Paul Edward Farmer (October 26, 1959 – February 21, 2022) was an American medical anthropologist and physician. Farmer held an MD and PhD from Harvard University, where he was a University Professor and the chair of the Department of Global Health and Social Medicine at Harvard Medical School. He was the co-founder and chief strategist of Partners In Health (PIH), an international non-profit organization that since 1987 has provided direct health care services and undertaken research and advocacy activities on behalf of those who are sick and living in poverty. He was professor of medicine and chief of the Division of Global Health Equity at Brigham and Women’s Hospital.
Farmer wrote extensively on Health and Human Rights, the role of social inequalities in the distribution and outcome of infectious diseases, and global health. Farmer pioneered the concept of community health works and decentralized models of care.[1]
He was known as "the man who would cure the world", as described in the book Mountains Beyond Mountains by Tracy Kidder. Farmer and Partners in Health received the Peace Abbey Foundation Courage of Conscience Award in 2007 for saving lives by providing free health care to people in the world’s poorest communities and working to improve health care systems globally. The story of PIH is also told in the 2017 documentary Bending the Arc. He was a proponent of liberation theology.[2][3]
On April 24, 2021, Farmer was named Aurora Humanitarian in recognition of his work with PIH.[4]
Early life and education
Farmer was born in North Adams, Massachusetts, and raised in Weeki Wachee, Florida. He had first lived in Alabama for some of his childhood years.[5] Then when his family moved to Florida, Farmer and his family of eight lived in an old school bus that his father had transformed into a mobile home. Farmer recounted his father as a “free spirit,” as he later on pursued commercial fishing and took his family to live with him on a houseboat in the Gulf of Mexico. Farmer’s father then anchored the houseboat in a primitive bayou called Jenkins Creek where the family bathed, bringing jugs with drinking water from Brooksville. Farmer prioritized his education and excelled academically in school. Farmer’s parents often read serious literature to their children, motivating them to learn as much as possible in regard to all that the world had to offer. The family dealt with financial difficulties that often led them to work in different environments. One summer, Farmer’s family worked with Haitian migrant workers and picked citrus fruit, which was Farmer's first encounter of many with Haitian people.[6]
He was the brother of former professional wrestler Jeff Farmer. He was a graduate of Hernando High School in Brooksville, Florida, where he was elected president of his senior class.[7] He attended Duke University as a Benjamin N. Duke Scholar,[8] graduating summa cum laude with a Bachelor of Arts in medical anthropology in 1982.[7][9] During his time at Duke, he went to Paris for half a year and learned French fluently which benefited him in his future work. He then came across the work of Rudolf Virchow, the 19th century German physician and scientist that developed public health medicine, who inspired Farmer's career trajectory. Farmer’s passions were further shaped by the political atmosphere around him at the time with civil war and revolution breaking out in Central America (including the Nicaraguan Revolution, Salvadoran Civil War, and Guatemalan Civil War), and the rise of liberation theology which the Catholic clergy used to defy authoritarianism in the region. This ideology emphasized the “preferential option for the poor,” which consisted of the physical and spiritual wellbeing of the poor as a crucial component of the word of God. To some followers of Christianity, part of “liberation theology" that Christians need to focus on as their primary obligation involves helping the least fortunate of those around them.[6]
Farmer later became involved with migrant labor camps near campus, and came into contact with Sister Juliana DeWolf. She was working with the United Farm Workers, seeking to ameliorate the living circumstances of the laborers harvesting tobacco. Through this encounter, Farmer befriended many of the Haitian farm workers, and listened to their life experiences and stories. He became interested in Haiti and began learning Creole, interviewing Haitian migrant workers, and reading about Haiti's history.[6] In 1983, while still in school, he started working with villages in Haiti's Central Plateau to help incorporate modern health care practices in their communities.[10] He ended up writing and co-writing more than 100 scholarly papers and several books.[10]
In 1987, Farmer, along with his colleagues from Harvard Jim Yong Kim, Ophelia Dahl, Thomas J. White and Todd McCormack, co-founded Partners In Health.[13][5] PIH began in Cange in the Central Plateau of Haiti and at the time of Farmer's death in February 2022 operated 16 sites across the country, with approximately 7,000 employees.[11] PIH in Cange was known as Zanmi Lasante, the sister organization of PIH. Zanmi Lasante built schools, homes, and communal sanitation and water systems to help the community in central Haiti have improved facilities and resources. The organization vaccinated all of the local children while successfully decreasing malnutrition and infant mortality rates in the area. Zanmi Lasante also focused on AIDS prevention during the HIV crisis and successfully decreased HIV transmission rates to 4% from mothers to babies.[14]
In 1999, the World Health Organization designated Farmer and a fellow PIH worker Jim Yong Kim to facilitate global multi-drug resistant tuberculosis (MDR TB) treatment programs, ensuring successful deliveries of antibiotics. With the help of a $44.7 million grant from the Bill & Melinda Gates Foundation, Farmer created specific drug-therapy initiatives for individuals in Haiti, Peru, and Russia.[15] With this program having some of the highest cure rates in the world, it was clear that treating MDR TB could be done cost effectively in poor countries with functional delivery systems.[5][15]
