A human rights view of health care

“What is the cost of not doing the right thing?” Paul Farmer, M.D., Ph.D., asked in March during a talk sponsored by the Diversity Action Committee at the School of Nursing. With that question he challenged the cost-benefit analysis that underpins most global health projects.

In Haiti, where he has spent most of his career, no patient, he said, has ever told him, “Thank you very much for offering me this therapy, but it’s really not cost-effective here.”

In 1987 Farmer co-founded Partners In Health (PIH), which is dedicated to improving health care in poor countries. PIH’s low-cost projects have achieved impressive outcomes in settings where resources were thought to be too scarce to make modern interventions practical. Their cure rate for multidrug-resistant TB—using innovative drug procurement strategies and locally trained community health workers—was 83.3 percent in the slums of Lima, Peru. The same model delivers antiretrovirals for aids patients in rural Haiti and in inner-city Boston.

He urged his listeners to have a “technically correct human rights perspective,” in which feasibility is a problem to be solved, rather than an excuse for inaction.