Paul Edward Farmer was an American medical pioneer anthropologist, academician, and physician. He co-founded and was chief strategist of Partners in Health (PIH), an international nonprofit organization that since 1987 has provided health care services, undertaken research, and advocacy on behalf of the poor and sick.

Dr. Farmer grew up in Alabama during much of his childhood years, and experienced living in considerable poverty in Florida, at times in an old school bus, a mobile home, and a houseboat. He studied medical anthropology at Duke University on a full scholarship and later went on to pursue an MD and a PhD in anthropology at Harvard University, combining academic research with hands-on fieldwork. Believing that anthropology should understand and abolish health disparities in poor countries, he co-founded in 1987 PIH, dedicated to improving the medical care of impoverished communities around the world. Early on he became involved with migrant camps of laborers harvesting tobacco. After graduating from Duke, he began to volunteer at a hospital in Cange, Haiti. Through the sister organization of PIH he built schools, homes, communal sanitation and water systems in central Haiti, vaccinating local children and greatly decreasing malnutrition and infant mortality rates. During the AIDS epidemic, he was instrumental in reducing the transmission rate of the disease. In 1999 he worked with the World Health Organization to facilitate the treatment of multi-drug-resistant tuberculosis and created specific drug-therapy programs for patients in Haiti, Peru, and Russia. All along he emphasized that treatments could often be done effectively and at low cost in poor countries that lacked sophisticated resources.

Partners in Health began to provide tertiary care in Haiti as well as working in Rwanda, Lesotho, Malawi, Mexico, Peru, Sierra Leone, Liberia, Russia, and the Navajo Nation. Dr. Farmer became professor of medicine and chief of the Division of Global Health Equity at Brigham and Women’s Hospital. In 2020 during the COVID-19 pandemic, he worked with PIH to develop a contact-tracing program in Massachusetts. He believed that anthropology was not a mere academic exercise but should be a tool for meaningful, transformative change. He died in Rwanda in February 2022 at the age of 62. He had all along maintained that “The idea that some lives matter less is the root of all that is wrong with the world.”

Dr. Farmer was a brilliant writer and lecturer. Quoting the aphorism of Tacitus that “they created a desert and called it peace,” he wrote about pain, illness, and suffering of the poor in his time and in the history of several former colonial countries, particularly in Haiti. He wrote about hospitals in ex-colonial countries, well-equipped but lying empty because the inhabitants could not afford to pay for the treatment and medicines, while several miles away the poor afflicted by cancer or infectious diseases lay huddled in unsanitary areas suffering from pain, lack of doctors, and lack of medicines. In one of his lectures, he takes his audience to the days of the ancien régime before the French Revolution, when affluent aristocrats were served incredibly luxurious menus (of which he gives some examples) while benefiting from the exploitation of their Caribbean colonies, in particular Haiti. He then takes his audiences and readers to the suffering of the modern Haitian poor under its cruel dictators in an environment replete with poverty, violence, oppression, and gross inequality. In our time much has been achieved but more remains to be done, and also to be gained from reading the lectures of this remarkable anthropologist who died before he could accomplish everything he had set out to do.

Further reading

1. Paul Farmer. “An Anthropology of Structural Violence.” Current Anthropology 45, no. 3 (June 2004): 305-25.
2. Paul Farmer. “Challenging Orthodoxies: The Road Ahead for Health and Human Rights.” Health and Human Rights 10, no. 1 (2008): 5-19.
3. Paul Farmer. “On Suffering and Structural Violence: A View from Below.” Daedalus 125, no. 1 (Winter 1996): 261-283.
4. Duncan Maru and Paul Farmer. “Human rights and health systems development: Confronting the politics of exclusion and the economics of inequality.” Health and Human Rights 14, No. 2 (December 2012): 1-8.