Tuberculosis Through Time: From Consumption to Modern Drug Access and the Fight Against Inequality

TB has haunted humanity for centuries, evolving from the romanticized notion of consumption to a modern, drug responsive disease. This overview traces how biology, poverty, housing, and stigma shaped who gets infected and who dies, from Koch's 1882 discovery of Mycobacterium tuberculosis to today’s battles against drug resistance and access to care. It highlights the role of sanitariums, public health campaigns, and the activists who expanded treatment to marginalized communities. The central message is clear: ending tuberculosis requires sustained investment in health systems, equitable access to medicines, and policies that address the social determinants of health.

Introduction

Tuberculosis is a disease with a long, complex history that reveals much about human society. Once described as consumption, TB has been linked with artistry, wealth, poverty, and war, and its story intersects with science, medicine, and inequality. The video traces how this pathogen, Mycobacterium tuberculosis, behaves and why the disease persists despite modern cures.

From Myth to Biology

Historically, communities attributed TB to genetics, bad air, moral frailty, or contagious breath. It took centuries before the germ theory of disease became accepted, culminating in Robert Koch's identification of M. tuberculosis in 1882. The shift from moralizing explanations to a microbial understanding transformed medicine and public health strategies.

Stigma, Society, and the Shape of TB

Stigma around TB has taken many forms, often tied to racialized and class-based narratives. In the 18th and 19th centuries consumption carried romance for some, while condemnation persisted for others. As urbanization intensified during the industrial era, TB disproportionately affected the poor, reinforcing discriminatory ideas that those suffering were responsible for their illness. Even today, stigma remains a barrier to timely diagnosis and treatment.

Public Health Responses

Efforts to control TB included culling myths about contagion, promoting cueing and spitting restrictions, and later, the rise of sanatoriums, rest, fresh air, and nutrition. By the early 20th century, diagnostic tools and imaging began to improve, and mortality declined in wealthier countries as housing and nutrition improved. Yet progress was uneven, particularly for Indigenous peoples, Black communities, and other marginalized groups.

Drug Era and Access Gaps

The discovery of antibiotics changed TB dramatically, with combination therapy making TB curable by the 1950s. However, treatment access remained unequal, and the rise of drug resistance presented new challenges. The HIV era emphasized how coinfections intensified TB tolls globally, while price and patent barriers limited access to lifesaving drugs like bedaquiline. Activists and health workers in low-income regions pushed for affordable, effective regimens and smarter delivery strategies.

Activism, Innovation, and a Path Forward

Stories like that of Fumaza Tisile show how advocacy, local innovation, and legal action can expand access to life-saving therapies. The video argues that ending TB is possible with sustained investment in health systems, equitable drug pricing, and addressing the social determinants that enable TB to persist. The call to action is clear: we can choose a world where no one dies of TB if we commit to collective, long-term solutions.