The History of Tuberculosis

Evidence of tuberculosis has been found in Egyptian mummies from around 2400 BC, including a spine showing the characteristic collapse of Pott's disease. Hippocrates later described "phthisis" as the most widespread disease of his time and considered it hereditary, a belief that persisted for more than two millennia and shaped ineffective treatment traditions.

Hermann Brehmer opened the first tuberculosis sanatorium, founded on his thesis that the disease could be cured through rest, fresh air, and altitude climate. Sanatoria spread across Europe and the Americas over the following decades, institutionalizing isolation of the sick and pre-antibiotic disease management. Edward Trudeau established the American movement with his Saranac Lake sanatorium in 1884.

Location: Goebersdorf, Silesia (then Prussia)

Robert Koch announced to the Berlin Physiological Society that he had isolated Mycobacterium tuberculosis, the cause of tuberculosis, publishing "The Etiology of Tuberculosis" three weeks later. The discovery ended the hereditary-consumption theory and founded modern bacteriology's attack on the disease. March 24 is commemorated as World TB Day.

Location: Berlin, Germany

Koch announced tuberculin as a cure for tuberculosis, triggering international demand before clinical results arrived. The compound failed as a therapy and damaged Koch's reputation, but was repurposed as the tuberculin skin test, which became the standard diagnostic tool for a century. The episode became a foundational lesson in the necessity of clinical trials before therapeutic claims.

Location: Berlin, Germany

Albert Calmette and Camille Guerin administered the first BCG vaccination, using a bovine tuberculosis strain they had attenuated over 13 years of laboratory passage, to an infant in Paris whose mother had died of TB. BCG spread widely after World War I and remains the most-administered vaccine in history, though its protective efficacy has varied widely across populations, a persistent subject of research.

Location: Paris, France

Selman Waksman's laboratory, with Albert Schatz, isolated streptomycin, the first antibiotic effective against tuberculosis, and the first patient was treated in November 1944. The 1948 British Medical Research Council trial of streptomycin, designed by Austin Bradford Hill, became the first published randomized controlled trial in medicine, proving both the drug's benefit and the rapid emergence of resistant bacteria.

Location: New Jersey, USA

Isoniazid, discovered independently by three research groups, was introduced as the first highly effective oral anti-tuberculosis drug. Combined with streptomycin and later PAS and rifampicin (1966), drug regimens turned a centuries-old death sentence into a curable infection, and sanatoria emptied across the industrialized world within a generation.

The World Health Organization declared tuberculosis a global emergency, the first disease so designated, as HIV co-infection and collapsing public health systems drove resurgent epidemics. WHO responded with the DOTS strategy, a standardized short-course treatment program that became the backbone of global TB control in the following decades.

Location: London, United Kingdom

The US Food and Drug Administration approved bedaquiline, the first anti-tuberculosis drug with a new mechanism of action in 40 years, for multidrug-resistant TB. The approval acknowledged a resistance crisis driven by incomplete treatment regimens, inadequate diagnostics, and drug supply gaps, with resistant strains emerging in India, Eastern Europe, and Southern Africa.

Location: Silver Spring, Maryland, USA

The WHO Global Tuberculosis Report documented the first rise in TB deaths in more than a decade, as the COVID-19 pandemic disrupted diagnosis and treatment access and reversed gains of the prior years. The report recorded that years of declining incidence had stalled, and that TB remained the world's second-deadliest infectious killer behind COVID-19 that year.