Everything is Tuberculosis by John Green

John Green’s most recent non-fiction book, Everything is Tuberculosis, is a personal narrative that explores the many social consequences of tuberculosis through a mix of historical anecdotes and the story of a Sierra Leonean boy affected by this disease. In the United States, tuberculosis (or TB for short) is often thought of as an eradicated disease of the past. While this may be mostly true for the US and other more developed nations, for the majority of the world, TB is still extremely prevalent in everyday life. Green shows this throughout his novel by sharing the story of Henry, a boy from Sierra Leone who contracted the disease when he was only five years old. Throughout his youth, Henry’s tuberculosis became drug-resistant, meaning it was harder to treat because the first-line antibiotics were not effective on the disease anymore. This was in part due to how difficult it is to get access to the 

necessary medicines in Sierra Leone and similar countries. One cause of this is the inadequate healthcare systems due to many factors, including ongoing conflicts, inadequate infrastructure, and insufficient resources and healthcare professionals. In the book, Green shares that the Sierra Leonean government spends an average of $39.32 per person for healthcare each year, while the US government spends an average of $14,570 per person. This number is extremely important because just diagnosing TB properly costs at least $25, which is over half of that budget. In addition to these upfront costs, any treatments are also expensive, and patients often have to travel each day to receive them. Many countries, including Sierra Leone, also have many social stigmas surrounding the disease. Oftentimes, when someone gets diagnosed with TB, they lose many of their friends and family. This is due to the common belief that TB is a disease you get when you live an unclean lifestyle, which continues to be spread through the lack of reliable information. The historical anecdotes also provided in the book touch more on this subject. Historically, TB was not always seen as an illness caught by “unclean” individuals, but instead a disease of civilization, and was viewed as delicate, spiritual, and even poetic. This can be seen in a lot of art and literature before the 20th century, where people with TB (or consumption as it was called historically) were romanticized because it aligned with the beauty standard of the period. Right before the turn of the century, this view began to shift. Some factors that contributed to this were increased industrialization and scientific advancements, including Robert Koch’s discovery of the tuberculosis bacteria. TB exploded in the lower, laboring classes because of the close quarters they lived in, which led to it changing from a disease of the civilized to the disease of the poor and uncivilized. Overall, Everything is Tuberculosis offers a lot of social commentary on the perception of diseases and the isolation of those who contract them. It shows how “other” diseases can make patients feel and also explains the reasons and causes why these stigmas were created and still continue to exist today. Although Henry’s TB was able to be fully cured, and he is now thriving, he was in an extremely fortunate situation where he was able to get the advanced drugs that he needed to fight off the infection. In the majority of patients, this is not the case. In the closing chapter of the book, Green asks “Where are the drugs? The drugs are where the disease is not, and where is the disease? The disease is where the drugs are not.” For decades, we have had good vaccines and advanced treatment, but the majority of them have been focused on the Western world. Once TB was under control in these countries, funding for research and new treatments of the disease slowed down. Johnson & Johnson created a new TB drug in 2012, but that was the first in 40 years. In addition, the companies that create the drugs often tremendously upcharge them in order to create mroe profit. While this may not be the worst problem in countries like the United States, it can be devastating for countries like Sierra Leone, which simply don’t have the resources to buy and distribute these expensive treatments.