Tuberculosis in the MCU

Spoilers for The Falcon and the Winter Soldier episode 3! This probably won't make sense anyway if you haven't watched the show, so you've been warned...

So, I've been back in the Marvel fandom for nearly 12 weeks, since the first episode of WandaVision. Meanwhile, I never stopped doing global health advocacy. While Monica and Sam become my favorite characters more and more every day, the tuberculosis epidemic is becoming more and more urgent. What can the two tuberculosis references in MCU canon teach us about the real-life epidemic?

Image description: my attempts at doodling the COVID-19 virus and tuberculosis bacteria

Tuberculosis (TB) is an airborne, infectious disease caused by bacteria that usually attack the lungs. Prior to the COVID-19 pandemic, it was the number one infectious disease killer in the world, taking 1.4 million lives in 2019 and sickening 10 million. And it took a long time for COVID-19 to surpass TB- not until November 2020! TB is still bigger by far in low and middle income countries today. Now, a mountain of COVID-related setbacks have worsened what was already an international emergency. (In 2020, 45% fewer people were tested for multidrug-resistant TB than in 2019, which is super scary.)

Unlike COVID-19, TB has been around for a long time. We can trace it in humans back 9,000 years! Another difference between the two diseases is that TB still doesn't have an effective, widely-used vaccine.

"The only TB vaccine available is called BCG, fully developed in 1921, exactly 100 years ago. It has very poor efficacy in preventing pulmonary TB, " says Amelie Jacobs in a recent letter to the editor. Jacobs is a current college student and RESULTS member in Dallas.

"Considering the speed of development of multiple COVID-19 vaccines, this raises the question of why TB care and prevention are so neglected," Jacobs adds.

Did I write this blog post as an excuse to rewatch FATWS during school hours? ... yeah, I totally did

Tuberculosis was first referenced in the MCU all the way back in Phase 1, when Steve Rogers (Captain America) tells an Army recruiter how his mother died: "She was a nurse in a TB ward. Got hit. Couldn't shake it."

• In 1936 (as far as I know, the year Sarah died in MCU canon) 71,527 people in America died of tuberculosis in real life.
• Here are some personal diary entries of a TB patient diagnosed in 1944- about ten years later than Sarah Rogers would have been working with patients, but I still think it's a primary source very worth reading.
• The last TB sanatorium in the United States closed in 2012, but many people in the United States have still been exposed and even fallen ill. We are TB is a U.S.-based network of TB survivors and advocates who recently lobbied members of Congress, telling their stories and requesting funding for U.S. and global tuberculosis programs.

While watching The Falcon and the Winter Soldier (long title, I'm just gonna say TFATWS) with my family, Mom and I shared a look when we both realized we were seeing the MCU's second TB death.

Karli Morgenthau, a leader of the Flag-Smashers, tearfully said goodbye to a loved one in a GRC resettlement camp in Latvia. Later in the episode, Dr. Wilfred Nagel tells Sam, Bucky, and Zemo about his last contact with Karli: Karli called, asking for help for someone close to her called Donya Madani. "Poor woman has tuberculosis, " Nagel explained, "typical of overpopulation and displacement camps like that."

While Nagel's obsession with becoming a god through his super-solider serum project is troubling to say the least, he happens to be absolutely right that displaced people in crowded camps have a high risk of tuberculosis. There's a ton of factors that contribute to this burden, including the lack of access to proper nutrition, sanitation, and healthcare. For a real-life example, here is a study published in September 2020 that focuses on TB and HIV care for internationally displaced populations in Northern Nigeria.

In the Marvel Cinematic Universe, we got a brief glimpse of post-Blip public health in WandaVision's fourth episode, when Monica Rambeau re-materialized in a hospital thrown into chaos, but TFATWS explores a little more of what happened after the initial panic. The Flag-Smashers seized control of vaccines and other supplies from the GRC in episode 2 (the Global Repatriation Council is in charge of getting the world back in order, since billions of people reappeared after a five year absence at during Avengers: Endgame) and staged another attack in episode 3. As Sam pointed out in the second episode, "the people with the resources" have taken the view that the GRC's control is the best way forward, but Karli and her allies believe they're doing what they have to for the people they love, failed by bureaucracy, to survive.

Inequitable and inefficient distribution of vaccines could be seen as a parallel to COVID-19. In the Amnesty International Report 2020/21, Secretary General Agnès Callamard writes about the coronavirus, "... the richest countries have effected a near-monopoly of the world's supply of vaccines, leaving countries with the fewest resources to face the worst health and human rights outcomes and thus the longest-lasting economic and social disruption."

Call to action- what can you do?

Ask your U.S. Senators and Representatives to commit to $1 billion for bilateral USAID TB programs. This will help us live up to the promises made by the U.S. and other nations of the UN to treat 40 million people with TB, including 1.5 million with drug resistant TB, and provide preventative treatment for 30 million people.

Image description: Captain America meme, "I want you to call Congress about TB"

Here's some sample language you can use for a letter or phone call:

I am writing/calling to ask that you include strong funding requests for global tuberculosis during the appropriations process for fiscal year 2022.


Prior to COVID-19, tuberculosis (TB) had been the leading infectious disease killer in the world for years, taking 1.4 million lives in 2019 and sickening 10 million. The pandemic has made it worse, interrupting treatment and diverting resources normally used for TB. Experts estimate that TB efforts have been set back ten years or more.


I’m asking (the Senator/Representative) to support $1 billion in bilateral TB funding for fiscal year 2022. Thank you.

Thank you for taking action to stop TB!

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Bonus history lesson:

New Englanders in the early 1800s thought that the spread of TB was caused by vampires! (I just learned this and wanted to share.)

If that were true, then Buffy the Vampire Slayer would definitely be the hero we need. But that's a different fandom...