Hôpital Universitaire de Mirebalais opened in 2013 and provides tertiary care to patients, including oncology and trauma surgery services.[11][13] Partners In Health also works in Rwanda, Lesotho, Malawi, Mexico, Peru, Sierra Leone, Liberia, Russia, and the Navajo Nation. The University of Global Health Equity is an initiative of Partners In Health that started in 2015 and focused on delivering the highest quality of health care by addressing the critical social and systemic forces causing inequities and inefficiencies in health care delivery.[16]
In May 2009, Farmer was named Chair of Harvard Medical School's Department of Global Health and Social Medicine, succeeding Jim Yong Kim, his longtime friend and colleague. On December 17, 2010, Harvard University's President, Drew Gilpin Faust, and the President and Fellows of Harvard College, named Farmer as a University Professor, the highest honor that the University can bestow on one of its faculty members.[18]
In August 2009, Farmer was named United Nations Deputy Special Envoy to Haiti (serving under former U.S. President Bill Clinton), in his capacity as Special Envoy.[19]
In December 2012, Farmer was appointed the United Nations Special Adviser to the Secretary-General on Community Based Medicine and Lessons from Haiti.[20]
In 2020 during the COVID-19 pandemic, Farmer worked with PIH to develop a contact-tracing program in Massachusetts.[15]
Farmer was editor-in-chief of Health and Human Rights. He was on the board of the Aristide Foundation for Democracy and was a co-founder and board member of the Institute for Justice & Democracy in Haiti.[21] He was on the Board of PIVOT, a recently formed healthcare and research organization operating in Madagascar. He was a member of the Advisory Board of Incentives for Global Health, the NGO focused on developing the Health Impact Fund. He also served on the Global Advisory Council of GlobeMed, a student-driven global health organization that works through a partnership model.[22]
Farmer served on the Advisory Board of Universities Allied for Essential Medicines, an international student-driven advocacy organization that works on issues of medicine development and affordability.[23] Farmer was a board member of Kageno Worldwide, Inc., a community development agency that has worked in Kenya and Rwanda. He was also on the Board of Trustees for EqualHealth, which builds critical consciousness towards health equity.[24]
Personal life and death
Farmer was married to Didi Bertrand Farmer, a Haitian medical anthropologist and community health specialist who has led several initiatives at Partners in Health. Her most recent work focuses on empowering girls and young women in Haiti and Rwanda.[25] They had three children.[26] Farmer was Catholic.[27]
In February 2022, Farmer was one of 38 Harvard faculty to sign a letter to The Harvard Crimson defending Professor John Comaroff, who had been found to have violated the university's sexual and professional conduct policies.[28] After students filed a lawsuit with detailed allegations of Comaroff's actions and the university's failure to respond, Farmer was one of several signatories to say that he wished to retract his signature.[29][30]
Farmer died in his sleep from an acute cardiac event in Butaro, Rwanda, on February 21, 2022, at the age of 62.[11][31] Farmer had been involved in medical education at Butaro District Hospital and the Butaro campus of the University of Global Health Equity, which accepted its first class of medical students in 2019.[32]
Books
Fevers, Feuds, and Diamonds: Ebola and the Ravages of History. Paul Farmer. New York: Farrar, Straus and Giroux, 2020. ISBN978-0-374-23432-4 Farmer first visited the Western African Ebola virus epidemic site in July 2014, and much of the book is devoted to his personal experiences. Reviewing the outbreak in 2020, he noted that there were almost no Ebola deaths in the U.S. or Europe. By Farmer's account, the West Africa Ebola death toll arose from the longstanding failure to invest in basic health infrastructure which resulted in a lack of proper medical care. Looking at the history of West Africa, Farmer blames the almost five centuries of European rule that resulted in the "rapacious extraction — of rubber latex, timber, minerals, gold, diamonds and human chattel" for the country's inability to provide adequate health care.[33]
AIDS and Accusation: Haiti and the Geography of Blame, Berkeley: University of California Press, 1992, 1993, 2006 edition: ISBN978-0-520-08343-1
The Uses of Haiti, Monroe, Maine: Common Courage Press, 1994, 2003, 2005 edition: ISBN978-1-56751-242-7
Infections and Inequalities: The Modern Plagues, Berkeley: University of California Press, 1999, revised 2001 edition: ISBN978-0-520-22913-6
Pathologies of Power: Health, Human Rights, and the New War on the Poor, Berkeley: University of California Press, 2003, 2005 edition: ISBN978-0-520-24326-2
Global Health in Times of Violence, co-edited with Barbara Rylko-Bauer and Linda Whiteford, School for Advanced Research Press, 2009 edition: ISBN978-1-934691-14-4
Women, Poverty & AIDS: Sex, Drugs and Structural Violence (Series in Health and Social Justice), with coauthor Margaret Connors, Common Courage Press; Reprint edition (September 1996), ISBN978-1-56751-074-4
Partner to the Poor: A Paul Farmer Reader. Ed. Haun Saussy. Berkeley: University of California Press, 2010, ISBN978-0-520-25713-9
To Repair the World: Paul Farmer Speaks to the Next Generation. Ed. Jonathan Weigel. Berkeley: University of California Press, 2013. ISBN978-0-520-27597-3
In the Company of the Poor: conversations between Dr. Paul Farmer and Fr. Gustavo Gutierrez. Ed. Michael Griffin and Jennie Weiss Block. Orbis Books, 2013: ISBN978-1-62698-050-1
^"The Liberation Theology of Dr. Paul Farmer | Religion & Politics". March 2016. PAUL FARMER & PARTNERS IN HEALTH received the Peace Abbey Couage of Conscience Award in 2007 for saving lives by providing free health care to people in the world’s poorest communities and working to improve health care systems globally. Read More
"Paul Edward Farmer, MD, PhD". Department of Global Health and Social Medicine, Harvard Medical School. Archived from the original on October 29, 2020. Retrieved May 14, 2020.