Dr Bharat Jayram Venkat speaks on writing a book on India’s battle against tuberculosis

How did you end up writing a book about India’s battle against tuberculosis?
In 2006, I began studying the influence of American philanthropies on HIV interventions in India, so I spent time in an HIV clinic where I saw patients dying—not from HIV, but tuberculosis. I was baffled, and my research began shifting towards tuberculosis. I stopped asking why people were dying from a curable condition and began asking what it meant to be cured in the first place.

What kind of research went into writing the book? How long did it take for you to put it together?
It took me over a decade. The fieldwork was conducted primarily between 2011 and 2016, when there were estimated to be just under three million new cases of tuberculosis in, India. I spent time in clinics and hospitals; I spoke to physicians, patients, and their families and met with government officials involved with the national tuberculosis control programme. I also travelled to Chennai, Kolkata, and London to access the archives and understand the long history of tuberculosis treatment. Finally, I also examined film, folklore, and fiction about tuberculosis and its cures.

What were some of the myths about the disease that you discovered during your research?
The story of Chandran, the great Moon King, is referenced in many medical textbooks even today. It is about how the moon was once perpetually full, never waning, until the king married the 27 daughters of Daksha Prajapati, the lord of all creatures. Chandran, however, only had eyes for one: Rohini.

The other wives complained to their father, who in turn, cursed Chandran to waste away until he disappeared from the night sky. The gods pleaded with Daksha to relent, but he declared that the moon would not only wane but also wax. This might be read as an origin myth. Chandran is not simply the primordial victim of tuberculosis; he is, in a sense, patient zero, passing his illness down to us mortals. In fact, many patients whom I met would be declared cured, only to return months or years later, to be cured again.

You write in the book, “The question of what is being cured reveals that cure might inevitably and always  be a metaphor with a slippery referent.” Please elaborate.

What I mean is that there’s no universal model for what a cure is. Instead, cure takes many forms  (pharmaceuticals or policies, for instance) and many objects (your body, environment or society). How we treat a particular condition or person is not just a technical question for medicine, but a social and political question.