Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection

by John Green

And so the work of TB caregivers, survivors, and activists in Peru in the 1990s helped Phumeza Tisile survive TB, and her work in turn lowered the price of bedaquiline, which will help many others survive TB. This virtuous cycle has dramatically expanded access to treatment by lowering its cost: MDR-TB was labeled as too expensive to treat in the 1990s, when it cost over $15,000 per patient. Organizations like PIH were able to drive that cost down to $1,500 by the late 1990s. Thanks to the efforts to lower the price of bedaquiline, that price has dropped further. In 2023, the endTB trials—funded by Unitaid, Doctors Without Borders, and PIH—found that around 90 percent of MDR-TB cases could be cured for about $300 per course, a 98 percent reduction in price from the 1990s. As Christian McMillen reminds us, when it comes to TB treatment, “cost-effectiveness is a moving target.”