Paul Farmer’s Public Health Revolution

April 15, 2011

We kicked off the second afternoon of the GPF 2011 Conference with remarks from a giant in public health: Dr. Paul Farmer, Co-founder, Partners in Health. Paul is leading the revolution in the way we think about health, not the least of which includes pushing us to think about healthcare as a human right.  Today, Paul chastised all of us – himself, the health sector, philanthropists – for our radical failure of imagination in envisioning how to provide high-quality healthcare to the poor. We must stop “low-balling” our standards for healthcare just because it’s for poor people, he argued.

With the tools we have at our disposal right now, high-quality healthcare for the poor is a realistic goal. And one that has a high return on investment.  Our inability to recognize this up until now points to one of Paul’s “five sins” in the public health debate: the untallied cost of inaction. Often we are plagued by health “sticker shock” – aversion to the costs required for implementation of health options for the poor. Yet we do not weigh these costs against the tremendous costs of inaction – the social costs of orphaning or lost income and of out-of-pocket health expenditures, among others.  These costs are significant and dramatically overshadow the costs of action.

Three speakers followed Paul, each speaking about progress in disease eradication, in the cases of polio, guinea worm, or meningitis. A common theme was the need for long-term commitment, and a willingness to look beyond returns on investment over one quarter, or one to two years.  Returns in health take time, but are worth the wait.  And in these three cases, eradication can be achieved with only an incremental expenditure.  

And so, we must usher in “long-term-ism” to replace our “short-term-ism.” Solving the problems of health and poverty, whether in Haiti or Boston, will require sustained and patient investment. A much-needed revolution in public health is happening right now – and, with Paul Farmer at the wheel, I think we are in good hands.


Jane Wales, President & Co-founder, Global Philanthropy Forum


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