Author John Green meets a young tuberculosis patient

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Author John Green has been obsessed with tuberculosis (TB) since 2019, when he first visited Lakka Government Hospital in Sierra Leone and met a young TB patient named Henry Reider. In his latest book Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection (Crash Course Books, 2025), Green explores the history of the bacterial disease, highlighting its impact in different eras of history. And he calls attention to the present reality of TB, a curable disease that nonetheless kills over a million people each year due to stark health care inequities around the globe.
In this day and age, Green argues that injustice is the root cause of TB cases and deaths, and that we can collectively choose to correct that injustice and finally snuff out the deadly disease.
Related: 'We have to fight for a better end': Author John Green on how threats to USAID derail the worldwide effort to end tuberculosis
At the time, I knew almost nothing about TB. To me, it was a disease of history — something that killed depressive 19th-century poets, not present-tense humans. But as a friend once told me, "Nothing is so privileged as thinking history belongs to the past."
When we arrived at Lakka, we were immediately greeted by a child who introduced himself as Henry. "That's my son's name," I told him, and he smiled. Most Sierra Leoneans are multilingual, but Henry spoke particularly good English, especially for a kid his age, which made it possible for us to have a conversation that could go beyond my few halting phrases of Krio. I asked him how he was doing, and he said, "I am happy, sir. I am encouraged." He loved that word. Who wouldn't? Encouraged, like courage is something we rouse ourselves and others into.
My son Henry was 9 then, and this Henry looked about the same age — a small boy with spindly legs and a big, goofy smile. He wore shorts and an oversized rugby shirt that reached nearly to his knees. Henry took hold of my T-shirt and began walking me around the hospital. He showed me the lab where a technician was looking through a microscope. Henry looked into the microscope and then asked me to, as the lab tech, a young woman from Freetown, explained that this sample contained tuberculosis even though the patient had been treated for several months with standard therapy. The lab tech began to tell me about this "standard therapy," but Henry was pulling on my shirt again. He walked me through the wards, a complex of poorly ventilated buildings that contained hospital rooms with barred windows, thin mattresses, and no toilets. There was no electricity in the wards, and no consistent running water. To me, the rooms resembled prison cells. Before it was a TB hospital, Lakka was a leprosy isolation facility — and it felt like one.
Inside each room, one or two patients lay on cots, generally on their side or back. A few sat on the edges of their beds, leaning forward. All these men (the women were in a separate ward) were thin. Some were so emaciated that their skin seemed wrapped tightly around bone. As we walked down a hallway between buildings, Henry and I watched a young man drink water from a plastic bottle, and then promptly vomit a mix of bile and blood. I instinctively turned away, but Henry continued to stare at the man.
I figured Henry was someone's kid — a doctor, maybe, or a nurse, or one of the cooking or cleaning staff. Everyone seemed to know him, and everyone stopped their work to say hello and rub his head or squeeze his hand. I was immediately charmed by Henry — he had some of the mannerisms of my son, the same paradoxical mixture of shyness and enthusiastic desire for connection.
Henry eventually brought me back to the group of doctors and nurses who were meeting in a small room near the entrance of the hospital, and then one of the nurses lovingly and laughingly shooed him away.
"Who is that kid?" I asked.
"Henry?" answered a nurse. "The sweetest boy."
"He's one of the patients we're worried about," said a physician who went by Dr. Micheal.
"He's a patient?" I asked.
"Yes."
"He's such a cute little kid," I said. "I hope he's going to be okay."
Dr. Micheal told me that Henry wasn't a little boy. He was seventeen. He was only so small because he'd grown up malnourished, and then the TB had further emaciated his body.
"He seems to be doing okay," I said. "Lots of energy. He walked me all around the hospital."
"This is because the antibiotics are working," Dr. Micheal explained. "But we know they are not working well enough. We are almost certain they will fail, and that is a big problem." He shrugged, tight-lipped.
There was a lot I didn't understand.
After I first met Henry, I asked one of the nurses if he would be okay. "Oh, we love our Henry!" she said. She told me he had already gone through so much in his young life. Thank God, she said, that Henry was so loved by his mother, Isatu, who visited him regularly and brought him extra food whenever she could. Most of the patients at Lakka had no visitors. Many had been abandoned by their families; a tuberculosis case in the family was a tremendous mark of shame. But Henry had Isatu.
I realized none of this was an answer to whether he would be okay.
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He is such a happy child, she told me. He cheers everyone up. When he'd been able to go to school, the other kids called him pastor, because he was always offering them prayers and assistance.
Still, this was not an answer.
"We will fight for him," she told me at last.
Editor's note: This excerpt, from Chapter 1 of "Everything is Tuberculosis," has been shortened for the purpose of this reprinting.
Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection
In "Everything Is Tuberculosis," John Green tells the story of Henry Reider, a tuberculosis patient he met at Lakka Government Hospital in Sierra Leone. Throughout the book, he interweaves Henry's story with scientific and social histories of how tuberculosis has shaped our world — and how our choices will shape the future of tuberculosis.View Deal

