The Current - Why John Green is obsessed with tuberculosis

Episode Date: March 13, 2025

Tuberculosis is entirely curable and yet also the deadliest infectious disease in the world. That paradox has fascinated John Green, the popular YouTuber and author of The Fault in Our Stars, ever since he met a boy called Henry at a TB hospital in Sierra Leone. Green's new book, Everything is Tuberculosis, tells Henry’s story and asks why this disease still kills more people every year than homicide, war, and malaria combined.

What does a mummified Egyptian child, the Parthenon marbles of Greece and an Irish giant all have in common? They are all stuff the British stole. Maybe. Join me, Mark Fennell, as I travel around the globe uncovering the shocking stories of how some, let's call them ill-gotten, artifacts made it to faraway institutions. Spoiler, it was probably the British. Don't miss a brand new season of Stuff The British Style. Watch it free on CBC Gem. This is a CBC Podcast. Hello, I'm Matt Galloway, and this is The Current Podcast. John Green is best known as a novelist. His 2012 young adult book, The Fault in Our Stars, was a runaway bestseller. It was subsequently turned into a Hollywood movie.

John Green is also an enormously popular YouTuber along with his brother, Hank. They are known as the Vlog Brothers. For the past several years though, John Green has had another mission. He has become, he will admit, obsessed with tuberculosis. This started when he met a boy named Henry at a hospital in Sierra Leone. Henry came close to dying from TB, a disease that kills more than 1.2 million people every single year. John Green's new book is a work of nonfiction.

It tells Henry's story and explores why TB is still the world's most deadly infectious disease, despite being eminently curable. That book is called Everything is Tuberculosis. John Green, good morning. Good morning. It's great to be with you. It's great to have you here. Tell me about that first meeting with Henry. What struck you about him

and the situation that you found him in? Well, in 2019, I had no idea that tuberculosis was still a thing. I had no concept of that, but we were in Sierra Leone to learn about the maternal healthcare system there. I was there with my wife. And on the last day, the doctors asked us to visit a tuberculosis hospital, and I was

shocked that there even were tuberculosis hospitals. We got there, and immediately this little kid who shares a name with my son, who's also named Henry, grabbed me by the shirt and just started walking me around the hospital. And he was the most charming person, and everybody was laughing with him and rubbing his head and lifting him up and giving him hugs and he showed me the kitchen in the laboratory and eventually we made our way back to the doctors who sort of shooed him away and I said whose kid is that? Is that one of your kids? And they said no he's a patient and he's one of the ones that we're really really

concerned about because even though Henry's tuberculosis was responding to antibiotics, they knew that it wasn't responding well enough and they knew that his infection would inevitably come roaring back. I think there are a lot of people who might find themselves in the position that you were in, not knowing that tuberculosis is still a thing.

Just remind, for people who don't know, remind us what it does to people. So tuberculosis primarily infects the lungs, although it can attack any number of systems inside the body. It's a bacterial infection. And in most cases, about a quarter of all humans living right now have experienced a TB infection,

but in most cases, those people will never become sick. They'll have what we call latent tuberculosis. But in about 10% of people, people will never become sick. They'll have what we call latent tuberculosis. But in about 10% of people, they will eventually become sick. The bacteria will overwhelm the body's defenses against it. And in that case, tuberculosis is usually fatal. Is it right in the book you say more people died in 2023 of tuberculosis than malaria,

typhoid and war combined? That's right, yeah, that's true. Why is it a weird disease? It's a weird disease because the bacteria has this thick fatty cell wall, and so it divides very slowly so that it can build its complex cell wall. And as a result of dividing very slowly,

it makes us sick slowly. So people can live with tuberculosis for years or even for decades and that makes it a strange bacterial infection. It also makes it a very hard bacterial infection to fight because that thick cell wall is hard to penetrate, hard to kill. And so instead of taking antibiotics for maybe a week or two weeks as we would if we had a strep or staph infection, you're much more likely to take antibiotics for four or six or even more months.

