segunda-feira, 6 de outubro de 2008

Global Health Equity



ABOUT THE LECTURE
Don’t foolishly advise Paul Farmer that his bold projects can’t succeed. For the past 20 years, Farmer’s been toppling orthodoxies concerning the delivery of health care to people of developing nations, and to our country’s inner city poor. In a talk full of insights and anecdotes, Farmer brings his audience up to date on his groundbreaking work and methods.

In the early 80s, Farmer was a Harvard medical student studying infectious disease in Haiti. HIV was taking a deadly toll there and in the U.S., but Farmer was struck by the inequity of treatment. “The idea of a different standard of care for people 1 ½ hours from Miami didn’t strike me as a good idea.” Health care, Farmer came to believe, is a basic human right.

In the early 90s, antiretroviral drugs emerged in the U.S. as a powerful treatment for AIDS -- but were priced beyond the reach of developing countries. Farmer and his colleagues began a public battle against such global inequalities. They demanded affordable drugs, and support for community-based health care initiatives, viewed by international funders as unsustainable and cost-ineffective.

With a loan from a commercial bank in Boston, Farmer set out to prove everyone wrong. Starting with one facility, Farmer established community medical clinics across Haiti, run by and for Haitians, securing and disbursing affordable drugs for HIV and TB, and educating the community in preventive medicine. Local workers spread out into neighborhoods, to initiate and follow up on care. Farmer used his AIDS programs “as a battle horse to ride into the fight against poverty, and to talk about education, food security and housing.”

Farmer’s support broadened to include such powerful funders as the Clinton Foundation. This has enabled him to take his program into Africa, first to Rwanda and more recently to Lesotho and Malawi. Farmer’s Partners in Health group rebuilds medical infrastructure weakened by war or years of neglect; takes care of the sick; and then trains hundreds of local citizens. Haitians, whom Farmer describes as his teachers, have been spearheading much of the work in Africa. The costs of scaling up come less from labor, than from basic goods like food, and bumps in the supply chain. But the biggest obstacle of all, says Farmer, is “nay-saying, low expectations, a certain undertow of censorious opinion. As if it weren’t hard enough to do the work, you have to fight a lot of skepticism, not from patients, coworkers or family members, but from your peers.”

ABOUT THE SPEAKER
Medical anthropologist and physician Paul Farmer is a founding director of Partners In Health, an international charity organization that provides direct health care services and undertakes research and advocacy activities on behalf of those who are sick and living in poverty. He is medical director of a charity hospital, the Clinique Bon Sauveur, in rural Haiti.

Farmer has written extensively about health and human rights, and about the role of social inequalities in the distribution and outcome of infectious diseases. He is the author of Pathologies of Power (University of California Press, 2003); Infections and Inequalities (University of California Press, 1998); The Uses of Haiti (Common Courage Press, 1994); and AIDS and Accusation (University of California Press, 1992). In addition, he is co-editor of Women, Poverty, and AIDS, (Common Courage Press, 1996) and of The Global Impact of Drug-Resistant Tuberculosis (Harvard Medical School and Open Society Institute, 1999).

Farmer is the recipient of the Duke University Humanitarian Award, the Margaret Mead Award from the American Anthropological Association, the American Medical Association’s Outstanding International Physician (Nathan Davis) Award, and the Heinz Humanitarian Award. In 1993, he was awarded a John D. and Catherine T. MacArthur Foundation “genius award” in recognition of his work.
Farmer is the subject of Pulitzer Prize winner Tracy Kidder’s Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World (Random House, 2003).

Farmer received his Bachelor’s degree from Duke University and his M.D. and Ph.D. from Harvard University.