A riveting narrative of the weakest links in the battle against TB

New Delhi: This is a definitive social history of tuberculosis, from its origins as a haunting mystery to its modern re-emergence that now threatens populations around the world.

It killed novelist George Orwell, Eleanor Roosevelt, and millions of others-rich and poor. Desmond Tutu, Amitabh Bachchan, and Nelson Mandela survived it, just. For centuries, tuberculosis has ravaged cities and plagued the human body.

WHO has some sobering statistics on the disease:

A total of 1.5 million people died from TB in 2020 (including 2,14,000 people with HIV). Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after Covid-19 (above HIV/AIDS).

In 2020, an estimated 10 million people – 5.6 million men, 3.3 million women and 1.1 million children fell ill with TB worldwide. TB is present in all countries and age groups. But TB is curable and preventable.

In 2020, the 30 high TB burden countries accounted for 86 per cent of new TB cases. Eight countries account for two-thirds of the total, with India leading the count, followed by China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa.

(In India, it is estimated that about 40 per cent of the population is infected with TB bacteria, the vast majority of whom have latent TB).

Ending the TB epidemic by 2030 is among the health targets of the United Nations Sustainable Development Goals (SDGs).

In ‘Phantom Plague — How Tuberculosis Shaped History’ (Penguin), Vidya Krishnan, traces the history of TB from the slums of 19th-century New York to modern Mumbai. In a narrative spanning a century, Krishnan shows how superstition and folk-remedies made way for scientific understanding of TB, such that it was controlled and cured in the West.

The cure was never available to black and brown nations. And the tuberculosis bacillus showed a remarkable ability to adapt-so that at the very moment it could have been extinguished as a threat to humanity, it found a way back, aided by authoritarian governments, toxic kindness of philanthropists, science denialism and medical apartheid.

Krishnan’s original reporting paints a granular portrait of the post-antibiotic era as a new, aggressive, drug resistant strain of TB takes over. ‘Phantom Plague’ is an urgent, riveting and fascinating narrative that deftly exposes the weakest links in our battle against this ancient foe.

Vidya Krishnan is an award-winning journalist who has been reporting on medical science for the last 20 years. She has written for the Atlantic, the LA Times, The Hindu (as its health and science editor) and for the British Medical Journal.

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