Summary
This chapter draws on concepts from medical anthropology to challenge the existing notion in global public health that tuberculosis (TB) is an acute disease. This is done in three ways. First, it describes how efforts to curb the global TB epidemic have heavily relied on biomedical, drug-centric, and vertical public health systems directed at identifying and curing a containable acute and short-lived disease. It problematizes this approach with the reality that poverty, malnutrition, and poor health systems drive susceptibility to tuberculosis infection, disease development, reinfection, and co-morbidity in a cyclical manner. Second, it engages with reinterpretations of Omran’s epidemiological transition theory that questions the acute versus chronic dichotomy and, thereby, introduces fluidity into mainstay conceptualizations of tuberculosis. Biographical research among people with tuberculosis, who have endured physiological and psychosocial scars, further reveals a chronicity that brings its transient nature and functional curability into question. Third, given this chronicity, it describes the consequential coinciding changes in patients’ identities to understand how they adjust to everyday debilitation following tuberculosis. Although current responses to tuberculosis centre around a linear continuum of acute care, this chapter argues for a more cyclical and rehabilitative approach that may address its interminable imprint on people’s lives.