How did you become obsessed with this? I think it was because of Henry. I think if I hadn't met Henry, I wouldn't have been so interested in tuberculosis, but after meeting Henry, I came home and just started reading about the disease because I wanted to understand what was wrong with my information feeds, that I had no idea that this disease was such a scourge in our world. And along the way I learned that everything really is tuberculosis, as I say in the book. History is tuberculosis, geography is tuberculosis, politics is tuberculosis, and social justice is tuberculosis. And so for me it became a way into all of those issues, understanding the history of TB,

but also understanding that tuberculosis is a disease that has used structures of injustice that we blazed for it to travel through the human world. Can you tell me more about just, I mean, that's the title of the book, but it comes out of, you were traveling in Sierra Leone, you mentioned with your wife, and your wife kind of jokes that for you,

it seemed like everything was tuberculosis, and tuberculosis was everything. Yeah, yeah. No, every, it's a ongoing joke in our household that when dad starts a story, the punchline is going to be tuberculosis. The kids don't let me get three or four words into a story before saying, we know dad. We know Ringo Starr had tuberculosis and he only became a beetle because he learned how to drum, because he was in a sanatorium, because he had tubercula. We know, dad.

Is that a true story? Ringo Starr had tubercula? That's a true story. See, again, the things I didn't know. Yeah. No, I mean, everywhere you go, it's tuberculosis. Ringo Starr had a tuberculosis infection when he was very young and lived in a sanatorium until he was able to get the curative care that was just becoming available. This was a, it's a disease that's changed over time in terms of how it, and who it affects,

but also how we see it, right? I mean, when it was known as consumption, there was almost a romanticization of tuberculosis. Yeah, very much so, very much so. So Charles Dickens called tuberculosis the disease that wealth never warded off. The richest person in the 19th century. Jay Gould died of tuberculosis. It was a disease that killed kings as well as peasants. And as such, it became a romanticized disease, which is a very strange

facet of world history. But, you know, people saw tuberculosis as being a disease that made you beautiful, but also a disease that made you brilliant. It was understood to be an inherited condition at the time, and so along with inheriting a susceptibility to consumption, you would also inherit other personality traits, a deep sensitivity and openness to the suffering and beauty of the world that purportedly made you a good poet, for instance. There was one that purportedly made you a good poet, for instance. There was one American doctor, as I recall, who said that as tuberculosis rates started to go down, that we might suffer culturally from our improved health,

because that's how deeply believed it was that tuberculosis was an essential part of creating art. How or why did that change, that romanticization? And part of this is about the racialization of the disease, right? Oh, absolutely, B. Oh, absolutely. Yeah. So, in the early 19th century, among white, European, and American, and Canadian doctors, it was understood that tuberculosis was essentially only a disease of white people. And as it became obvious that that wasn't the case, the disease was racialized and seen instead of white supremacy holding that only white people

could get this disease of civilization, it sort of switched to racialized medicine holding that people of color and indigenous people were uniquely susceptible to tuberculosis because of racial traits. Now, of course, that was hogwash and it was understood to be hogwash by many doctors, including many African American doctors here in the united states who pushed back very hard against this racialization of the disease But it was still had a profound effect on the way we imagined and still imagined tuberculosis You said something interesting earlier, which was that in some ways? This is a form and expression of injustice and in the book that you write

TB has exploited biases and blind spots. Tell me more about that. Yeah, I mean tuberculosis was allowed to thrive in colonized regions, partly because white people believed that it was impossible in colonized regions. And so that shaped the disease burden globally. But it's also an expression of injustice because if I got tuberculosis tomorrow, I would have access to the newest and best treatments. Someone like Henry, living in Sierra Leone, was told, well, there's nothing that we can do for you, even though there were drugs available that would cure his tuberculosis, but they weren't drugs that were yet approved by the Ugandan physician, Dr. Peter Mugeny, where he said of HIV AIDS, where are the drugs? The drugs are where the disease is not and where is the disease? The disease is where the drugs are not. And that's very much the case for tuberculosis as well.

