Everything is Tuberculosis by John Green

Tuberculosis. Is that still a thing?

It seems like a disease from our misty past. Like scurvy, or the Black Plague. Tuberculosis, or TB, used to be a serious affliction, people suffered, but we got rid of it...right?

Wrong. John Green makes important points in his new book "Everything is Tuberculosis": TB is still here, it's the world’s deadliest infection (killing about 1.25 million people in 2023), but it's completely preventable and treatable. We just, as a human species, choose not to address it.

This choice reveals something profound about how we see, or rather, don't see, the systems that protect us.

Reading a book about TB in 2025 wasn't high on my list, but I saw Green in an interview, and the injustice of it all intrigued me. What I discovered was more fascinating than expected: a window into the invisible infrastructure that keeps some of us safe while abandoning others.

The multiple invisible systems in our lives

I'm lucky enough to live in a world where I haven't had much exposure to TB, and even if I did, I'm 99% sure I have access to a healthcare system where antibiotics are accessible. There are doctors I can see to detect it, tests available including X-rays, variety of antibiotics I can access, cold storage facilities where drugs are kept, and on and on.

This book made me appreciate all the systems that have to be functioning so we as a local society can keep TB mostly at bay. We notice these systems only when they fail, but when they work, they're completely invisible to us.

But here's the thing: it's not the same everywhere, and not even the same in all parts of Canada. Levels of TB are much higher in First Nations populations, for example.

In 2022, the rate of active tuberculosis in Canada was 5.1 per 100,000 population. The rates were highest among Inuit (136.7 per 100,000), First Nations (21.4 per 100,000) and people born outside of Canada (14.4 per 100,000).

Source: Government of Canada

And why is that? It's a complex web of factors like poverty, access to healthy food, and healthcare access, but it all boils down to what Green identifies as injustice:

“The infection has long exploited human biases and blind spots, wriggling its way through the paths injustice creates. Of course, tuberculosis doesn't know what it's doing, but for centuries, the disease has used social forces and prejudice to thrive wherever power systems devalue human lives.”

— Everything is Tuberculosis

Green walks us through the history of TB and how culture has shaped attitudes toward the disease. But the most powerful insight isn't historical—it's about what's happening right now.

He humanizes the book by interspersing details about his friend in Sierra Leone, Henry who struggles with getting treatment for TB. He wrestles with the disease for years, and the heartbreaking part is that with more money and access to treatment, he likely wouldn't have ended up fighting for his life for so long. It's heart wrenching, and a really important part of this book that makes TB more than just statistics, or injustice in the abstract.

We have tests and treatments for TB that could prevent or even eradicate the disease in Africa and other places. In many parts of North America, we effectively have eradicated it (although rates are inching up, even here). The systems work when we choose to fund and implement them properly.

This is why TB matters in 2025

It's a perfect example of how functional systems become invisible, while dysfunctional ones reveal the true priorities of our societies. TB persists not because we lack the tools to stop it, but because we lack the will to extend those working systems to everyone who needs them.

Green's call to action cuts to the heart of it:

“And this is why I would submit that TB in the twenty-first century is not really caused by a bacteria that we know how to kill. TB in the twenty-first century is really caused by those social determinants of health, which at their core are about human-built systems for extracting and allocating resources. The real cause of contemporary tuberculosis is, for lack of a better term, us.

...And so we have entered a strange era of human history: A preventable, curable infectious disease remains our deadliest. That's the world we are currently choosing.”

— Everything is Tuberculosis

When systems work well, we forget they exist. When they work for some but not others, we see the true measure of our values. TB forces us to confront an uncomfortable truth: we have the power to save lives, we just choose not to use it equally.

That's what makes this more than just a book about disease - it's a book about the systems we build, the ones we maintain, and the ones we allow to crumble. And why all of that matters more than we might think.

This is a great read on an important, and often overlooked, subject.

"This is the middle of the story, not the end of the story, and it falls to us to write a better ending."

— John Green

And yes, once I read this, I started seeing everything is tuberculosis!