Paul Farmer, a global health pioneer and the world's 'most extraordinary medical humanitarian,' dies at 62

·6 min read
Dr. Paul Farmer was chair of the Department of Global Health and Social Medicine at Harvard Medical School and co-founder of Partners in Health.
Dr. Paul Farmer was chair of the Department of Global Health and Social Medicine at Harvard Medical School and co-founder of Partners in Health.

Dr. Paul Farmer, a giant in the field of global health, professor at Harvard Medical School and co-founder of the nonprofit Partners in Health, died Monday in Butaro, Rwanda, in a hospital he helped build.

The cause was not announced, but his death was confirmed by Sheila Davis, executive director of Partners in Health.

Farmer, 62, spent his professional life fighting for quality medical care for people regardless of their income, race or geography. That quest brought him to some of the poorest places in the world, including Rwanda as it rebuilt from genocide in 1994, Peru as it battled an epidemic of drug-resistant tuberculosis and Russian prisons overrun with HIV.

He began his medical career in rural Haiti and helped build infrastructure in that country through Partners in Health, which led a medical response to the devastating earthquake there in 2010.

Farmer was "the most extraordinary medical humanitarian the world has seen in our times," said Dr. Arthur Kleinman, a Harvard professor who trained Farmer in the field of medical anthropology, the specialty they shared.

Farmer, who held a medical degree and a doctorate in medical anthropology from Harvard, did not lead an army or a country but had that level of global importance and leadership ability, Kleinman said. "That's what Paul was."

"He had a lightness of being," Kleinman said, that would animate people from students to patients to taxi drivers. "It was as if something came from Paul that was transmitted to the other person."

He used that connection with others to convince drug companies to lower the price of HIV drugs, funders to support his work, patients to follow his advice and legions of students to enter the field of public health.

"The number and diversity of people who Paul Farmer inspired to pursue justice through health is simply incalculable," Jonathan Cohen, a professor at the Institute on Inequalities in Global Health at the University of Southern California, wrote on Twitter Monday. "This is a titanic loss for global health that will reverberate for generations to come."

Anatole Manzi, a Rwandan nurse who worked with Farmer since 2005 and is deputy chief medical officer for Partners in Health, said his mentor taught him to be a professional caregiver.

"He's the one who taught me food is cure. He's the one who told me I should make sure patients have food before I even talk about tablets," Manzi said.

Not until Farmer put it into words did Manzi realize that poverty was making people sick.

Farmer taught him to dream big, then make that dream a reality.

At first, Manzi struggled to get his head around Farmer's vision of rebuilding the Butaro region's sole hospital, which had been left an abandoned shell more than a decade earlier. At the time, tuberculosis and HIV patients lined up for hours at the region's only clinic, where Manzi was a nurse.

"His words were – I don't want to say 'magic' – but the magic happened," Manzi said. "In some ways, I thought he was just crazy saying an abandoned hospital would reopen."

But Farmer, working with Manzi and one other colleague, made it happen. In 2008, the rebuilding started, and the hospital sits in a striking building, alongside a university.

"Every time we would just try to dream small, he would always amplify, turning any small dream into a gigantic action," Manzi said.

Farmer was the subject of a 2003 book by Tracy Kidder called "Mountains Beyond Mountains," which described his hardscrabble upbringing with five siblings and their teacher father who housed the family in a school bus in Florida.

Much of Kidder's book features Farmer's work in Haiti, where he transformed medical care in the rural area around the village of Cange.

"He saved many lives in Haiti," said Michèle Duvivier Pierre-Louis, a former Haitian prime minister, who knew Farmer from his earliest days as a doctor. He was known as "le docteur des pauvres," the doctor of the poor.

"He never stopped fighting against poverty and also the stigmatization of poverty on Haiti," Pierre-Louis said. "Lots of people who have been trained by him in Haiti and other countries will continue his work."

Farmer and his life and work were the subject of a 2017 documentary, "Bending the Arc."

He wrote a dozen books on different aspects of global health. His most recent, "Fevers, Feuds, and Diamonds: Ebola and the Ravages of History," focused on the Ebola epidemic of 2014-2015, the patients he met while fighting it and the mistakes he said were made by his own organization and others who tried to help.

Lawrence Gostin, a professor of global health law at Georgetown University, described Farmer as "the world's most powerful advocate for health and justice."

"He believed everyone has the right to the same cutting edge treatments as are available in the United States and other rich countries," said Gostin, who knew Farmer since the early days of the HIV/AIDS epidemic.

Many of the people Farmer taught and mentored at Harvard Medical School became leaders in global public health.

Later in his career, Farmer became more interested in public policy and worked to transform the system of international aid from its focus on charity and dependence to empowerment and building local capacity, USC's Cohen said.

"The legacy they leave behind is more doctors, more nurses, stronger institutions, a greater sense of pride in a health system that has been very much neglected if not rattled by the international aid system through the years," Cohen said. "You can measure the impact in terms of lives saved, but also a more sustainable health system."

His impact stretched beyond patient care.

Michael Murphy was an architecture student at Harvard when he heard Farmer speak and decided to volunteer with Partners in Health. A few years later, Murphy formed a firm, the Model of Architecture Serving Society (MASS) Design Group, to build that hospital in Butaro.

It was based on Farmer's philosophy that the poor deserved more than the most basic facilities, that "dignity is something we can't afford not to have and push for," Murphy said.

The firm, which built other Partners in Health buildings, was awarded the 2022 American Institute of Architects Architecture Firm of the year and is considered a model for the field.

Although Farmer wrote like a scholar, he talked like a regular guy, keeping up with the Red Sox and the reading recommendations of friends and remembering details about the children of acquaintances.

He was hilarious and accepted people for who they were, former colleague Jennifer Goldsmith said. "He didn't judge other people," Goldsmith said. "He was just unfailingly kind and unfailingly funny."

During the COVID-19 pandemic, he and Partners in Health performed contact tracing for a handful of states and spoke out against inequities in vaccination and care.

A nonstop traveler before the pandemic, he spent most of the past two years working out of his home in Miami, Goldsmith said, tending to his beloved garden.

Farmer's friends often accused him of being “pathologically optimistic,” seeing promise in seemingly hopeless situations.

In an interview with USA TODAY in 2020, he had a different take: "The thing about idealism, is if you can always link it to pragmatism, you’re going to be OK."

Farmer is survived by his wife, Didi Bertrand Farmer, and their three children, Catherine, Elizabeth and Sebastian; his mother, Ginny; his sisters, Katy, Jennifer and Peggy; and his brothers, Jim and Jeffrey.

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: Paul Farmer, global health pioneer and Harvard professor, dies at 62