Philanthrocapitalism_ How Giving Can Save the World - Matthew Bishop [15]
In 1987, he founded Partners In Health, along with fellow doctor Jim Yong Kim, his friend Ophelia Dahl, and Boston businessman Tom White, who put up the first $1 million to support the Zanmi Lasante Clinic that Farmer and Haitian colleagues opened in Cange in the central highlands of Haiti, the poorest nation in the Western Hemisphere, long burdened by oppressive, corrupt, and violent rulers. For the next several years, Farmer spent about four months a year practicing medicine at the Brigham and Women’s Hospital in Boston, where he earned enough to pay his bills. The rest of his time was devoted to caring for people at Zanmi Lasante and building an innovative public health-care model that holds great promise for the rest of the developing world. Farmer lived in a simple home by the clinic, with a tin roof and concrete floors, with no hot water, but with the relative luxury of a toilet.
More than 600,000 people live in the clinic’s “catchment area,” in small villages that are served by community health workers trained by Partners In Health. Many people from outside the area also come to the clinic because of the high quality of its care. It has about 1.7 million patient visits a year; has built schools, houses, and water and sanitation systems; has vaccinated all the children in its area; and has reduced infant mortality and malnutrition dramatically.
What brought Farmer’s work worldwide notice is the progress he and his colleagues made in treating tuberculosis and AIDS. For about $150 to $200, one percent of what it costs to treat a TB patient in the United States, Partners In Health, relying on community health workers, fought TB in central Haiti to a standstill. Almost no one in the catchment area has died from TB since 1988. By the late 1990s the clinic had also reduced the transmission of HIV from infected mothers to their babies to 4 percent, as low as the rate in the United States at the time.
Over the years, Partners In Health has won support from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and George Soros, the Gates Foundation, and other private donors. The money has enabled it to expand its lifesaving work, especially in the care and treatment of people with HIV/AIDS. It also expanded its TB treatment into Russia and Peru, where it achieved particularly impressive results under the leadership of Jim Kim, who, like Farmer, has devoted his life to public health. After leaving Partners In Health, Kim went on to the World Health Organization, where he led the push for widespread treatment for people with AIDS. He is now the director of the Department of Social Medicine at Harvard Medical School and at Brigham and Women’s Hospital in Boston and back with Partners In Health.
I first met Farmer in 2002 at the World AIDS Conference in Barcelona. In 2003, I joined him in Haiti to cement my foundation’s partnership with the government to provide training and low-cost medicine to fight HIV/AIDS. We held an event to announce our joint efforts at a hospital in Port-au-Prince. When my interpreter proved not very adept at translating my words into Creole, Farmer politely took over for him and saved the day, a familiar role for him.
A couple of years later, Ira Magaziner persuaded Paul to try to implement the Partners In Health model in Rwanda. The health-care system there had been decimated by the 1994 genocide, in which about 800,000 people—10 percent of the population—had