Dr Paul Farmer, a physician, medical anthropologist, activist, humanitarian and a global health visionary, will be sorely missed.
Farmer made a first and enduring impression on me when I met him at Columbia University in New York City. He dedicated his life and effort to delivering high-quality healthcare for the poorest.
Farmer started off as a volunteer in Haiti, where he founded a community clinic in 1983. In 1987, with former President of the World Bank Jim Kim and two others, he co-founded Partners in Health.
PIH is simultaneously a global health and social justice organisation. Farmer believed that illness had social roots and health must be addressed through social structures.
With an example from his work in Peru, Farmer shows that 100 per cent of patients who received free tuberculosis treatment alongside a monthly stipend were cured of the disease, compared with 56 per cent who received drugs and no stipend.
This study underlines his argument that it is ineffectual to treat patients and send them back to desperately poor living conditions that created the environment for disease in the first place.
PIH supports clinics, hospitals, education and training in 12 countries, including Haiti where PIH established Mirebalais, a university hospital, and in Rwanda where they helped start the University of Global Health Equity in Butaro.
The mission of UGHE is to train a new generation of global health leaders who will build and sustain equitable healthcare systems.
As a devotee of health equity, Farmer denounced monopolies on Covid-19 vaccines. He urged US President Joe Biden to ease intellectual property hurdles that prevented big pharmaceutical companies from sharing vaccine technology.
Farmer believed morally that everyone deserved treatment of the highest quality. He argued that money required to save lives can always be found if lives, all lives, were valued equally.
As Joshua Cohen wrote in Forbes, Farmer was acutely aware of patronising, hegemonic vestiges of tropical health. His philosophy was to proceed from understanding the social, economic and political dimensions of health, disease, treatment and healing.
Farmer did not accept the constraints. For him, what is the most good we can do with limited resources was never the moral question. Access to high-quality healthcare was a human right, whether in Boston, Massachusetts or Butaro in Rwanda.
Mathew Bonds, my friend and fellow postdoc at Columbia University, who worked with Farmer at Harvard Medical School, likens his intellectual fearlessness to that of the naturalist Alfred Russel Wallace.
Bonds describes Farmer as “one of the great and improbable complex thinkers of his time”, whose genius was the ability to see how each part of the system was connected; from physicians to scientists, drivers, cleaners and funders.
Paul Farmer’s views were radical, exacting. Two cannons defined him: That medicine must intervene in social and political life, and that the purpose of medical education is not to provide a way of making a living but for the health of the community.
The views expressed are the writer’s
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