Is that what you mean, one, in the book you write about how we pay a lot of attention to how we treat illness and much less to the question, you say it's a critical question of how we imagine illness, that illness can be kind of like a constructed phenomenon? Yeah, I mean, tuberculosis is very much a biomedical phenomenon, but it is also a really constructed phenomenon. For many years, we saw tuberculosis as the disease that wealth never warded off,

and now we see tuberculosis as the disease that wealth almost entirely wards off. And I think that grappling with how we imagine disease is really important because that shapes not just how we live and die of diseases like tuberculosis, but it also shapes who lives and dies of diseases like tuberculosis. Stigma is a big part of that too. You talk to people who say that fighting the disease is hard, but fighting the stigma around the disease is even harder. Tell me a bit more about that and how stigma impacts

who gets better and who gets treatment. Stigma is so profound when it comes to tuberculosis. I've talked with healthcare workers who told me that the hardest part of their job is burying their patients and knowing that no one will come to the funerals because they're so afraid of tuberculosis and so the healthcare workers have to be the only grievers at the funerals. You know, someone like my friend Henry was very fortunate not to be abandoned by his family and I think that's part of the reason why he was able to survive tuberculosis because

his mother never stopped visiting him, never stopped bringing him extra food whenever she had any, and I think that's a big part of the reason why he lived, why he lived long enough to get access to the kind of personalized treatment that I would have had access to on day one of my infection. And so I think this is another way in which the way we imagine illness has a really profound effect on who gets sick and who dies because when we stigmatize tuberculosis and say it's only a disease of poverty or a disease of filth or whatever,

however it is that we wanna imagine this airborne illness, we end up marginalizing the lives of people living with the disease and we end up making their lives even harder. I mean, maybe that hints at this, but why do you think given everything that we can do, why have we in this world not done a better job at reducing rates of TB?

Well, in the years since tuberculosis became curable, we've allowed over 150 million people to die of it. And I think that's a result of building social orders that value some lives more than others, rather than social orders that treat all lives as being equally valuable. Just before you continue, tell me more about that, because you write in the book about quantifying

whether it's good to intervene in a disease, right? Yeah, I mean, for years it was argued that when it comes to multi-drug resistant tuberculosis, we shouldn't do anything. We should just allow patients to die and allow patients to spread tuberculosis to more people as they die. And that was the case because it wasn't seen as cost-effective. It was expensive to treat multi-drug resistant tuberculosis, but it wasn't expensive because we have to go to the moon to get those drugs or because they're made of gold or platinum or something.

It was expensive because of human-built systems said they should be expensive because we allowed, even though most of these drugs were funded with public money primarily, we still allowed pharmaceutical companies to have monopolies on the pricing of those drugs, especially drugs developed and patented in the United States. And so that's had a huge impact on the burden of the disease, unfortunately. Is it possible to cure tuberculosis? Yeah, no, it's easy to cure tuberculosis.

I mean, not easy. It's relatively easy, right? Like, my brother had cancer a year and a half ago, and he had to undergo chemotherapy and radiation. It cost about 150 times more to cure my brother's cancer than it costs to cure Henry's tuberculosis. And yet, my brother was never once told, oh, we're not sure if this makes sense. We're not sure if this is a good investment. We're not sure if we can

afford this as a community. But that's what Henry was told when it came to him getting access to the newest and best drugs. The assumption is that, you know, my brother deserves access to the newest highly personalized medical treatments. And the assumption is that, you know, my brother deserves access to the newest, highly personalized medical treatments. And the assumption is that Henry doesn't. Are you ready to take control of your finances and build a life you've always dreamed of? I'm Jessica Morehouse, a Canadian money expert, accredited financial counselor, bestselling author and host of More Money. financial counselor, bestselling author, and host of More Money. Each week, I bring you inspiring interviews and practical advice to help you make smarter financial decisions. Tune into More Money on your favorite podcast platform, and let's start your journey to financial empowerment today.