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Buzz Feed

5 hours ago

• Buzz Feed

Water Safety Lessons From A Grieving Parent

When my son Zachary drowned in our backyard pool, I never dreamed that 15 years later, in the midst of a global pandemic and a severe lifeguard shortage, that his younger brother Henry would step up to pursue a job as a lifeguard. Henry now stands among the ranks of water-safety first responders, and his new position serves as a meaningful living remembrance on what would have been Zachary's 21st birthday. I'm still overwhelmed with emotion when I think back to that horrible day in 2007, the day that changed our lives forever. Each traumatic detail is etched into my memory ― the chlorine scent, the reflection of the late afternoon sun on the pool, the sweaty humidity, the piercing screams. The chaos of my son's drowning death comes rushing back in a wave of indescribably intense pain. It was a searing July afternoon, just two months after our fourth child, Sydney, was born. We had just moved into our dream home, and the family swam and played in our brand-new backyard pool. Zachary, then 6, showed off his swimming skills (thanks to an excellent program at his summer camp). Little did we know an unexpected tragedy beyond our wildest imagination was about to unfold. We believed we'd done everything to follow measures to keep our family safe. The pool was in full compliance with town safety codes that mandated fencing and door alarms for entrances to the pool area. Our children had taken swimming lessons; they were strong and comfortable in the water and always closely supervised. We couldn't know that the pool's drain cover was defective and had become loose, removing the barrier between swimmers and the powerful vacuum pump that can exert hundreds of pounds of sucking water pressure. In an instant, the strong suction from the drain had trapped Zachary's arm, holding him underwater. We were unable to free him until we were able to shut down the power to the pool. In the months that followed his death, we reeled from our loss. We tried to make sense of it and wondered how we could recover as a family and give meaning to a young life cut short so unfairly. The more we learned about water safety statistics ― that drowning is the leading cause of unintentional death for children between the ages of 1 and 4 and is the second-leading cause of death for children younger than 14 ― the more we knew we wanted to prevent other families from ever having to experience the loss of a child from drowning. With Zachary as our inspiration, we formed The ZAC Foundation a few years later. Over the last decade, the foundation has provided free swim camps for more than 20,000 kids around the country (especially in urban areas), has awarded grants for water safety education and research, and fostered partnerships to develop community-based drowning prevention plans in four large cities. Importantly, The ZAC Foundation has contributed toward the development of a national Water Safety Action Plan, designed to educate everyone (from homeowners to aquatic center personnel) about best practices to promote water safety and prevent drowning. Our entire family has been engaged from Day 1 on this journey to build the foundation. So it was no surprise that Henry said, at my suggestion, that he was 'all in' to become a lifeguard. Since the onset of the coronavirus pandemic, the American Lifeguard Association reported a whopping 40% to 50% staffing shortage at swimming areas across the country. These are well-paying jobs requiring skill and grit. I was confident that Henry ― a very strong, skilled swimmer and someone hyper-aware of the importance of water safety ― would make a highly competent lifeguard. On the first day of his training, Henry had to dive to the bottom of the deep end, retrieve a brick and swim with it to the shallow end. Even though he was strong and played sports, he found it hard to do, and at least two of his fellow students couldn't complete the task. When Henry came home and told us about the exercise, we couldn't