Nearly 1.3 million people died from tuberculosis (TB) in 2023, according to the World Health Organization—despite a cure being developed decades ago. These deaths occur disproportionately in the world’s most poverty-stricken countries.
John Green, the celebrated young adult author and vlogger, has been an advocate for TB treatment access since 2019, when he met Henry, a teenager with TB, during a trip to Sierra Leone. Henry gave Green “the view from below,” he says, quoting his late friend and global health pioneer Paul Farmer, who described the gaps in care for the marginalized as a systemic, ethical dilemma.
Green’s new nonfiction title, Everything Is Tuberculosis (Crash Course Books, March), chronicles the disease’s history from a biological and social standpoint, as well as Henry’s story.
Green spoke with American Libraries about health equity and his connections to ALA.
What was it about meeting Henry that inspired your yearslong passion for tuberculosis health care reform?
You can hear abstract numbers like “1.3 million people die of TB every year” and be horrified by them. But in the end, what moves us is human stories. Henry helped me understand what his particular experience was like, and through that, I was able to glimpse the larger story of tuberculosis.
For me, meeting Henry brought home the fact that each of these 1.3 million people has a life that’s individual to them, and a tremendously valuable life. It really underscored the horror of the systems we’ve built that exclude so many people from treatment.
You’ve described this book as both a departure from your other projects but also as very similar. How do the themes and structure align with your fiction titles?
Everything Is Tuberculosis is about a teenager, like a lot of my books. And about a teenager who loves poetry and writes poetry, like a lot of my books. But on a deeper level, it’s about the way we imagine other people, the distance between ourselves and others, and how in that distance, empathy starts to break down, and we can allow for a world that we would never accept if it directly affected ourselves or those who are closest to us. In a way, that’s something I’ve been writing about since Looking for Alaska was published 20 years ago.
I’ve always been interested in how we misimagine people and what the costs of that are, and I’ve always been interested in the ways that we romanticize and dehumanize others as well. I think that’s something we see very profoundly in the history of tuberculosis; both a romanticization of the illness in 19th-century Northern Europe but also the relentless stigmatization of TB patients ever since.
How did you use libraries and archives while writing this book?
I could not have written this book without libraries, librarians, and archivists who helped me with everything from understanding 18th-century corsetry to where my great-uncle Stokes died. My great-uncle had tuberculosis and died in a sanatorium in Asheville, North Carolina, and I’d always known that [he died of TB], but I’d never known where he died, the circumstances of his death, or how long he was a patient there. An archivist helped me understand that. I did a lot of the writing here at the Indianapolis Public Library.
The book’s title references how TB has played a significant role in our shared history. In your research, was there one finding that stuck out to you?
I was really surprised to learn that all three of the assassins of Archduke Franz Ferdinand [whose death sparked World War I] were dying of consumption [TB], knew they were dying of consumption, and knew they did not have long to live. I think that changes the way you behave when you’re a teenager, if you know you don’t have a long time to live. That really surprised me. I actually learned that from my son, who came home from school one day saying, “Did you know that [Ferdinand assassin] Gavrilo Princip had tuberculosis and knew he was dying?” And I said, “No, he didn’t. If that were true, I would already know it.” And I was completely wrong.
In the last few years, there have been some strides. Some pharmaceutical companies have lowered prices of TB test cartridges, and some treatment costs have gone down. What keeps you hopeful for the future?
We have the resources to confront this disease. It’s been curable since the 1950s. Our tools are getting better all the time. There are good vaccine candidates in the pipeline. There are really, really good tests coming down the pipeline. There’s no reason not to be optimistic. The reasons to be pessimistic are that humans, again and again, make choices that further oppress the already oppressed, that further marginalize the already marginalized. That’s what worries me. But what gives me hope is that we know how to live in a world without tuberculosis. We just need to choose to live in that world.
You wrote this book amid a global pandemic. Did that lived experience open people’s eyes to the importance of prevention and treatment for other deadly diseases, like TB?
Certainly, when I was a child, I did not think of infectious disease as being a threat in my community. I did not think of infection as a huge problem in the rich world. Obviously, we got chicken pox, we got the flu, but I didn’t think of it as being a risk to the social order or my life. That’s very different for my children, and that’s very different for anyone who lived through the past five years. So I do think we’re more aware of the role that infectious disease can play in our shared history, which is good.
We ignore disease a lot of times when we tell the story of human history, but we shouldn’t. The story of what microbes do and what microbes have done to us is really at the center of human history in a lot of ways, from the Black Death to COVID. It’s always a good time to be talking about infectious disease and the ways that it continues to deepen the paths of injustice. That’s true for COVID too. Inequitable access to COVID treatment is a huge problem. This is certainly not a problem that’s exclusive to tuberculosis in any way. I just think tuberculosis is a really powerful example of global health inequity.
We know how to live in a world without tuberculosis. We just need to choose to live in that world.
You’re also a staunch supporter of the freedom to read. What would you say to those who are concerned about the future of book challenges, especially in this political landscape?
I’ve never been so worried about it. I’ve never experienced attacks on my work like the ones I’ve seen in the last couple years, and that’s even more true for authors of color and LGBTQ authors. It is really upsetting to live in a world where the freedom to read is at such risk where so many kids are denied access to the breadth of literature because of activist parents going and trying to get books removed from libraries. I think it speaks to the power of literature. I think it speaks to the fact that these books are important. But the old saw that it’s good news when your book gets banned because it’ll sell more copies, that’s just not true. At least it’s not true now. What’s true now is that there has been a fair amount of success at removing books from the hands of kids who would otherwise read and be transformed by those books, and that worries me a lot.
In the early 2000s, you worked at Booklist as an editorial assistant and production editor. How did that time shape your career as an author?
My time at Booklist was hugely important to my life as a writer and a person. I reviewed hundreds and hundreds of books while I worked there, which is the best apprenticeship an author could ever ask for. To be asked to think critically about a huge diverse range of books is such a gift.
My mentors from the time when I worked there are still my mentors. [Former children’s books editor] Ilene Cooper is still my mentor. [Longtime editor and publisher] Bill Ott was still my mentor until he passed away [in 2023]. It was the most important time of my life in terms of my development as a writer. And I love that place. I love ALA, so much
