Farmer, Paul

▪ 2005

      By 2004 anthropologist, epidemiologist, and public-health administrator Paul Farmer had spent more than two decades and more than 4.8 million km (3 million mi) in the air shuttling between Boston—where he served as an attending physician in infectious diseases and chief of the division of Social Medicine and Health Inequalities at the Brigham and Women's Hospital—and Cange, Haiti. In Haiti he demonstrated, almost single-handedly, that multidrug-resistant tuberculosis (MDR TB) could be treated cost-effectively among the poor in a country with few resources and had determined that the progression of MDR TB could be halted only if the poor were given adequate resources as well as medication.

      Paul Edward Farmer was born in 1959 in North Adams, Mass. His father moved the family often. While living in Birmingham, Ala., the family purchased a bus for family vacations, but the vehicle became their permanent home for five years after they moved to Brooksville, Fla. He won a full scholarship to Duke University, Durham, N.C., from which he graduated (1982) summa cum laude. In 1990 Farmer earned both an M.D. and a Ph.D. in anthropology from Harvard University.

      He was still a student when he began touring North Carolina tobacco plantations, where Haitians toiled in severe circumstances. After graduating from Duke, he visited the Krome detention center in Miami, Fla., and began protesting U.S. immigration policies that returned Haitian refugees home but welcomed Cuban refugees. In 1983 Farmer helped establish a community-based health project in Cange, and four year later he cofounded Partners in Health (PIH) to support clinics, schools, and training programs for medical outreach workers in impoverished countries. His work in Haiti led to the thesis of his 1992 book AIDS and Accusation. The following year Farmer was awarded a MacArthur Foundation fellowship and donated the prize money to PIH for the formation of the Institute for Health and Social Justice.

      In 1994 Farmer adopted a community-based model, akin to the one in Haiti, for treating disease and securing residents' access to health care in Carabayllo, a Peruvian shantytown. Two years later PIH and its Peruvian partner, Socios en Salud, developed a successful scheme for treating drug-resistant TB patients. In 1999 the World Heath Organization appointed Farmer and PIH worker Jim Yong Kim to launch international MDR TB treatment programs and establish effective antibiotic delivery. Following a $44.7 million grant from the Bill & Melinda Gates Foundation to PIH and Harvard Medical School to fund MDR TB research, Farmer established individualized drug-therapy programs for patients in Haiti, Peru, and Russia.

      Farmer, who also served as professor of medical anthropology at Harvard Medical School, published numerous books and was the winner of the 2003 Heinz Award for the Human Condition. A biography of Farmer, Mountains Beyond Mountains by Tracy Kidder, appeared in 2003.

Karen J. Sparks

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