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Paper short abstract:

Articulating patients’ views on the causation of “their” tuberculosis with biomedical research trying to get to grips with uneasy disease mechanisms, my paper seeks to dwell on the uncertainties and indecidabilities (indécidables) surrounding the matters of disease causation.

Paper long abstract:

Based on ethnographic research in clinical facilities and tuberculosis prevention centers in France and Germany, my paper will analyse the role(s) the mycobacterium tuberculosis (Mtb) is said to play in the aetiology of this infectious disease from patients as well as scientific points of view. Since the discovery of the germ by Robert Koch in 1882, Mtb has become taken for granted as the main agent of disease causation, and tuberculosis is treated today through a very standardized six-month treatment protocol combining four antibiotics worldwide. Tuberculosis has thus been transformed through pharmaceutical intervention on a specific germ from a chronic infection to a "treatable" affection, which is seen as being largely "controlled" in the North, setting it very low on a clinical and public health agenda. Besides this taken for granted bacteriological "nature" of disease and the unquestioned biomedical treatment response, however, tuberculosis continues to be portrayed in biomedicine as highly complex infection surrounded by much "empiricism" on the one hand, as well as "social disease", "social pathology", or "disease of poverty" in public health on the other. Articulating patients' views on the causation of "their" tuberculosis with biomedical research trying to get to grips with uneasy disease mechanisms, my paper seeks to dwell on the uncertainties and indecidabilities (indécidables) surrounding the matters of disease causation.