Dr. Paul Farmer, a renowned American professor and physician, came to Miami University to speak about his opinions on social justice and global health equity.
One of the biggest problems that Haiti, and many third world countries, are facing today is the AIDS epidemic. There has been a marked decrease in life expectancy in sub-Saharan Africa since the AIDS epidemic broke out. Interestingly enough, the United States has seen a decreased death expectancy related to AIDS during the same time period because of effective anti-retroviral therapy provided everyday. The therapy consists of a cocktail of drugs to slow the rate of resistance in the viruses, and they act to prevent immune system suppression that could cause serious nosocomial infections. HIV prevalence is hugely concentrated in Africa, while the physician prevalence is concentrated in first world countries, like the United States. This demonstrates that the global health perspective needs to be altered to accommodate for areas that need more help.
Dr. Farmer stressed the importance of pushing for a treatment agenda. Many people have asked him if his plan to help these third world countries is “cost-effective.” The drug procurement team is responsible for shuttling HIV/AIDS drugs to places like Haiti. In 2002, it cost United States AIDS patients $10,220 for three treatments, while it cost the drug procurement team $701 for three treatments of African AIDS patients. Since then, that number has decreased to $120 for three treatments. This is a demonstration that prices can be renegotiated by the government to make programs like the PIH cost-effective.
Dr. Farmer also emphasized the important role that the community has played in Haiti and Rwanda in order to get these medical facilities working. According to the Durban declaration, places like Haiti and Rwanda need community health workers, not just doctors, to create functioning medical facilities in third world countries. Community based care is extremely important in these countries because it provides the people with jobs, thus attempting to halt the continuous cycle of poverty. It is a low cost program that yields highly effective results. It is attacking poverty directly by providing jobs with dignity to the people who need it most. By slowing down the rate of poverty, it gives the people there a chance to make a change and fight the diseases and gender inequality that they experience everyday. With American support, they can use their AIDS money to rebuild the faulty health systems. In Haiti and Rwanda, PIH has helped rebuilt 7 hospitals in 4 years.
Since 2001, Dr. Farmer has noticed that more resources are now available to make these ideals possible. The debate has significantly changed, considering that a few years ago people never thought to treat these African AIDS patients and now they want to know how to best treat the them. There is more political will, money, and more abundant, inexpensive medications that are now available. Another point Dr. Farmer made was that there has been a change in the attitude of the people living in these countries since the quality of care has improved dramatically. Pregnant women are getting tested for AIDS at prenatal care clinics in order to prevent the disease transmission from mother to child.
Organization like the PIH tend to target universities as sources of volunteers to help out with the cause. A change needs to be made, in that there needs to be a more significant link between service and solid teaching/research. The United States is renowned for their research capabilities and teaching programs, but all of that work is lost if it cannot be applied to real situations. One cannot cross the social or historic boundaries without service.
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