Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection

Content Warning: This section of the guide includes discussion of illness and death.

Green discusses the concept of a “superbug,” a strain of illness that evolves to resist all currently available antibiotics. Although the concept is alarmist in nature, it helps compel rich communities into acting against diseases like TB.

Green argues that the superbug scare isn’t necessary to compel action. For people in poor countries, the superbug is already a reality as it continues to spread untreated. At the same time, the recent COVID-19 pandemic showed that it is possible for wealthy communities to quickly invest in prevention and treatment.

This once again implies that investment in TB research is a matter of cost-effectiveness. When rifamycin was invented in the 1960s, it was considered too expensive to produce at a massive scale. Over time, the cost to produce rifamycin dramatically lowered, yet manufacturers continue to work according to the cost standards of the 1960s. This lengthens treatment and risks resistance to rifamycin, a vital cure for TB.

Green challenges the scarcity mentality by comparing Henry’s situation to that of Green’s brother, Hank, who received treatment for lymphoma in the United States. While the cost of cancer treatment in the US is extremely high, it is still made available through insurance, private systems, or public pressure, showing that high treatment cost alone does not necessarily prevent access in wealthy countries.