Number of words: 147

In the history of medicine, no significant disease had ever been eradicated by a treatment-related program alone. If one plotted the decline in deaths from tuberculosis, for instance, the decline predated the arrival of new antibiotics by several decades. Far more potently than any miracle medicine, relatively uncelebrated shifts in civic arrangements—better nutrition, housing, and sanitation, improved sewage systems and ventilation—had driven TB mortality down in Europe and America. Polio and smallpox had also dwindled as a result of vaccinations. Cairns wrote, “The death rates from malaria, cholera, typhus, tuberculosis, scurvy, pellagra and other scourges of the past have dwindled in the US because humankind has learned how to prevent these diseases. . . . To put most of the effort into treatment is to deny all precedent.”

Excerpted from pages 228-229 of ‘The Emperor of All Maladies: A biography of Cancer’ by Siddharth Mukherjee