Awakenings by Bharat Jayram Venkat

Tuberculosis is curable.

Figure 1: Propaganda materials rehearsing the curability of tuberculosis are produced by a variety of institutional actors across India. From left to right: poster from Christian Medical College, Vellore (accessed via US National Library of Medicine); logo from Government of India’s Revised National Tuberculosis Control Programme (RNTCP); and poster from a series developed by the Indian Development Foundation, an NGO. 

But what if it isn’t?

TB not curable

Figure 2: Clippings from Indian newspaper reports on the emergence of totally drug-resistant strains of tuberculosis in India.

What would it mean to awaken to a post-antibiotic future, to a world in which the promise of cure has come undone? In December of 2011, a two-page letter appearing in the journal Clinical Infectious Diseases threatened to rouse even the deepest of sleepers from their reverie. In the letter, Dr. Zarir Udwadia and his team at Mumbai’s P.D. Hinduja Hospital announced that they had identified the first cases of totally drug-resistant tuberculosis in India.

“You write a good article, four to five people will ask you for reprints and it dies its natural death,” Udwadia told me when I met him in his clinic in the summer of 2015. “But this,” he said, referring to his letter, “this just took off. Suddenly, drug resistant TB was on everyone’s radar. The papers didn’t stop. It appeared on the front page of the Times of India. It ended up on the BBC, the Lancet, the British Medical Journal, Time Magazine. Have you seen that Time Magazine cover?”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.