help but wonder if we had made the right decision. Would he be able to handle the physical rigor and emotional stress of this job? And could we? Getting safety-certified wasn't easy. Henry nearly missed his sister's eighth-grade graduation due to lifeguard training. But he persevered, earned his certification and was hired at a pool in our community. From the get-go, he was hyper-vigilant. On his first day at the pool, he surprised his peers and supervisor by proactively asking them to locate the safety equipment. For Henry, water safety was not an abstraction. It was urgently real. He fully understood the importance of safety training and safe pool management. As statistics bear out, drowning incidents happen all the time ― even when lots of safety precautions have been taken. It is terribly easy (even typical) for a parent or caregiver to become distracted while watching toddlers play in the kiddie pool and, even worse, while also trying to keep an eye on their older kids in the main pool. It happens! For lifeguards, unanticipated dangers lurk everywhere. Many pools are overcrowded, and it can be difficult to monitor children who become hidden. In larger pools, sightlines are often obscured by columns and curves. Glare on the water can mask danger. And unanticipated distractions for the lifeguard can be especially risky. Despite warnings from well-intentioned friends in the drowning prevention movement, the pitfalls and risks (emotional and otherwise) never overwhelmed Henry. I feel deeply touched by his seriousness and courage, given the tragedy we had lived through with Zachary. By the end of the summer, the closest Henry came to rescuing someone was when he offered to help an older gentleman navigate the pool stairs on his way out. The man gruffly rebuffed the offer, but Henry stood nearby to make sure that the man was able to safely hold his footing. No family should ever have to endure the loss of a child. When a parent turns to me, with fear and sympathy in their eyes, they will often ask how they can learn from Zachary's loss and prevent this from happening to them. We share easy-to-remember lifesaving tools, like the ABCDs of drowning prevention. There should always be an A dult present with eye-to-eye contact on the child swimming. B arriers, like fences and gates, are a must for restricting children's access to the water. Families should enroll in C lasses ― swim lessons for kids and CPR training for adults. D rains should be regularly inspected for broken and/or loose covers. And proper lifesaving D evices, i.e. U.S. Coast Guard-approved life jackets, should be worn at all times in open water. After our family's devastating loss, I never would have imagined that my other children would take on what has become my life's work. Maybe Henry didn't realize what the impact would be for me when he agreed to try lifeguarding, but his decision made me deeply proud. His willingness to be vulnerable and address our family's trauma head-on is a source of strength and hope. During the year of Zachary's 21st birthday, I look back and feel grateful for life's lessons learned and the opportunity to hopefully prevent a tragic loss for others. Karen Cohn co-founded The ZAC Foundation in 2008 with her husband, Brian Cohn, after their 6-year-old son, Zachary Archer Cohn, drowned when his arm became entrapped in a pool drain. Zachary's memory is the inspiration for the foundation's mission and activities. The ZAC Foundation has funded free water safety and swim camps for more than 20,000 children in at-risk communities nationwide and is spearheading the development of drowning prevention plans in four U.S. communities in the hopes of reducing the national drowning rate. Through her role at The ZAC Foundation, Karen has testified before congressional subcommittees as well as before state and federal agencies, including the Consumer Product Safety Commission and the Centers for Disease Control and Prevention. She has written about water safety issues for major media outlets and is also a Northeast Trustee of the Boys & Girls Clubs of America.

