Rx for Survival — A Global Health Challenge

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Global Health Champions

Paul Farmer

Paul Farmer, MD, PhD

Founding Director
Partners in Health

Paul Farmer has been described by Pulitzer Prize-winning author Tracy Kidder as "a man who would cure the world." Founder of the Boston-based nonprofit group Partners In Health, Paul Farmer is known worldwide for his pioneering work in global health. Farmer grew up as the second of six children in an unconventional family that moved frequently, living at times in a trailer park, in a bus, and on a boat without running water. Making friends easily and possessing a "photographic memory" for facts, he graduated from high school as valedictorian and went to Duke University on full scholarship.

It was there he began reading about the German physician Rudolf Virchow. Virchow, sometimes called "the father of public health," wrote: "Medicine is a social science, and politics is nothing but medicine on a large scale. The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them." Of his inspiration, Farmer explains, "Virchow had a comprehensive vision: pathology, social medicine, politics, anthropology — my model."

Farmer splits his time between Boston's renowned Brigham and Women's Hospital and a small hospital built by Partners In Health in the tiny village of Cange, Haiti, called Zanmi Lasante (Creole for Partners In Health). Since beginning his medical career in the 1980s, he has devoted his life to improving the health and lives of the world's neediest people — building a health care center in central Haiti; helping prison officials fight epidemic tuberculosis in the former Soviet Union; and working with his colleague Jim Kim to fight multidrug-resistant tuberculosis (MDR TB) in the shantytowns of Lima, Peru. Most recently, Partners In Health has expanded its work into the African nation of Rwanda.

Trained as a medical anthropologist as well a physician, Farmer never stops asking the sometimes uncomfortable question "Why?": Why shouldn't poor people have access to medical care and drugs when they are sick? He has taken this message around the world and said it enough times that he now believes the world is beginning to listen.

"Finally people are starting to notice that a lot can be done, and they can be part of it," says Farmer. "The essence of global health equity is the idea that something so precious as health might be viewed as a right."

In true Robin Hood fashion, Farmer has begged, borrowed, and stolen AIDS drugs from virtually any source he could find, carrying the pills back to Haiti in his suitcase. He goes to the same lengths to secure medical supplies. Much of his time on planes, he says, is spent writing thank-you notes.

His dedication is paying off. When Farmer recently took some donors to visit the project in Haiti, they asked why they hadn't seen any AIDS orphans as they had in Africa. Farmer replied, "It's because we've been taking care of their mothers." Mothers who are HIV-positive are treated with AIDS drugs so they can raise their own children. Farmer and his team pioneered a system that showed that with the help of community health workers called accompagnateurs, rural people could follow even a complex regimen of antiretroviral therapy. The antiretroviral drug program began in 1999, when such efforts were almost unknown. "We didn't do it to be a model program; we did it because people were croaking," says Farmer, with characteristic deadpan outspokenness.

Farmer believes it's his responsibility to be outspoken, and he lectures widely on global health. "I feel it's part of my job to make the problems of the poor compelling," he says. "It's only through a failure of imagination that people turn away. The poor are doing their job — they're shouting as loud as they can. It's we who can't hear them. What the American public thinks is very important to the future of global health. Many people are moved by the idea that there is unnecessary suffering in the world, and we could do a lot to stop it. We have the technologies necessary to stop most of the suffering."

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From the Series

An Incurable TB?

Paul Farmer and Jim Kim are changing the way the world combats multi-drug resistant tuberculosis.

Part I: Poverty and the Rise of MDR TB in Peru (3:49)

Part II: Everyone Around Her is at Risk (8:20)

Part III: Facing TB Head-On (4:56)

Part IV: Reason to Endure (3:40)

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