ABSTRACT

On World TB Day at the end of March 1996, a World Health Organisation (WHO) report showed that global tuberculosis mortality has been on a steep upward curve since the 1950s; indeed, in 1993 the Organisation had declared the disease a ‘global emergency’. The report described two epidemic waves: the first, which was concentrated in northern, industrialised countries, peaked around 1900 and went into decline before a second wave, concentrated in southern, Third World countries, picked up in the 1950s. During the trough in the 1920s and 1930s, mortality in the north fell rapidly, but an increase in the south became ever more apparent. In this chapter we discuss the development of medical awareness and explanations of the second epidemic wave in the first four decades of this century. More precisely, our focus is the debates amongst tuberculosis experts on how and why a disease, previously confined to industrial countries and imperial metropolises, began to become a serious health problem in colonial territories and amongst ‘primitive’ peoples.