Everything Is Tuberculosis: Chapter 15 Summary & Analysis

Soon after Green first met Henry, Dr. Girum, a new doctor, began working at Lakka Hospital. Dr. Girum was moved to work with TB patients because of how magic the treatments can seem when they help desperately ill people. However, he also often sees people who receive treatment too late and, in poor countries, don’t have the resources needed to survive. In wealthy countries, like the U.S., active case-finding (especially for those early on in their TB infections) was prioritized to stop chains of infection, allocate for proper treatment, and notify close contacts with the infected individual to provide preventative therapy.

In Sierra Leone, these strategies were very rare even in the 2020s due to financial restraints. As such, many TB patients in Sierra Leone are diagnosed too late and can’t access the necessary resources for effective treatment. For example, TB is diagnosed only by smear microscopy in Sierra Leone; though it is quick and cost-effective, it can’t determine if someone’s TB is drug-resistant. In other countries, molecular testing is used instead, as it is incredibly quick and much more sensitive to the various strains of TB. Like bedaquiline, though, companies skyrocket prices of molecular testing to make more money, effectively shutting out countries like Sierra Leone that don’t have the funding to afford them. In the long run, using these more expensive tests would outweigh the negatives that come with the use of less sensitive but more inexpensive tools, but, once again, humanity is devalued for the sake of money.