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

Content Warning: This section of the guide includes discussion of illness, death, ableism, antigay bias, gender discrimination, and racism.

While the book covers the global spread of tuberculosis (TB), Green also makes the root causes of the crisis the subject of his critique. These causes emerge from a psychological interpretation to illness, which influences the sociological response to such conditions. In Green’s assessment, the underlying cause for the TB crisis is bias, which manifests through forms of exclusion such as stigmatization and romanticization.

Green shows how the TB crisis has been used to complement the exclusion of marginalized communities on various bases of identity, specifically race, gender, and class. Before rich white communities had a clearer understanding of the science behind infection and illness, they tried to frame TB as an affliction exclusive to their community. Other communities, like Black and Indigenous communities, were said to have suffered from an entirely different disease that went unnamed on purpose. Green points out, “Acknowledging that consumption was common among enslaved, colonized, and marginalized people would have undermined not just a theory of disease, but also the project of colonialism itself” (74). In this way, medicine was weaponized not only to treat illness but also to preserve systems of oppression—maintaining a fiction that protected dominant narratives while letting truth, and lives, slip through the cracks. Once a more scientific explanation was discovered and disseminated throughout the general public, the rich white communities’ attitudes shifted, such that those who had TB were stigmatized. This allowed the spread of TB to be weaponized against communities of color, who were already disadvantaged by poor living conditions.

The exclusivity of TB to rich white communities also drove a shift in beauty standards. The implication of the “consumptive chic” trend is that TB was also weaponized to undermine women as the “weak” gender. The idealization of TB erased the experience of suffering and downplayed its impact on people who were restricted from playing an active role in society, including white women and people of color. This reframing of illness into aesthetic further exposes the societal impulse to romanticize pain when it occurs in certain bodies while vilifying it in others. This subtle form of bias misrepresented TB as an ideal when all it did was reinforce the patriarchal and colonialist structures of the time. Much later, TB would once again disproportionately affect gender when it exacerbated the symptoms of HIV/AIDS during the AIDS crisis. Although Green doesn’t explicitly discuss the impact of the crisis on members of the gay community, knowledge of the crisis’s underlying causes makes it easy to see how the same forces that enable the continued spread of TB applied to the AIDS crisis. The silence here is itself meaningful, pointing to the patterns of selective empathy and systemic neglect that continue to echo across pandemics.

Once the cure was discovered, bias was applied in the development of treatment methods and prevention strategies. Profit maximization became the main driving force for cure delivery, rather than care. As a result, the countries that needed the cure the most—the same countries that were economically disadvantaged as a result of colonization—were barred from accessing the cure. Green describes global health organizations as operating under a scarcity mindset: “Curing MDR-TB was challenging even in the best hospital. It was, they argued, basically impossible in middle-income countries like Peru. So why bother?” (168).

Green argues that inasmuch as TB is the oldest and deadliest disease known to the human body, there also exists an equally perennial illness of the spirit—bias. Bias drives people to make the choices that perpetuate vicious cycles, allowing a curable disease like TB to continue destroying millions of lives. The book is intended to discourage all forms of bias, whether intended or not, as part of the drive to eliminate TB. By identifying bias as both a cause and accelerant, Green reframes TB not just as a medical failure but as a moral one—making the case that the healing we require is as spiritual as it is scientific.