MEMORIAL

In Memoriam: Paul Edward Farmer, MD, PhD (1959–2022): An Extraordinary Physician and Humanitarian of Our Time

Professor Paul Farmer was born on October 26, 1959 in North Adams, Massachusetts, United States, and died on February 21, 2022 in Butaro, Rwanda. He was 62 years old. He was an extraordinary physician who pioneered a novel community-based treatment strategy that delivered high-quality health care in poor settings in the USA, and in poor countries around the world.

He launched the world’s first medical school that was dedicated to global health equity, in collaboration with the Cummings Foundation, the Bill & Melinda Gates Foundation, and the government of Rwanda. University of Global Health Equity (UGHE), Rwanda, accepted its first set of medical students in 2019 to the Butaro Academic Campus, 80 miles from Kigali, Rwanda. He was the chancellor of UGHE, a model academic institution recently praised in the UNESCO Global Education Monitoring report. At the time of his death, he was deeply involved in providing direct health care to the poor people of Rwanda. He was also professor of medicine and chief of the Division of Global Health Equity at Brigham and Women’s Hospital, Boston, USA, and he was the Kolokotrones University Professor and the chair of the Department of Global Health and Social Medicine at Harvard Medical School, Boston, Massachusetts, USA.

Farmer was exposed to challenges early in life by watching his father cope with financial difficulties. To house his eight-member family, his father converted a bus into a mobile home. At one point, he housed his family on a houseboat anchored on a creek. One summer, Farmer’s family worked alongside with Haitian migrant workers picking citrus fruit. This was his early encounter with Haitian people. Despite this humble background, Farmer excelled academically in school and was the president of his high school senior year. He received a scholarship to study at Duke University, Durham, North Carolina, USA. Even at Duke, he spent time at migrant labor camps near the campus. He stood close to them and gained understanding of the plight of the poor. While at Duke, he took half a year to go to Paris to learn French. He became fluent in it, a move that became useful when he moved to the French-speaking Haiti. He later stumbled onto the work of Rudolf Virchow, the 19th century German physician, the father of social medicine. This positively changed Farmer’s career trajectory.

After his premed at Duke University, he completed his medical education at Harvard Medical School with an MD and a PhD in anthropology. He did his residency in internal medicine at the Brigham and Women’s Hospital, where he also did his fellowship in infectious diseases. In 1995/96, our paths crossed at the Brigham and Women’s Hospital, where we were both fellows in the Department of Medicine. He was in infectious diseases, and I was in cardiovascular disease prevention. I was also enrolled for Masters in Public Health degree at the Harvard School of Public Health. We both left Boston in 1996. What I remembered the most about him was his consistency and lack of ambiguity. He was clear, specific, and focused like a laser beam on his mission. Even back then, his determination and devotion to the care of the poor and under-served people of the world was unparalleled. ‘Helping the poor and downtrodden get better health and a better life was my calling’, he once told me. He said, ‘There is nothing I like more than building a hospital – that’s what I call a good pastime. That inspires me’.

Nobel Peace Prize laureate, South Africa’s Archbishop Desmond Tutu once referred to Farmer as ‘one of the great advocates for the poorest and sickest of our planet’. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, USA, and chief medical adviser to the US President Joe Biden, said of Dr. Farmer as ‘He really stands out as one of the most influential global health figures of our time’. Dr. Rochelle Walensky, MD, the director of Center for Disease Control and Prevention, Atlanta, Georgia, USA, said of Dr. Farmer as ‘There are so many people that are alive because of that man’.

Farmer co-founded and served as the chief strategist officer of Partners in Health (PIH), an international nonprofit organization that provided direct healthcare services, research, training, and advocacy for those people who are sick and living in poverty. PIH started operating to help the poor, indigent, and underserved communities in Haiti with one room. At the time of his death, PIH was operating in 16 medical centers and employing over 7,000 local workers and providers in Haiti. Under his leadership, PIH built a hospital in Haiti after the major earthquake that rocked the country in 2010, fought tuberculosis in Peru, assisted Liberia and Sierra Leone during Ebola, and worked tirelessly to stop Zika virus.

His body of work had been published in the Bulletin of the World Health Organization, The Lancet, The New England Journal of Medicine, Clinical Infectious Diseases, the British Medical Journal, and Social Science and Medicine. He has published over 200 scientific papers and several books. His work was described in a 2003 book by Pulitzer-winning author, Tracy Kidder, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, ‘a man Who Would Cure the World’. This book chronicled Dr. Farmer’s work in Haiti, Peru, and Russia.

Farmer was the Editor-in-Chief of Health and Human Rights Journal. He was also on the Board of Trustees for Equalhealth, an organization that builds critical consciousness toward health equity. In 2020, during the COVID-19 pandemic, he worked with PIH to develop a contact-tracing program in Massachusetts.

Farmer was a recipient of numerous honors; they include the 2020 Berggruen Prize for Philosophy and Culture, the Margaret Mead Award from the American Anthropological Association, the American Medical Association’s Outstanding International Physician Award, a John D. and Catherine T. MacArthur Foundation Fellowship, and, with his PIH colleagues, the Hilton Humanitarian Prize. He was a member of the American Academy of Arts and Sciences, and the National Academy of Medicine.

Farmer died in his sleep from an acute cardiovascular event in Butaro, Rwanda, on February 21, 2022. He is survived by his wife, Didi Bertrand Farmer, and their three children. May the Good Lord rest his soul.