The world pays close attention when an infectious disease begins to kill people in an area where the disease had been rare or when the microbe that causes the disease had not been well known. That’s because we evolved to notice change.
But what about an infection that can be cured and is caused by a well-known bacterium, yet kills enormous numbers of people every day, year in and year out, in most geographic regions of the globe? That describes tuberculosis (TB)—a disease that archaeologists tell us has been felling humans for at least ten thousand years. Let’s call this what it is: a “standing pandemic”.
Over the last century and a half, TB has been the single leading cause of death from infection, except when certain viruses sweep through human populations. Over that period, four viruses have been major killers, fortunately in time-limited ways. The influenza pandemic that started in 1917 faded on its own. Some years after the HIV/AIDS pandemic broke out in 1981, anti-viral drugs finally stopped HIV from killing most of its victims. Widespread vaccination snuffed out smallpox by 1979. Vaccination put a check on COVID beginning in December 2020. As each of these viruses began to claim fewer lives, TB’s steady death toll—well over a million people a year— put it back in front as the leading killer from infection. When something acts steadily over many years, it tends to lose its hold on our attention.
We don’t have to let that happen. Let’s give TB the attention it deserves, especially now. Why now? Three reasons.
First, the sciences of vaccinology and drug discovery are equipped with more powerful tools than ever before. AI is powering many of them.
Second, academic groups that usually compete are collaborating with each other in efforts to prevent TB from spreading and killing. Pharmaceutical companies that usually compete are doing the same. Best of all, discoverers and drug-makers are working now side-by-side. This is a sea-change and it’s had an outsized impact: the consortium approach for TB that began 16 years ago helped teach the world how to respond to COVID in record time.
Those are two happy reasons. The third reason why this moment is special is a terrible one. In 2025, the government of a wealthy country, with no planning or warning, abruptly and cruelly demolished a major support system for health care in regions that bear some of the world’s heaviest burdens of TB. Rather than discourage TB fighters, this wanton destruction, this choking off of the delivery of new treatments to people most in need, has redoubled their dedication.
For too long, too much of the world has looked away while TB killed someone every 15 seconds. We are better than that. It’s time to show it.