Paper short abstract:

Consumption, once considered a disease of wasting, has become a commonplace cultural practice. Did a monocausal theory of tuberculosis open the space for the commodification of the body and eventually lead to disease control strategies oriented towards consumerist pharmaceutical interventions?

Paper long abstract:

The identification of the causative agent of tuberculosis (TB) altered what it meant to suffer from consumption, and catalysed the adoption of medical models of hygiene as a means of prevention. The discovery of antibiotic treatment for tuberculosis some 60 years later, solidified biomedical authority over the disease and simultaneously laid the foundations for the growth of big pharmaceutical companies organised around meeting the health needs of consumers. Medical institutions and social processes, justified by the moral power of germ theory and fortified by the market power of pharmaceutical companies, have slowly transformed consumption, an undesirable disease of wasting, into consumerism, an acceptable commonplace practice for TB control and prevention. In this paper I argue that the isolation of the consumptive ultimately came to characterise the individualism of the consumer, and that this transition has had patterned and differential impacts. Today, as WHO-mandated TB treatment programs are rolled out around the globe, to what degree are new cohorts of patients expected to conform to the consumerist standards of the Western medical model? For a person living with TB in the developing world, medical treatment is an offer they cannot decline. People who are diagnosed with TB are placed under a surveillance system where their consumption of pharmaceutical products is closely monitored. In inculcating and being inculcated by the global medical enterprise, patients are pulled into adopting and reinforcing a biologically reductive narrative of disease and a consumerist model of treatment.