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.

Tackling Malaria - Challenges and Opportunities

Recently, there has been a surge in awareness and action in recognizing the horrible toll malaria has on the developing world. From mainstream advocacy by groups such as 'madness for malaria' and less publicized day-to-day field worker initiatives, the battle to saves lives is taking place every day.

In Tanzania, malaria still accounts for the highest all cause mortality among children. Reasons for this are complex. These include cultural, political, biological, and economic.

For example there has been important progress in Zanzibar over the years in combating the disease among children and adults. Yet despite these efforts, success has been more challenging on the mainland. Some of this was due to ineffective policy that had prohibited private sector facilities from procuring preferentially priced pharmaceuticals, creating an undue tiered system that created inequities in access to life saving medicines. Other reasons include resistant strains of the malaria parasite, inadequate distribution of bed nets, and mainstream beliefs that inhibit widespread prophylaxis.

A cautionary tale is while currently there is hundreds of millions of USD invested in the search for a malaria vaccine, it is critical to appreciate that barriers to effective treatment are multi-factorial and no magic bullets exist. New microfluidic diagnostic tools will also allow for large low cost panels to screen children and adults for dozens of infectious diseases, including the malaria parasite, within minutes. But diagnosis must also be accompanied by affordable access to life saving medicines. Even with an effective vaccines and/or diagnostic tools, public health innovation must also be achieved in policy reform that streamlines procurement and distribution practices between both public and private stakeholders for eradication strategies to be effective.