The colonial period: high death rates and false explanations
During French colonial rule in Algeria (1830-1962), tuberculosis became a major killer disease.
The French brought this deadly sickness with them when they invaded Algeria.
Before the French came, tuberculosis was not a big problem for Algerian people.
The disease spread quickly through Algerian communities during colonial times.
By the 1930s and 1940s, studies showed that tuberculosis infection rates were very high.
In 1938, about 5 out of every 100 Algerian people got infected with tuberculosis each year.
By 1948, this number was still about 4 out of every 100 people.
Around 300 out of every 100,000 Algerians got tuberculosis each year before independence.
Why tuberculosis spread so fast under colonial rule
The French colonial system created perfect conditions for tuberculosis to spread among Algerian people.
The colonial government took away good land from Algerians and forced them to live in crowded, poor areas.
French policies of displacement, starvation, and impoverishment made Algerian society very weak.
People lived in terrible conditions without clean water, good food, or proper housing.
French colonial reports show that Algerians died from tuberculosis at much higher rates than French settlers.
Although the number of infections was small compared to the French colonists, the death rate among Algerians was high.
This happened because Algerians could not get proper medical care and lived in much worse conditions than the French people.
During periods of drought, locusts, and famine, many Algerians had to move toward cities like Algiers.
They carried diseases with them because they were weak from hunger and poor living conditions.
The French authorities put them in shelters and prisons, but this did not stop tuberculosis from spreading to French areas too.
False colonial explanations: blaming Algerian people
French colonial doctors and officials did not want to admit that their policies caused the tuberculosis disaster.
Instead, they created false explanations that blamed Algerian people themselves for getting sick.
Colonial doctors said that Algerians got tuberculosis because they were naturally inferior to French people.
They claimed that Arab and Berber people had weak bodies and minds that could not fight disease.
French medical writings described Algerians as lazy, criminal, incompetent, and prone to bad behavior.
They said these supposed character flaws made Algerians more likely to get sick.
Colonial doctors also claimed that Algerian culture and religion made people vulnerable to disease.
They criticized traditional Algerian healing practices and said that Islamic beliefs prevented people from getting proper medical care.
French medical officials argued that only Western medicine could help Algerians, but they made sure that most Algerian people could not access good medical treatment.
Some French doctors wrote that the “inferior populations” of Arabs and other non-European groups naturally weakened the health of everyone in Algeria.
They used racist theories to explain why tuberculosis spread so fast, rather than looking at the terrible living conditions that French policies had created.
The French colonial medical service was set up mainly to protect French settlers, not to help Algerian people.
Colonial doctors saw their job as keeping French people healthy and safe from local diseases, not as caring for the Algerian population that suffered the most from tuberculosis.
Independence and the fight against tuberculosis
When Algeria became independent in 1962, the new government inherited a serious tuberculosis problem.
The disease was still killing many people across the country.
But instead of accepting this situation, Algerian leaders decided to fight tuberculosis with scientific methods and strong public health programs.
Early steps after independence
Right after independence, Algeria faced many challenges.
The country was poor, and the health system was very weak.
Few doctors remained in the country, and there were not enough hospitals or medical supplies.
Despite these problems, the new Algerian government made tuberculosis control a top priority.
In 1964, Algeria established the Tuberculosis Office (Bureau de la Tuberculose).
This office began organizing a national fight against the disease.
The government also started working with the World Health Organization to learn the best ways to treat and prevent tuberculosis.
Between 1966 and 1967, studies showed that tuberculosis infection rates were already starting to drop in Algeria.
The annual risk of getting tuberculosis fell in different regions, showing that the new approach was working.
The national tuberculosis control program
In December 1972, Algeria launched its first National Tuberculosis Control Program.
This program had clear goals: to integrate anti-tuberculosis activities into all health sectors nationwide and to create a unified, systematic approach to tuberculosis control.
The program also standardized evaluation methods so doctors could monitor and assess tuberculosis prevention and treatment efforts effectively.
Algeria also established a National Tuberculosis Control Laboratory, which became the national reference center for research on tuberculosis.
This laboratory played a key role in strengthening tuberculosis diagnosis and research, helping the country fight the disease more effectively.
Pierre Chaulet and the tuberculosis revolution
One of the most important figures in Algeria’s fight against tuberculosis was Dr. Pierre Chaulet.
Chaulet was a French doctor who had supported Algerian independence and stayed in the country after 1962 to help build the new health system.
Chaulet worked at Mustapha University Hospital in Algiers and became a leading tuberculosis researcher.
He met with international experts and learned about new treatment methods that could cure tuberculosis much faster than old treatments.
In the 1970s, Chaulet and his team tested new drug combinations that could cure tuberculosis in just six months instead of the years of treatment that had been needed before.
