Opinion | Give Good Health to Anyone, Anywhere, Whether They Can Pay or Not
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By Zeynep Tufekci
This article is part of Times Opinion’s 2022 Giving Guide. Read more about the guide in a note from Opinion’s editor, Kathleen Kingsbury.
Shortly after Paul Farmer helped get Partners in Health off the ground in 1987, international global health groups were debating whether it was even possible to treat poor patients with multidrug-resistant tuberculosis, as its treatments were expensive and required patients to stick to complicated regimens. Indeed, even ordinary tuberculosis for which cheaper drugs and proven regimens existed kept killing poor people around the world.
Farmer, and the band of can-do mavericks who had assembled around P.I.H., had no patience for such excuses — or any excuses for denying care to poor people.
Their programs, based on providing high-quality care regardless of patients’ ability to pay and empowering them in their own treatment, were so successful that they upended global public health.
In his biography of Farmer, “Mountains Beyond Mountains,” from 2003, Tracy Kidder noted that even as tuberculosis killed more adults than any other disease in Haiti, not a single person had died of it since 1988 in the P.I.H. hospital that served a desperately poor rural area with a population of about 100,000 people. Protocols the group developed in Peru for successfully treating multidrug-resistant tuberculosis were adopted globally.
After learning about Farmer and P.I.H. from Kidder’s book, I’ve been donating to the organization ever since.
This year is particularly poignant, though. Farmer died in February.
According to Kidder, P.I.H. reduced newborn H.I.V. transmission from mothers to babies in the rural Haitian community it served to 4 percent, which he also noted was less than the rate in the United States at the time. Their clinic stopped outbreaks of drug-resistant typhoid with effective antibiotics and by cleaning up water supplies. It drastically reduced infant mortality. They achieved this despite a meager budget and with many patients traveling for hours, sometimes on foot or by donkey.
How? Farmer had a very straightforward philosophy: All sick people deserve high-quality treatment. Illness and poverty are intertwined. The proper response is to provide resources while working with people to empower them — thus Partners in Health.
The secret? Treat the whole person. With respect.
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