Paul Farmer

Paul Farmer was one of six children of a restless schoolteacher father who at various times housed the family in a converted bus and a boat moored in a Florida bayou. He won a scholarship to Duke, and as a student began working with Haitian migrant farm labourers picking tobacco nearby. In 1983, before starting at Harvard Medical School, he went to Haiti and found his way to Cange, a settlement of families displaced by a hydroelectric dam, with no clinic and no clean water.

He commuted between Harvard and Cange for years, earning a medical degree and a doctorate in anthropology while treating patients in a squatter camp. With Ophelia Dahl, Jim Yong Kim and others, and money from a Boston businessman named Tom White, he founded Partners In Health in 1987 and built a hospital in Cange that treated people free, paid community health workers to visit patients at home, and refused to accept that anything was too complicated for the poor.

That refusal put him at odds with international health orthodoxy. In Peru in the 1990s his team treated multidrug-resistant tuberculosis with expensive second-line drugs that experts said were not cost-effective in poor countries, and cured most patients; the policy changed. In Haiti they showed the same for HIV treatment. In Rwanda after 2005 they helped rebuild the rural health system.

Tracy Kidder's book Mountains Beyond Mountains made him famous in 2003. He died in his sleep in 2022 at a hospital he had helped build in Butaro, Rwanda, aged 62.