Why the world and America needs Paul Farmer

I remember very clearly in March 2004 arriving into Kingston Jamaica. I was just tapped to be a Volunteer Country Director for the Clinton Foundation. The task was to work closely with a team of clinicians, business personnel, and ministry officials to help finalize the HIV/AIDS treatment and scale up country proposal for the Global Fund.

I remember during the first week on the job driving past a local prison. Our guide described the prison as a place where only ‘The Lord” smiles upon. It was known as a place where HIV/AIDS was rampant from drug use and unsafe sexual practice. However, for a variety of reasons was a population where no one cared to provide access to treatment.

It seems everyone has an opinion about Dr. Paul Farmer. The Far right question America’s role and tax payer dollars to help in the fight against poverty and strengthening health care abroad with over 40 million uninsured in America. The left promote Dr. Farmer as the world’s ambassador against poverty and disease. But without question, quite simply, Dr. Farmer has dared to go to those places where only ‘The Lord” smiles upon.

Paul (Dr. Farmer prefers both strangers, myself included in this first category, and close colleagues to avoid formal titles) has dedicated his life to improving the lives of those forgotten in the global economy. Regardless of whether you support his work, one cannot deny him full respect and admiration. He will be the first to admit he is not someone to be worshiped. Just a doer, who loves to do. Through his actions and doing, Paul and Partners in Health have directly impacted the lives of millions around the globe.

The world is a much better and enlightened place because of Paul and his ability to inspire many to think less about themselves and more about how they can help others.

Currently the Obama administration is working to convince Paul that he should become their global health ambassador. If this ultimately becomes reality, let us all be thankful. Because not withstanding the inevitable political minefields that await and budget battles to be fought, Paul will assuredly exponentially raise America’s stature in the world as a serious advocate for human rights, poverty reduction, and global health.

HST939 Update – The Fight against MDR-TB. Example of Public Private Partnership Collaboration.

Dr. Gail Cassell, Vice President for Scientific Affairs and Lilly Research Scholar for Infectious Diseases, Eli Lilly and Company was our distinguished guest today in HST939. Dr. Cassell is heading up the Lilly initiative to fight the spread of multi-drug-resistant tuberculosis (MDR-TB). The genesis for this program stems from a conversation that Dr. Cassell had with Paul Farmer and Jim Kim of Partners in Health fame. To Lilly and Dr. Cassell’s credit they embarked upon a path to develop new therapeutics to treat this deadly form of TB.

MDR-TB is defined as TB that is resistant at least to the two most powerful first line anti-TB drugs. MDR-TB has been on the rise and the WHO reported in 2008 that there are nearly one half million new cases per year of the estimated 9 million total new cases of TB estimated per year. WHO further reports that extensively drug-resistant tuberculosis (XDR-TB), a virtually untreatable form of the respiratory disease, has been recorded in 45 countries.

It was recently estimated that worldwide approximately 450 million USD was devoted towards treatment, discovery and diagnosis for TB globally. To put this in perspective it is further estimated that 1 Billion USD is required to develop and bring a new product to market. Thus as with most neglected diseases, there is a great short fall in global industry and public sector monies to tackle this disease.

The MDR-TB effort at Lilly is an example of a successful public and private collaborative for neglected disease and reportedly one of the largest philanthropic industry efforts to date. However there is much more that the global community has to do. It certainly cannot be left up to the private sector to subsidize research and development for neglected diseases in the developing world. The internationally community must come together to develop policy that incentivizes private sector partners to develop products and extend IP to ensure that the most in need receive life saving medicines.

This is arguably one of the greatest opportunities and challenges our generation has to tackle in addition to global warming and poverty; the development of capital markets that incentivize private industry to serve the world’s poor. The answers are not hard to find. Combinations of tax incentives, patent protection, subsidizes to spur innovation coupled with strengthen of quality assurance and health delivery systems can help eradicate/reduce disease burden in developing countries as well as resource poor settings within the united states, Europe and Asia. Within this context it is critical to develop an overall global health investment strategy that focuses on health systems to avoid targeting simply high profile diseases.