I recently read John Green’s new book, Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection, which inspired me to write to Revcom readers. The book is a powerful call for justice in the face of savage inequalities and is worth reading.
This system has created a world where diseases that should have been wiped out long ago cause massive suffering and death. Tuberculosis (TB) is a prime example.
In the past, TB was called consumption because it consumed its victim’s body causing them to waste away. In Europe, during the 1800s about one-quarter of all deaths were due to the disease. In the U.S. today, most people rarely think about TB, perhaps only when they get a TB scratch test after they are hired for a job. This is because a cure for TB was developed in the 1950s and most people in this country have access to the necessary treatments.
Yet TB kills one and one-quarter million people each year, especially in the poor countries of the Global South and is the leading cause of death by infectious disease worldwide. Green quotes physicians and scientists who say that while it is not possible to eliminate tuberculosis, with basic healthcare not a single person need die from the disease. Let that sink in. More than one million people every year—who have friends and families, hopes and dreams, who are full of potential—have their lives extinguished needlessly by a disease that was cured 75 years ago!
TB is a disease that can be dormant in the body for many years or even a lifetime, and only become active when the body’s immune system is weakened from poverty, hunger, or other diseases.
Throughout the book, Green follows the case of a young man with TB from the African nation of Sierra Leone. He traces the history of colonialism and exploitation that shaped the poverty and lack of health care that are responsible for TB’s spread in that country. Green quotes a Sierra Leonean doctor as telling him, “If you want to understand why Sierra Leone is poor, you must look at a map of our railroads.” Green explains that railroads in Sierra Leone were not built to connect people and build a national economy as in the United States. The British Empire built railroads in Sierra Leone “primarily to take Sierra Leone’s wealth, as quickly and effectively as possible out of Sierra Leone.”
While Sierra Leone became independent in 1961, foreign powers continued to bleed the country of its wealth. Sierra Leone is rich in mineral resources, but it remains one of the poorest countries in the world. The economy is still centered around mining for export to capitalist-imperialist powers. Banks and other large global financial institutions now exploit the country and dictate cruel policies like slashing healthcare.
As a result, one-third of the people in Sierra Leone do not have electricity. The average income is just over $2 per day. Sierra Leone spends $35 per person per year on health care, compared to $13,000 in the U.S. Meanwhile, drugs to treat TB, if they are available, can cost over $1,000 per year, even under programs meant to help people in poor countries.
The history and current reality of who gets tuberculosis in the U.S. exposes the shameless lies spouted by Trump fascists (and others) who deny and cover up the racism at the root of U.S. society or say it is a thing of the past. In the 1900s, a Tennessee doctor put forward the prevailing view “the negro is to blame for his own susceptibility to tuberculosis.” In other words, it was their own fault, so let them die. Even today, the rate of TB is 14 times higher among U.S.-born non-white people compared to white people.
In the Global South, where TB kills the most people, patients are forced to make long, often impossible, journeys to clinics every day in order to be observed taking medications. They were told they couldn’t be trusted to take their medications even though studies have shown that this is not the case. Medicine, especially those to treat drug-resistant strains are priced outside what people and even their governments can spend or the drugs suddenly become unavailable.
Green writes, “From India to Bolivia to Cambodia to Ethiopia, low- and middle-income nations continues to have TB death rates higher than seen in the U.S. before the antibiotic era… It was as if the cure didn’t exist.” Rates of TB in Ethiopia are higher than rates were in the United States in 1882 when the bacteria that causes the disease was discovered.
While the ways that global powers have addressed TB is horrific, the response of the fascist Trump regime goes further; it is depraved and genocidal. Trump has slashed funding to programs that provide any assistance to poor countries and took the U.S. out of the World Health Organization. According to a study by Harvard T.H. Chan School of Public Health and Boston University School of Public Health, Trump’s cuts would cause an additional 8.9 million child TB cases and more than 1.5 million child deaths over the next 10 years.
In South Africa where there is a high rate of TB, Ntutuzelo Vukani sits outside his two-room metal shack which houses five people. The shack, held together with nails hammered through rusting bottle caps, has an outdoor tap and a pit latrine toilet. Photo: AP
Green argues the real killer is no longer the bacteria but the economic and political relations: exploitation, colonialism, racism, poverty. But he sees the solution as international aid organizations like Doctors Without Borders and Partners in Health providing medical care to people in poor countries, medical aid from government and nonprofit organizations, and a desire by people for a more just world.
While such actions may improve the conditions of people in limited ways, the reality is that we are up against a system based on international exploitation and plunder and driven by ruthless competition for profit. It is not the people but the economic system and its calculations of “cost-effectiveness” and “profitability” that determine what gets produced.
While there is much to learn from someone like John Green, to uproot the many horrors that this system endlessly produces, and to bring into being a whole new way to live, we need to get beneath the surface and understand that the real problem is a system of capitalism-imperialism and the solution is a revolution based on the New Communism.
As Bob Avakian has said in his 2025 New Years Message:
This system is completely absurd—criminally, monstrously absurd—and completely outmoded: long past its expiration date, past the time when it can lead to anything positive for humanity—and, on the contrary, it stands as the direct barrier to the emancipation of humanity from all this madness, atrocity, and unnecessary suffering.
WE NEED AND WE DEMAND A WHOLE NEW WAY TO LIVE, A FUNDAMENTALLY DIFFERENT SYSTEM!
