John Green Talks Tuberculosis and Community at Emory Book Tour Stop

By Shelby Crosier

“This is what I hope tonight will be for you—an opportunity to reflect in community on the world we’ve built and the world we might build instead.” Those were author John Green’s words to a lively crowd at Glenn Memorial United Methodist Church on March 21.

Tuberculosis (TB) researchers, public health enthusiasts, and “Nerdfighters”—the term Green and his brother, Hank, use for their dedicated community of fans—packed the pews for the Atlanta stop of Green’s tour for his book Everything is Tuberculosis. After reading an excerpt that details his first meeting with Henry, a young Sierra Leonean boy with TB who is the central figure of the book, Green was joined on stage by Laurel Bristow, associate director of audience development at Rollins and host of Health Wanted, for a Q&A session.

Bristow remarked that, in her view, the strength of Green’s book lies in its ability to bring humanity to TB.

“For people who work in infectious disease, depending on what capacity you work in, you sometimes can be removed from the human experience and the patient experience. You look at disease like a fun puzzle to solve,” she said. “But [in your book] you really ground the impact of the disease in the human experience with Henry in such a beautiful way.”

Listen to the full event here.

TB as a Disease of Injustice

Throughout the evening, Green repeatedly returned to the idea of “diseases of injustice,” or diseases that tend to have the greatest impact on those who are the most marginalized in society.

“There are so many diseases of injustice,” he said. “Cancer is a disease of injustice. Diabetes is a disease of injustice. If you take a map of poverty in my hometown, Indianapolis, and you put a map of cancer rates on top of it, it’s the same map.”

Each year, 10 million people become ill and 1.5 million people die from TB around the world, despite it being both preventable and curable. The majority of those people live in low- and middle-income countries that lack the health infrastructure and resources to effectively combat the disease. It is easy to see, then, why Green called TB “the exemplary disease of injustice.”

“Where there is inequity in our social orders, there will be tuberculosis,” he said.

The TB Staircase

Recent U.S. Agency for International Development (USAID) funding cuts pose a serious risk for people living with TB, or who could become ill with TB in the future, worldwide. Green shared how interruptions in funding, which lead to interruptions in treatment, could be setting back decades of progress.

“I think of the story of TB as a long staircase,” he said. “Twenty-one hundred years ago, Hippocrates told his students to not even try to treat TB, because it would make them look like bad healers, because it was totally impossible to do anything about it. And then we’ve slowly walked up the staircase from there.”

In his metaphor, he said that humanity had taken steps up the TB staircase when we discovered that the disease was contagious, and when we identified the causative agent, Mycobacterium tuberculosis, in 1882. We walked up the staircase more with a vaccine that prevents severe illness and death in children and with diagnostic tools like chest x-rays. We walked dramatically up the staircase when antibiotic treatments were developed.

“In the last eight weeks, I want to be very clear, we didn’t take a couple of steps down the staircase—we fell down the staircase. It’s catastrophic.”

Green noted a recent USAID memo which reported that cuts to TB funding from the U.S. could increase drug-resistant TB worldwide by up to 30%—something that we may not have the tools to fight without research funding to develop new treatments.

Community is Vital

Green remains hopeful that we can make a difference in TB by coming together to urge companies and governments to make choices that will help the global TB effort. Already, a sub-group of his fan community called TBFighters has successfully advocated for lower tuberculosis test prices.

But the fight to end TB is not the only area where Green encouraged the audience to find strength in community. He ended the evening with a call for hope and togetherness in a time when many, especially those working in public health, are feeling hopeless.

“I argue in this book that we are the products of history, but we are also ourselves historical forces, and together we can change the arc of our shared story,” he said. “I know that because I have seen it happen.”

“Today is not the end of the story. Today is the middle of the story, and it falls to us to make a better end.”