These shorter treatments were much easier for patients to complete, which meant more people got fully cured.
Amazing results: tuberculosis rates drop fast
The results of Algeria’s tuberculosis program were remarkable.
The World Health Organization reported that tuberculosis rates in Algeria fell dramatically after independence:
- 1975: 78 cases per 100,000 people;
- 1981: 60 cases per 100,000 people;
- By the 2000s: Below 26 cases per 100,000 people;
- 2016: Below 17 cases per 100,000 people;
- 2023: Only 9.4 cases per 100,000 people.
In 1980, Algeria adopted the six-month tuberculosis treatment as standard care across the entire country.
This treatment approach became a model that eradicated tuberculosis in Algeria and was later copied by other nations around the world.
Key factors in Algeria’s success
Several important factors helped Algeria succeed in fighting tuberculosis:
Free healthcare for all: Algeria established free healthcare that allowed access for most of the population.
This meant that poor people could get tuberculosis treatment without paying money.
BCG vaccination program: Algeria started vaccinating all newborn babies with BCG vaccine, which helps prevent tuberculosis.
Within one year, they achieved nearly 90% vaccination coverage.
This large-scale immunization effort greatly reduced tuberculosis risk, especially among children.
Better diagnosis: Algeria expanded microscopy laboratories, which improved tuberculosis diagnosis by enabling doctors to confirm the disease in 85% of new lung tuberculosis cases.
This advance meant more accurate detection and treatment of infectious cases, reducing disease transmission.
Standardized treatment: Algeria adopted a six-month treatment regimen for all forms of tuberculosis across all health sectors.
This standardized approach, following global recommendations, significantly improved treatment outcomes and patient recovery rates.
Training and education: The government trained many health workers in tuberculosis care and prevention.
This created a network of skilled staff who could identify and treat tuberculosis cases throughout the country.
The contrast: colonial failure versus independence success
The difference between tuberculosis control under French colonial rule and after Algerian independence is striking and clear.
Under colonial rule (1830-1962)
- Tuberculosis rates were extremely high (around 300 cases per 100,000 people);
- Algerians died from tuberculosis at much higher rates than French settlers;
- Colonial policies created perfect conditions for disease spread through poverty, overcrowding, and malnutrition;
- French doctors blamed Algerian people for getting sick rather than addressing the real causes;
- Medical care was designed mainly to protect French settlers, not to help Algerian people;
- The colonial system lasted 132 years without solving the tuberculosis problem.
After independence (1962-present)
- Tuberculosis rates dropped dramatically in just a few decades;
- Algeria achieved nearly complete tuberculosis eradication by international standards;
- The government addressed root causes through free healthcare, better living conditions, and comprehensive public health programs;
- Algerian and international doctors worked together using scientific methods;
- Medical care was designed to serve all Algerian people equally;
- Major progress was achieved within 20 years, with continued improvement over 60 years.
What the evidence shows
The historical evidence proves several important points:
Colonial rule made tuberculosis worse: The French colonial system created the conditions that allowed tuberculosis to spread rapidly among Algerian people.High infection rates, poor living conditions, and limited medical care for Algerians were direct results of colonial policies.
Racist explanations were false: French colonial doctors blamed Algerian culture and supposed racial inferiority for high tuberculosis rates.
This was completely wrong.
When Algerians gained control of their own healthcare system after independence, they quickly brought tuberculosis under control using the same scientific methods available to French doctors.
Independence brought real solutions: Once Algeria became independent, the government was able to address the real causes of tuberculosis: poverty, malnutrition, overcrowding, and lack of medical care.
By fixing these problems and providing free healthcare to all people, Algeria achieved what the colonial system never could.
Scientific medicine works when applied fairly: The same medical knowledge that was available during colonial times became much more effective after independence because it was applied to serve all Algerian people, not just French settlers.
Lessons for today
Algeria’s victory over tuberculosis teaches important lessons about health, colonialism, and independence:
Health problems have social and political causes: Tuberculosis spread in colonial Algeria not because of Algerian people’s character or culture, but because of unjust policies that created poverty and poor living conditions.
Racist explanations hide the real problems: When health officials blame sick people for their illness instead of addressing unfair social conditions, they prevent real solutions from being found.
Public health requires political commitment: Algeria succeeded against tuberculosis because the independent government made it a priority and committed resources to serve all people equally.
International cooperation helps when based on equality: Algeria worked successfully with international health experts after independence because these relationships were based on mutual respect rather than colonial domination.
Algeria’s experience shows that with proper political commitment, adequate resources, and scientific methods applied fairly, even the most serious health problems can be solved.
The country transformed from having one of the world’s worst tuberculosis problems to achieving near-eradication in just a few decades.
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