News24

a day ago

• News24

These are the children the United States left to die in Mozambique

In Mozambique, the health system is overwhelmingly built on US money. When the Trump administration instantly pulled much of this funding without warning, disease and death spread. Spotlight and GroundUp visited one of the worst affected regions to describe the human toll. Hospitals run short of life-saving drugs. Doctors and nurses are laid off en masse. Hospital lines get longer and longer. Some patients are given the wrong medication, likely because the data capturers (who manage patient files) have lost their jobs. Community case workers who deliver HIV medication to orphaned children stop coming. Without their antiretrovirals (ARVs), some of these children die, GroundUp reports. Following US President Donald Trump's executive order to suspend US global aid funding on 20 January, the health system in parts of Mozambique fell into a state of chaos. US aid agencies had financed much of the country's healthcare workforce, along with the transportation of drugs and diagnostic tests to government hospitals. In some provinces, this money came from the US Centres for Disease Control and Prevention (CDC), which restored much of its funding shortly after the executive order. But in the central provinces of Sofala and Manica the money came from the US Agency for International Development (USAID), which permanently pulled most of its grants. For a week in June, I travelled to nine rural villages and towns across the two provinces. Interviews with grieving caregivers, health workers and government officials across these settlements all converged on one clear and near-universal conclusion: the funding cuts have led to the deaths of children. One of the clearest reasons is this. After USAID-backed community health workers were dismissed, thousands of HIV-positive children under their care were abandoned. Panic at all levels In 2020, a Sofala-based organisation called ComuSanas received a large USAID grant to employ hundreds of community workers throughout rural parts of the province. 'The project aimed to reduce mortality among children living with HIV,' says Joaquim Issufo, a former community worker with the project. He spoke to me from a street market in the impoverished district of Buzi, where he now runs a stall selling fish. 'We worked with children aged 0 to 17, especially orphans and vulnerable children.' These children live in remote villages, far away from public amenities. Some were found living in homes without any adults. Many others live with an elderly grandparent who can barely afford to feed them. Jesse Copelyn/GroundUp In the midst of poverty and isolation, the case workers, known locally as activists, functioned as a bridge between these children and the country's hospitals. They shuttled diagnostic tests between communities and health facilities. They brought children their medicines and ensured they took the correct doses at the right times. And they accompanied them to health facilities, and helped them weave through bureaucracy. Issufo notes that their role also extended far beyond health: they organised birth certificates, enrolled children in schools and referred them for housing. When drought and famine ripped through villages, they brought food baskets and provided nutritional education. In the villages that I went to, children and their caregivers referred to the activists as 'mother', 'father' or 'sister', and said that they were like family members. But after USAID issued stop-work orders to ComuSanas in January, those 'mothers and fathers' abruptly stopped visiting, and suddenly the region's most desperate children were left to fend for themselves. Issufo says that after this, there was 'panic at all levels, both for us as activists and also for our beneficiaries'. Children hospitalised and left for dead About 80km from Issufo's fish stall is the village of Tica, in the Nhamatanda district. Amid homes of mud brick and thatch, a group of former ComuSanas activists sit on logs, buckets and reed mats and explain the consequences of the programme's termination. '[Before the USAID cuts], I was taking care of a boy because [he] lives with an elderly woman, and she had to work,' says Marta Jofulande, 'I had to go to the health facility and give the child his [ARV] medication. I also helped to do things like preparing food. But with this suspension, I couldn't go anymore.' Jesse Copelyn/GroundUp Shortly after, Jofulande was told by the child's elderly caregiver that he had fallen ill, and was in critical care at a central hospital. 'I was the one bringing the [ARVs] to him,' says Jofulande, 'As soon as the programme stopped, he no longer took the medication, and that's when he relapsed. He is in a very critical condition and is breathing through a tube.' 'His name is Cleiton,' she adds. 'He's eight years old.' Jesse Copelyn/GroundUp Many other children have already perished. A 20-minute drive from Tica is the settlement of Mutua, in the Dondo district. There, activist Carlota Francisco says, 'During this pause, we had cases [of children] that were really critical that ended up losing their lives.' One of them had been a 2-year-old girl under her care. 'That child depended on me,' says Francisco, who explains that she would fetch and provide the girl's ARVs. After she stopped, she says the girl's caregivers failed to give her the correct dosages. The 2-year-old died shortly thereafter. Stories such as this were repeated in almost every village that we visited. Often, children or their caregivers attempted to get the medication without the activists. But many of the hospitals were in a state of chaos because USAID-funded health workers and data capturers had been laid off. The linkage officers that knew these children and had previously assisted them were gone too. (The procurement of the country's ARVs is financed by The Global Fund to Fight AIDS, Tuberculosis and Malaria. This money continues to flow, but the distribution of these drugs to hospitals relies on US money.) Endless queues, drug shortages and the loss of patient files meant some didn't get their medication. Rates of ARV treatment fall throughout the province The director of health for the Buzi district, Roque Junior Gemo, explains that a key role of the community workers had been to extend health services to remote areas that they had long struggled to reach. 