You know you’re a global health rock star when you can tease the Bill & Melinda Gates Foundation on its home turf and get away with it.
That was what Paul Farmer did last night as the keynote speaker for the Seattle Biomedical Research Institute’s Passport to Global Health fundraiser. Farmer is best known as the protagonist in Tracy Kidder’s book Mountains Beyond Mountains, which tells the story of how Farmer found his calling as a young doctor at Harvard to treat the serious illnesses of the world’s poorest people. He spoke to a crowd of several hundred people gathered for dinner at the Washington State Convention and Trade Center.
Farmer peppered his talk with lots of side references and jokes. “I like to use levity when I feel emotional,” he said at the beginning.
For people in global health outside of Seattle, the Bill & Melinda Gates Foundation is simply known as “The Foundation,” sort of like how the CIA is known to some as “The Firm,” Farmer said. And even though “The Foundation” is famous for insisting on metrics of progress before they write checks, Farmer resisted using any statistics at all to describe his fight against global scourges like tuberculosis.
Instead, Farmer used an old-fashioned storytelling narrative to show how his work can make a difference. He showed a picture of a young boy in Haiti who came into the clinic looking skeletal, suffering from TB. He was put on “lots of drugs, high doses, never miss a dose,” the tenacious regimen that Farmer and his colleague from Partners In Health, an international healthcare nonprofit, swear by.
Once the drugs went to work, he needed to put on his medical detective hat and find out where the TB came from to cut it off at the roots. Most kids spend their time in two places—school and home. So he investigated, and found out the boy’s father had TB, too, and needed treatment.
After getting to the bottom of this, Farmer said self-deprecatingly, “They get better, I forget about them.” He lost track of the boy after the treatment.
Nine years later, the little boy has grown up into a teenager, and he recently sent a photo to Farmer via e-mail to provide a progress report. The crowd ooohed when Farmer showed the picture of an athletic-looking young man, smiling, wearing a black Air Jordan T-shirt that would make him fit in at any American mall.
All this is happening on what Farmer called “the delivery end” of global health, but he said none of it would be possible without what scientists like those at Seattle Biomedical Research Institute do on the “discovery end.” And he reminded the audience that there’s an enormous amount of work to do on discovery. TB, for one example, hasn’t had any innovative new drugs come along in decades, there’s no vaccine, and diagnostics aren’t very accurate. “I want everybody here in the lab to stay in the lab,” Farmer says.
Farmer, who started out in the global health field 26 years ago, long before it could pull together swanky fundraisers like this one, closed his talk by reminding people how far the field has come.
“This city and a number of institutions here have performed CPR on international health,” Farmer said. “It was not a growing field, it was not drawing young people. It was kind of a hangdog, depressed field.” That’s all changed now, he said. “I think we’re on a path to real progress in global health and reversing epidemics.”
