M.M. worked at a gold mine for 24 years before being released in 2008 whena medical exam showed he was co-infected with TB and HIV. In South Africa TB is the biggest killer among people with HIV. Here, a priest prays for him to get better at the African Gospel Church in his hometown of Bakuba.

Gold miners pray for their safety before beginning a work shift 6500 feet underground at the Great Noligwa mine in Orkney, South Africa. The miners have historically had high rates of TB, due to poor screening and treatment programs, cramped living quarters and high rates of silicosis, an occupational lung disease that increase the likelihood of developing active TB. Miners have a disproportionately high rate of HIV, further complicating the issue.

Women sing during a service at the African Gospel Church in Bakuba, South Africa. Tuberculosis is very contagious and it can be dangerous for miners carrying the disease to go home untreated, as they may pass it on to their family members.

Angela Orlovsky is coinfected with HIV and MDR-TB. She is very weak and spends most of her time in bed. She tried in vain to get admitted to the TB hospitals in her hometown of Balti, Moldova and in the country's capital but was always turned away. She died a few months after this photo was taken.

Men rest after a long day working in a tailoring shop. The men are migrants, coming from all over India, and do not have the money to rent rooms to stay in. They work about 16 hours a day sewing clothing together and then sleep together in the workshop. Lok Seva Sangam, a local NGO working on TB, gives educational talks to workers like these, teaching them about the potential risk of living together in such a small, cramped space.

K.N. was released from his job at a gold mine after 19 years when a medical exam revealed he had TB and HIV. He is currently unemployed and tries to support his wife and children by working a small plot of land outside of their home in Mnceba, South Africa.

A doctor visits a patient at the Group of TB Hospitals in Mumbai during the daily rounds.

Thembinkosi Nodyontylo, 50, worked in the mines for 30 years when he was released in 2004 after a medical exam showed he had TB. His wife died of TB in 2007 at the age of 31 and he regularly visits her grave to pray.

Llife in these buildings presents problems and obstacles to TB patients. Overcrowding is a problem as are the socioeconomic factors that can lead to other risks, like poor nutrition and hygiene. The elevators in these buildings usually are not maintained and do not work, making it difficult for very sick or elderly patients to get up and down the stairs to go to the health clinics and get their medicines. Cramped living conditions are a risk factor to catching TB.

Igori Revenco has spent time in and out of prisons and currently has MDR-TB. The prison system in Moldova has greatly reduced their TB incidence rate over the past 5 years, but still have a rate consistent with what the WHO defines as an epidemic.

Miners and their friends drink and play pool inside a tavern in Khutsong, a poor mining community outside of Johannesburg. Miners often have very little understanding of lung disease, referring to any chest problem as “TB”. This lack of education makes it more difficult for them to spot the symptoms of the disease and seek treatment. Even those who know they have TB often have no way to begin, or continue, treatment.

E.M. worked in the gold mines for 12 years, when he was released after a medical test showed he had TB and HIV. He is now very weak and gets assistance from home health care workers, though he says the workers do not bring him enough medicine for his daily dose. He is unable to get to the health clinic on his own and is totally dependent on the workers. This is the second time he has had TB.

A patient at the Group of TB Hospitals in Mumbai lays on his bed as a crow sits perched next to him. Later that day the patient was moved to a different bed where he could receive oxygen. He died early the next morning.

Dumitru Stuplaov was an ex-prisoner who died of MDR-TB. His mother, Evgenia Stupalov, stands over his body at a wake in Balti, Moldova. Dumitru%u2019s life was filled with many of the risk factors that can make it much more likely for a person to develop active TB, and then much more difficult to treat it: he lived in poverty, used drugs, was co-infected with HIV and spent time in prison.

Many people in Balti, Moldova use public transportation, which is one of the places where it is possible to get infected with TB by someone who already has it.