'They are like our tree branches to bring services to the people,' says Gemo, 'Our villages are very remote, and we have a large population that needs information [and] basic services.' 'Especially in the HIV area, we have terminal patients who were once followed up by activists. They used to get medications at home. Without that help, their condition worsened, and some died.' This forms part of an issue that extends far beyond the district of Buzi. In the Sofala capital of Beira, I sat down with some of the province's senior health officials. The HIV supervisor for the province, Manuel Seco, provided data on the HIV response in Sofala, before and after the cuts. Between May and December of 2024, the total number of people on ARVs in the province had risen by over 20 /000 people, the data shows. This increase occurred steadily, rising by 500 to 5 000 people each month. But as soon as the cuts were made, this progress was halted and the trend reversed. Since January, the number of people on ARV treatment has been falling by hundreds of people each month. The reason, according to Seco, is that many people who were on ARVs have stopped their treatment, while new ARV initiations have dropped sharply. And the impact extends far beyond just the HIV response. Jesse Copelyn/GroundUp TB left untreated Buried within a compound owned by Tongaat Hulett is a government hospital that services the rural population of Mafambisse, in Dondo district. Joaquim Mupanguiua, who deals with TB at the hospital, says that after the activists were laid off, the hospital saw a steep decline in the number of TB patients coming to the facility. 'Only when they are already very ill do they come to the health unit,' he says. 'But with the activists they would easily go to the communities and find the sick.' Indeed the number of patients coming to the hospital is roughly a third of what it once was: 'We used to get around 28 to 30 [TB] patients per month, but now we're down to fewer than 10,' Mupanguiua notes. Because patients come to the hospital when they're already severely ill, there's significantly less that health facilities can do for them. It's thus no surprise that Mupanguiua believes that there has been an uptick in needless TB deaths. Finding other ways Back in the Buzi district office, Gemo says that efforts have been made to assist terminal patients that had previously been supported by activists, but there are so many people in need that they aren't able to help everyone. Activists often said something similar – they continue to visit their beneficiaries when they can, they say, but without ComuSanas sponsoring their transport costs, many struggle to visit children in remote areas. And the loss of their income with the programme means that they now need to spend their days finding other ways to survive – subsistence farming and street markets are the usual routes. But this work rarely offers the kind of regular income that ComuSanas had been providing. 'Honestly, buying notebooks, pens and clothes for my children [has become] very difficult,' says Dondo-based activist, Brito Balao. Meanwhile, in Tica, activists asked how they could provide food to their former beneficiaries when they are themselves going hungry. Despite this, the activists still live within the same villages as their beneficiaries. And so unlike those in Washington, they cannot withdraw their support without facing the resentment or desperation of their communities. 'We work with love, and we get really sad not being able to be there for those kids,' says one Mutua-based activist. 'There's even another family that cried today [when they saw me]. 'You've been away for a while,' they said. Gosh, we feel bad.' Among former beneficiaries of the programme the sense of abandonment was palpable, and their anger was often directed at the former activists. This was often compounded by the fact that no one had explained to them why the programme had stopped. Jesse Copelyn/GroundUp In the village of Nharuchonga, Joana, explains that in the past her activist, Fatima, would always come and ensure that her daughter took her ARVs. Now that Fatima has stopped coming, her daughter doesn't always take the medication, she says. (Fatima is present during this conversation.) 'We've been abandoned by Fatima,' she states, looking directly away from the former activist. 'Until now we have been too shy to ask why she has abandoned us.' In many other cases, the tone was simply one of sadness. Back in Tica, inside an outdoor kitchen made of corrugated iron sheets, Maria holds her five-year-old granddaughter Teresa. Despite facing hunger at various points over recent years, she cooks sweet potatoes above a small fire, and insists that everyone eats. Both of Teresa's parents died of AIDS, says Maria. It has been left to her to raise the child, all the while trying to grow rice and maize for subsistence – an effort hampered by frequent drought. For a long time Maria has had help with this parental role, she says. Activist Marta Jofulande had been assisting her family and acting like a mother to the child. But since the programme was terminated, they don't see much of Jofulande anymore. Instead, five-year-old Teresa has been forced to deal with the exit of yet another parental figure./ A note on quotes: Most of our interviews were in Portuguese and were mediated by a local translator. We subsequently transcribed and translated the recordings of these interviews using AI-based software, including Descript and ChatGPT. Where there was a significant mismatch between the interpretations of the translator and the software, we contacted the interviewee or got third parties to help translate the recordings. The cost of travel, accommodation and the journalist's remuneration was shared between GroundUp and Spotlight.