How do you think about this conversation and what you were just talking about in light of what's happening in your country right now, where an enormous internationally received foreign aid program from the United States when it comes to public health and a backbone for public health around the world has been decimated, in the words of Elon Musk, put into the woodchipper over the course of a weekend? Yes, I can't believe he said that,

but also I can believe he said that. Sorry, that's just such an evocative and horrifying image, and yet he used it. It's devastating to me. It's devastating to everyone who cares about the overall quality of human health. The United States has long been the most generous donor of tuberculosis response and essentially walked all of that back in a weekend, walked 100% of that back so that almost all contracts

related to tuberculosis were canceled without notice. This means untold numbers of people, perhaps hundreds of thousands of people will see their TB treatment interrupted in the middle of their course of treatment, which is devastating. Even a two week interruption in treatment can lead to a skyrocketing chance of drug resistance. That drug resistance means more drug resistant TB circulating in communities, which is a threat to humans everywhere. It's a threat to all humans. It's a threat to Canada. It's a threat to the United States. It's a threat to global health. And to see my government make these decisions so chaotically and so callously in ways that will devastate human health has been absolutely horrifying to me. I feel that so much of the progress that we've made has just evaporated. I mean, the most recent estimate I saw said that we're looking at about a 30% increase

in tuberculosis rates in the next couple years as a result of the defunding of USAID. That means instead of 10 million people getting sick, 13 million people get sick instead of 1.25 or 1.3 million people dying, 1.7 or 1.82. And each of those 400 or 500,000 lives is incalculably valuable and their deaths will be utterly needless and a direct effect of what the United States government has chosen to do over the last few weeks.

How do you understand that decision? I don't understand it. At decision? I don't understand it. At all? I don't understand it at all. I mean, I don't think it's in our national interest. I think it's a rounding error in our federal budget. I understand it only as vice signaling. We talk about virtue signaling a lot,

like people making some kind of nominal donation to an organization as a way of trying to assuage their guilt about some kind of action or whatever. We don't talk enough about vice signaling and attempt to just disgust and horrify the world, but that's what it feels like to me. I don't have any other explanation for it. It makes absolutely no sense to me. And just like going, I mean, not to get on my high horse, but like just starting

a trade war with Canada makes absolutely no sense to me. This is our closest ally, our closest neighbor and our closest friend for centuries now. And I have absolutely no understanding of what's going on, only horror, disgust, and fear. You sounded, when I asked you about the wood chipper comment, if I might say, I mean, you sounded angry, but also like emotional in the response to that. Yeah, I mean, it made me tear up because I can't believe that someone would say that about a program

that has saved tens of millions of lives over the last 50 years. Who do you think of when you think of what's happening right now? I mean, Henry, I'm sure, is one of those people, but these are decisions that will impact individuals. We talk on this grand scale of things, but this is about people, right?

Yeah, that's so true. And when we talk about millions of human lives, almost none of us can understand what that means. I certainly can't understand what that means. I don't know what a million human lives, almost none of us can understand what that means. I certainly can't understand what that means. I don't know what a million human lives looks like, you know? I can't, I've never been in a stadium that big. And that's why when I was writing this book, I wanted to tell one human story, because in the end we are moved by the stories of real humans, not by statistics, or at least I am. And so I wanted to tell the story of one boy trying to survive tuberculosis.

And he does survive tuberculosis. He is cured of tuberculosis. Today he is a junior at the University of Sierra Leone. He's doing great. I'm so thrilled with how his life has gone. But his life is still very vulnerable. He is still a hugely marginalized person. And frankly frankly he depends upon USAID organizational support for the long-term effects of his tuberculosis and for some of the other health care problems he has as a result of his TB infection and so his life is his life is put at risk by these decisions. Millions of people's lives are put at risk by these decisions. And so if I sound emotional or upset, it's because I cannot fathom a world

in which someone would describe the lives of other human beings as being worthy of being put into a woodchipper. It also speaks to what you say in the book about how, well, we are the cause and we must be the cure, right? That we have a role, broadly, society has a role in trying to tackle a disease like this. Absolutely, I think this is a really important thing

to understand, you can't really say in the 21st century that tuberculosis is caused by a bacteria anymore because we know how to kill that bacteria. Tuberculosis is caused by us, it's caused by choices that we make, it's caused by human-built systems. And that means that's devastating news in the sense that our deadliest infectious disease is curable.

Our deadliest infectious disease is something that we are, for lack of a better term, choosing. But it's also good news in the sense that we can choose a different world. We can be the cure for tuberculosis. I believe that we will be the cure for tuberculosis. It's just on what time scale. You say in the book that when we know suffering and when we see suffering, we are capable of extraordinary generosity.

