Paul Farmer

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Port Loko is not far from Freetown, the capital of Sierra Leone and a global hub of maritime commerce. City and town, linked by paved roads, remain epicenters of Ebola transmission and deaths. Getting to zero new infections is the overarching goal of what is now the world’s largest public-health endeavor. But it’s still far from an ambitious clinical endeavor. The numbers say it all. Not a single American has died of Ebola; the majority of Europeans infected have survived; a Cuban survivor is already back here at work. Across West Africa, 70 percent of those afflicted die. And that figure applies only to the sick who receive care at treatment centers: Over 90 percent of those who stay home perish.…  Seguir leyendo »

If the Ebola epidemic devastating the countries of Guinea, Liberia and Sierra Leone had instead struck Washington, New York or Boston, there is no doubt that the health systems in place could contain and then eliminate the disease.

Hospitals would isolate suspected cases. Health workers would be outfitted with proper protective clothing and equipment. Doctors and nurses would administer effective supportive care, including comprehensive management of dehydration, impaired kidney and liver function, bleeding disorders and electrolyte disturbance. Labs would dispose of hazardous materials properly. And a public health command center would both direct the response and communicate clearly to the public about the outbreak.…  Seguir leyendo »

A decade after the global AIDS response began in earnest, it’s worth asking whether the lessons learned will be sustained over time and used to avoid past mistakes when tackling new challenges.

One such challenge is chronic hepatitis C infection, which afflicts an estimated 170 million people worldwide. Since its discovery 25 years ago, hepatitis C has become the leading indication for liver transplant in the United States and a common cause of liver failure around the world. For some, however, it is about to become eminently curable.

When I trained as an infectious disease physician in the mid-1990s, I traveled frequently between Boston’s teaching hospitals and rural Haiti.…  Seguir leyendo »

President Obama’s nomination of Jim Yong Kim to be president of the World Bank is a powerful choice for an institution charged with addressing some of the world’s toughest challenges. Chief among these is to help developing economies achieve sustained growth by ensuring that its benefits are broadly shared.

Recent claims from some economists that Kim is “anti-growth” are based on a willful misreading and selective reporting of passages from Kim’s co-edited volume “Dying for Growth: Global Inequality and the Health of the Poor,” to which we both contributed. Any reasonable reading of the book indicates that “Dying for Growth” is pro-growth, raising questions about particular policies and patterns of growth that exclude the great majority of people living in poverty.…  Seguir leyendo »

Ten years ago, the heads of the G-8 countries met in Genoa, Italy, to back the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria — a new funding mechanism that dramatically increased resources available to fight preventable, treatable diseases stalking the poor and depleting developing economies around the globe.

In 2001, very few people — almost none, really — living with H.I.V. in Africa had access to antiretroviral medicines. Today, more than 3.3 million people — more than half of those on treatment worldwide — are on treatment supported by the Global Fund: A true victory for the global community.…  Seguir leyendo »

Do the lives of Gandhi, Solzhenitsyn and Mandela tell us more about the future than those of Stalin, Hitler and Mao? Several prominent world-watchers tell us what they think.

Ai Weiwei, Chinese artist and activist.

Throughout history, political and social change only existed in the forms we knew because protest actions, be they violent or peaceful, were carried out with a lack of resources, especially in terms of communications. Individuals could mobilize and share information with others only to a limited extent. Such circumstances posed obstacles to protest actions that people can take and hindered the impact of their efforts.…  Seguir leyendo »

Ten million people — many of them young and most of them poor — will die around the world this year from diseases for which safe, effective and affordable treatments exist. In Haiti, these are known as “stupid deaths.” What’s more, inadequate health services predominate precisely where the burden of disease is heaviest, keeping a billion souls from leading full lives in good health.

In recent years, initiatives such as the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria have helped rein in some of the biggest scourges. We’d be hard-pressed to point to a more inspiring achievement in global public health since the eradication of smallpox in 1977.…  Seguir leyendo »

President Bush made a historic pledge in his 2003 State of the Union address: to get urgently needed AIDS treatment to 2 million people living with HIV in impoverished countries by 2008. Congress concurred and launched a major initiative to fight AIDS focusing on 15 developing nations. At a U.N. General Assembly conference on AIDS this year, the United States went further and committed, along with other countries, to come as close as possible to universal access to HIV treatment by 2010.

We have come a long way since 2000, when AIDS treatment was available to only the fortunate few. Activists campaigned successfully to drive down the cost of treatment with affordable off-patent AIDS medicines that are now available in most developing countries.…  Seguir leyendo »