Chicago Tribune

3 days ago

• Chicago Tribune

Aurora considers giving $500,000 to VNA in support of newly-opened clinic

The city of Aurora is considering giving VNA Health Care $500,000 in support of its newly-opened clinic at the Bloomhaven campus on Aurora's near East Side. The current proposal, which is set to go before the Aurora City Council for final approval on Tuesday, would split the payment in half, distributing $250,000 this year and $250,000 next year. This year's amount is set to be paid from city interest earnings, and the funding source for next year's payment will be decided during the 2026 budget process, according to Aurora Chief Financial Officer Chris Minick. The funds are going to support the opening of VNA's new Primary Care Center at 323 Weston Ave., which offers primary care and pediatrics as well as urgent care, mental health care, outpatient physical therapy, podiatry, OB/GYN, vaccines, lab testing, nutrition counseling and more, with all services offered in both English and Spanish. The organization invested around $8 million in the clinic, and financial planning for the project included the $500,000 pledged by the city, according to a city staff report about the project included with a recent committee meeting agenda. Staff said in the report that the funds were pledged because of the 'nature and extent of the medical services provided by VNA to the Aurora population in general and specifically to the neighborhood surrounding the development.' Although the $500,000 was pledged by city administration last July and formally recognized through a letter signed by both former Mayor Richard Irvin and VNA CEO Linnea Windel, the agreement never went before the Aurora City Council for approval, nor was it included in the 2025 budget. VNA's agreement with Aurora was that, once the clinic was fully built-out and received a Certificate of Occupancy, the city would pay out the full $500,000, according to the signed letter. So, after the certificate was issued in April, VNA came to the city to ask for the funds. The proposal was then set to go through the process of getting Aurora City Council approval, which starts at one of the City Council's committees. But when Mayor John Laesch's incoming administration saw the item, which was planned to go before the Finance Committee on May 15, just two days after Laesch was inaugurated, they were confused about why it hadn't previously gone before City Council for approval, and they requested the item be held so more research could be done. That's what Aurora Chief of Staff Shannon Cameron told the Finance Committee on May 29, the first time the proposed $500,000 payment to VNA was publicly discussed by members of the Aurora City Council. An item like this one most likely should have gone before the Aurora City Council for approval when the agreement was made, she said at the time, and it seems like it was simply an oversight of the previous administration. In addition to the signed letter, there were also many emails from city officials pledging the funds to VNA, according to Cameron. 'While it is a bit of a legal gray area, whether we actually owe the funds, we are in support of the VNA and the work it does,' she said. 'We want to make good on this promise.' At various Aurora City Council committee meetings, Minick has said the funds were not included in the 2025 budget because of the timing of the agreement. The proposed payment was again held at the May 29 Finance Committee meeting after several aldermen questioned and discussed how this happened. Ald. Edward Bugg, 9th Ward, said it is a 'disservice to our citizens' when things come before the Aurora City Council for ratification after they've already happened. When this has happened in the past, departments were told this is 'not how we do business in the city of Aurora,' he said. Minick agreed with Bugg and said ratifications will be held 'to an absolute minimum' and be used only for emergencies. This is an early cautionary tale to the new administration, Cameron said, to make sure everything goes through the proper process. The item came back before the Finance Committee on June 12, this time with a proposed change by Minick: pay out half now and then half next year. VNA tentatively agreed to this change, according to the staff report. Ald. Ted Mesiacos, 3rd Ward, who chairs the Finance Committee, said Minick's proposal was 'very equitable.' Aldermen on the Finance Committee recommended for approval the amended proposal, with Bugg voting against. The Committee of the Whole, which sets the agenda of the upcoming Aurora City Council meeting, reviewed the proposal at its meeting Tuesday and decided to place the item on the 'unfinished business' portion of the June 24 Aurora City Council meeting agenda. That means the proposal will be discussed and voted on separately from other items, which is typically done if an item is particularly important or controversial.