Good morning Hank, it's Tuesday.

Today's video was going to be a silly thing about the Project for Awesome fundraiser which begins at midnight tonight, but yesterday I learned that Partners in Health co-founded Dr. Paul Farmer died in his sleep in Rwanda at the age of 62.  Dr.

Farmer devoted his life to improving health care access for the world's poorest people. He was a husband and father. I am devastated for his family.

He also had so many people who considered him a friend and a mentor and I am one of those people.

I don't really know what to say, so I think I'm just going to tell you a story. 

In 2001, the head of the USAID, one of the world's largest health aid organisations told the US Congress that he opposed extending antiretroviral therapy to people living in impoverished countries. He said that such an initiative would inevitably fail, because for the treatment to be effective, the medications must be taken on a schedule and, this is a quote, "these people do not know what watches and clocks are". But that lie had already been exposed, because under Dr. Farmer's leadership, Partners in Health helped pioneer comprehensive HIV care, including antiretroviral therapy in profoundly impoverished communities. Using a network of community health workers, PIH proved that with adequate support and accompaniment, HIV treatment could have similar outcomes in poor countries as in rich ones. 

Today in Haiti, over 12,000 people receive HIV treatment in PIH supported facilities and in Sierra Leone, the average monthly rate of people returning for ongoing HIV care is over 99.9%. 

Similarly, when it comes to multi-drug resistant tuberculosis, Dr. Farmer helped make the case that when treatment is expensive or logistically complicated it is also necessary. As he wrote in his brilliant book Infections and Inequalities: the Modern Plagues, opposition to the effective treatment of MDR TB in developing countries may be justified as sensible or pragmatic, but as a policy, it is tantamount to the different valuation of human life. For those who advocate such a policy, would never accept such a death sentence themselves.

Of course, he would be quick to point out that he was never alone in this work, like partnership is built into the name of Partners In Health, and that was at the foundation of Dr. Farmer's work. Partnerships with hospitals and governments and philanthropists, and most of all with his fellow clinicians. And working together, Paul and his partners proved the world wrong again and again. 

The world said "we can't treat HIV in poor communities" and Dr. Farmer said "yes we can." The world said "a country like Haiti can't have a world class hospital" and Dr. Farmer led the way to the building of the university hospital in Mirebalais. And the world said "there's nothing we can do about the fact that 1 out of every 17 women in Sierra Leone will die in pregnancy or childbirth and Dr. Farmer said "yes there is something we can do about it."

And that is how our community came to support PIH in building a world class maternal and childcare centre at Koidu Government Hospital in Sierra Leone. 


Today, child and maternal mortality are the lowest they have been in human history, and healthcare systems are getting stronger, even in extremely poor communities, but profound health inequities still persist. Paul was never satisfied with progress in a world of such injustice and we shouldn't be either. Healthcare access cannot wait, justice cannot wait. And so his partners around the world will carry forward his legacy. 

I'm going to link to a conversation I had with Paul and another PIHer in November in the dooblydoo, where you can also find a link to the Project for Awesome donation page and to donate to PIH directly. 

The last time I spoke to Paul I asked him what keeps him going in the face of it all, and I can't quote him directly but he said something like "what keeps me going is getting to do hard work with friends." So here's to doing hard work with friends. And to the light that Paul Farmer's life showed all of us. 

Hank, I'll see you on Friday.