Do you still believe that? I mean, do you see evidence of that now based on what's happening in the world? I do believe that. I believe that very strongly. I mean, look, it's easy to feel like I'm at the end of history because this is the most recent day I've ever lived through. You know, I inevitably see my story as one that starts at my birth and ends today because

I don't know what tomorrow holds. But I'm not at the end of history. I'm in the middle of history. I'm not at the end of the story. I'm in the middle of the story. I don't live outside of history. I live within history. And so I need to fight for a better end to the story. And I believe, and I see every day,

people fighting for a better end to the human story. And that is what moves me and what motivates me and why I refuse to give up on my hope. Can I ask you a little bit about that motivation? I mean, you wrote a book, as I said, in the introduction that was unbelievably successful, turned into a movie, but this book has ended up in the hands of people around the world and has given you fame,

but as you write about in the book, also a megaphone. And a megaphone can be used, I mean, you can shout on social media about putting something in a woodchipper, or you can use that megaphone for good. How do you decide where to direct the megaphone? Well, that's a verychipper, or you can use that megaphone for good. How do you decide where to direct the megaphone? Well, that's a very hard question, and one that I try to take seriously, because it is a real privilege to have a megaphone,

and it's really easy to do harm with your megaphone. But I feel like tuberculosis is a good place to use it, not so much because I'm fascinated by the bacteria itself or anything like that, but because I think that it is the exemplar of diseases of injustice and those diseases of injustice are ones that we can, we have the tools now to battle effectively. This goes beyond TB, right? I mean, you and Hank have, I mean, you've raised tens of millions of dollars as part

of this effort to make the world suck less and increase the awesome in some ways. And there's this whole, I mean, the nerdfighters kind of subculture that people are fighting against a world that they find to be awful and they wanna make it better. What do you wanna do with that? That's just, you find yourself in this position

because of success in some ways, and you don't have to do it because success could allow you not to do it, but you are doing it. What are you trying to do with that? I think my wife would be annoyed all the time if I didn't work. I'm a lot.

I'm a little, as the kids say, extra. And so I think I need to be working. I need to be doing stuff. And this feels like a reasonably good use of my time. And that's really what I'm looking for is, how can I use my limited time here and my limited amounts of attention and everything to try to participate in my little way,

to try to help in my little way? And I see so many people helping in their little ways. And I just, I wanna be part of that story. I mean, it's kind of needed now, not just broadly, but also I'm sure for yourself, right? There's a lot of bad news that's out there. And when you are helping to contribute something that is changing that channel and giving people

some sort of sense of optimism and hope, it has to feel good. It's really easy to feel despair. It's always easy to feel despair, but it's really easy right now. And the thing about despair is that it tells such a compelling story. It says, don't bother with anything because what's the point anyway? There's no point.

You know, we're just a temporary phenomenon, which is true. We're just, this is misery. There's no, don't get out of bed. And that voice is very loud in my head. It always has been. And yet I also think that voice is lying. The thing about despair is it just makes more of itself. It doesn't do anything. And so my work, my life is about

fighting that despair and trying to find causes for hope. And I will be honest, that is certainly not easy right now. That's certainly not easy for me as an American right now, but I still believe that hope is the correct response to consciousness. The year I graduated from high school, 12 million children died before the age of five, and last year, five million did. That progress is real and it only happened because millions of people came together to make it happen.

And I really, really believe that evidence like that is what we should hold onto in hard times like this one. What do you hope for, just finally for Henry? When you think of him now, you talk to him regularly, you stay in touch, what do you hope for his future? I hope that he gets to live the same, a life with the same kind of freedom and opportunity that I would hope for my own children.

I hope that he's able to complete his education to his satisfaction, that he's able to follow his dreams. You know, Henry told me once that his dream is to be a person in society, to be seen as fully human by his social order, and that is my hope for him. Pete It's a real pleasure to talk to you. This book is fascinating, but the work that you have done to make it into something that people will be hopefully compelled to act upon is quite something as well. John, thank you very much. Thank you. I've really appreciated this conversation. John Green's new book is called Everything is Tuberculosis. You can find it in bookstores as of next Monday.