere. This created global demand for the necessary drugs.
Activists used this momentum to challenge the high prices, arguing that there was a market for these medicines – it just wasn’t a wealthy one. They kickstarted generic manufacturing of drugs whose patents had expired, and the price of treatment plummeted by over 90 percent, from more than fifteen thousand dollars per patient to just fifteen hundred.
A human-made problem had a human-made solution.
This is the virtuous cycle that saved Henry Reider’s life. It’s the reason survivors like Phumeza Tisile in South Africa lived to become activists themselves, successfully fighting to break Johnson & Johnson’s patents on bedaquiline and making it affordable for millions more.
This chain of solidarity, stretching from a slum in Peru across decades and continents, is what allowed a dedicated doctor in Sierra Leone to finally get Henry the drugs he needed.
Today, Henry embodies the virtuous cycle. He is a university student, a content creator, and an advocate, using his voice to fight the stigma of his disease and support the very hospital where he was once told he would die.
His life is proof of a truth: if the cause of so much suffering is injustice, then the cure is the active and relentless pursuit of justice itself.
Conclusion
In this summary to Everything Is Tuberculosis by John Green, you’ve learned that tuberculosis is not just a disease caused by a bacterium, but a story of injustice shaped by human prejudice, corporate greed, and systemic neglect.
This story travels from the 19th-century romanticization of tuberculosis – then called “consumption” – to the modern-day stigma that afflicts patients like Henry Reider in Sierra Leone. You’ve seen how the discovery of a cure led not to global relief, but to a system of control that failed the world’s poor and created deadlier, drug-resistant strains. The fight for survival became a battle against corporate patents and a global health system that puts profits before people.
But despair is not the final word. Through the power of a “virtuous cycle,” you’ve seen how solidarity and activism can break these systems of neglect, proving that the cure for this disease of injustice is, and has always been, justice itself.