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EMBL/EMBO Joint Conference 2002

Paul Farmer, Harvard Medical School, Cambridge, USA

Biography

Paul Farmer, MD, PhD is a medical anthropologist whose work draws primarily on active clinical practice and focuses on diseases disproportionately afflicting the poor. He divides his clinical time between the Brigham and Women's Hospital (Division of Infectious Disease), where he is an attending physician, and a charity hospital in rural Haiti, the Clinique Bon Sauveur, where he serves as medical co-director.

An infectious disease physician as well as anthropologist, Dr. Farmer has worked in communicable-disease control in the Americas for over a decade and is a world-renowned authority on tuberculosis treatment and control. Along with his colleagues in the Program in Infectious Disease and Social Change in the Department of Social Medicine at Harvard Medical School, Dr. Farmer has pioneered novel, community-based treatment strategies for tuberculosis – and also sexually transmitted infections (including HIV) and drug-resistant typhoid – in resource-poor settings.

Dr. Farmer is a founding director of Partners In Health, a nonprofit organization active in Latin America, the Caribbean, Asia, and the United States. Dr. Farmer has written extensively about health and human rights, and about the role of social inequalities in the distribution and outcomes of readily treatable diseases. Author or co-author of over 75 scholarly publications, his research and writing stem in large part from work in Haiti and Peru, and from clinical and teaching activities. Dr. Farmer is the author of AIDS and Accusation (University of California Press, 1992), The Uses of Haiti (Common Courage Press, 1994), Infections and Inequalities (University of California Press, 1998) and of the forthcoming Pathologies of Power (University of California Press). In addition, he is co-editor of Women, Poverty, and AIDS (Common Courage Press, 1996) and of The Global Impact of Drug-Resistant Tuberculosis (Harvard Medical School and Open Society Institute, 1999).

Abstract

Infections and Inequalities: Examples from Haiti and Peru

Infectious disease is the leading cause of pediatric and young adult death in developing countries; social forces contribute to disease burden as well as the advent of drug resistance. The example of tuberculosis, with its persistence in poor countries and its resurgence among the poor of many industrialized nations, is telling - not only are the poor more likely to become infected, but once exposed they are more likely to progress to active disease. And once sick, the poor have increased likelihood of dire outcomes. HIV/AIDS has further crystallized these inequalities of risk and treatment, and poses substantial challenges to health systems as the leading infectious cause of young adult death in much of the developing world. Our experience with endemic infectious disease in Haiti, Peru, and other high-prevalence settings has taught us that these maladies are strongly influenced by social, economic, and political factors, and treatment efforts must take equity seriously. By linking a technically sound series of interventions to a social-justice agenda, most of the plagues of the poor can be controlled effectively.