Paul Farmer

Paul Farmer (born October 26, 1959, North Adams, Massachusetts, U.S.—died February 21, 2022, Butaro, Rwanda) American anthropologist, epidemiologist, and public-health administrator who, as cofounder of Partners in Health (PIH), was known for his efforts to provide medical care in impoverished countries.

When Farmer was a boy, his father moved the family often. While living in Birmingham, Alabama, they purchased a bus for family vacations, but the vehicle became their permanent home for five years after they moved to Brooksville, Florida. Farmer won a full scholarship to Duke University in Durham, North Carolina, from which he graduated summa cum laude in 1982. In 1990 he earned both an M.D. and a Ph.D. in anthropology from Harvard University.

Farmer was still a student when he began touring North Carolina tobacco plantations, where Haitian migrant workers toiled in severe circumstances. After graduating from Duke, he visited the Krome detention centre in Miami and began protesting U.S. immigration policies that sent Haitian refugees home but welcomed Cuban refugees. In 1983 Farmer helped establish a community-based health project in Cange, Haiti, and four years later he cofounded 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 he 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 multi-drug-resistant tuberculosis (MDR TB) treatment programs and to establish effective antibiotic delivery. Following a $44.7 million grant from the Bill & Melinda Gates Foundation to PIH and to Harvard Medical School to fund MDR TB research, Farmer established individualized drug-therapy programs for patients in Haiti, Peru, and Russia. In Haiti Farmer demonstrated, almost single-handedly, that MDR TB could be treated cost-effectively among the poor in a country with few resources, and he determined that the progression of MDR TB could be halted only if the poor were given adequate resources as well as medication.

Farmer split his time between Cange and 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. Farmer also served as professor of medical anthropology at Harvard Medical School and was the winner of the 2003 Heinz Award for the Human Condition. In 2008 the Skoll Foundation named him a social entrepreneur of the year, an honour to which a $2 million grant was attached.

Farmer was named deputy United Nations special envoy for Haiti in August 2009. PIH was dealt a blow by the Haiti earthquake of 2010, which damaged some of its facilities, but Farmer and the organization continued working to provide emergency relief and medical care in the aftermath of the quake. In 2012 he stepped down as special envoy to become UN special adviser to the secretary-general on community-based medicine and lessons from Haiti. In his new role, Farmer’s focus was on ending the country’s cholera epidemic, which was widely believed to have been caused by infected UN peacekeeping troops.

During this time Farmer was instrumental in the opening (2011) of a hospital in Butaro, northern Rwanda; the facility was a collaboration between PIH and the country’s government. The University of Global Health Equity, another PIH initiative, was also established (2015) in Butaro, with Farmer as its chancellor. In 2020, after an outbreak of COVID-19 became a global pandemic, Farmer and PIH were involved in various efforts regarding the viral illness, notably helping create a contact-tracing program in Massachusetts. That year he received the Berggruen Prize, having been cited “for transforming how we think about infectious diseases, social inequality, and caring for others while standing in solidarity with them.”

Farmer was the author of numerous books, including Infections and Inequalities: The Modern Plagues (1999), Pathologies of Power: Health, Human Rights, and the New War on the Poor (2003), and Fevers, Feuds, and Diamonds: Ebola and the Ravages of History (2020).