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Infections and Inequalities

The Modern Plagues, Updated with a new preface

Paul Farmer (Author)


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ISBN: 9780520927087
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Paul Farmer has battled AIDS in rural Haiti and deadly strains of drug-resistant tuberculosis in the slums of Peru. A physician-anthropologist with more than fifteen years in the field, Farmer writes from the front lines of the war against these modern plagues and shows why, even more than those of history, they target the poor. This "peculiarly modern inequality" that permeates AIDS, TB, malaria, and typhoid in the modern world, and that feeds emerging (or re-emerging) infectious diseases such as Ebola and cholera, is laid bare in Farmer's harrowing stories of sickness and suffering.

Challenging the accepted methodologies of epidemiology and international health, he points out that most current explanatory strategies, from "cost-effectiveness" to patient "noncompliance," inevitably lead to blaming the victims. In reality, larger forces, global as well as local, determine why some people are sick and others are shielded from risk. Yet this moving account is far from a hopeless inventory of insoluble problems. Farmer writes of what can be done in the face of seemingly overwhelming odds, by physicians determined to treat those in need. Infections and Inequalities weds meticulous scholarship with a passion for solutions—remedies for the plagues of the poor and the social maladies that have sustained them.

Paul Farmer directs the Program in Infectious Disease and Social Change at the Harvard Medical School and divides his clinical time between Boston's Brigham and Women's Hospital and the Clinique Bon Sauveur in central Haiti. He is the author of AIDS and Accusation (California, 1992), which was awarded the Wellcome Medal, and The Uses of Haiti (1994), and editor of Women, Poverty and AIDS (1996), which won the Eileen Basker Prize.

"A strangely uplifting read. Infections and Inequalities is a powerful and rigorously argued critique of economic and health care inequality."—Phil Whitaker, The Guardian (UK)

"The only things that distinguish Farmer's account from a Dostoevskian novel is a meed of hard, effective science and a depressingly familiar story of the powerfully malignant of racism. . . . It is hard to think of more compelling examples to underpin his arguments. It makes the book and its message accessible to the general reader and forcefully reminds doctors, nurses, scientists, sociologists, economists and aid workers of their unfinished business. . . .But the main lessons he draws are for us all. We must do all we can to diminish social inequality."—Hugh Pennington, Times Higher Education Supplement

"Bolstered by thorough knowledge of the countries in which he practices, relevant and cogent case histories, and a caring but disciplined attitude, Farmer powerfully argues for substantial changes in epidemiological theory and practice. He raises thought-provoking and necessary questions, and he provides answers that, if often unsettling, are pertinent and capable of beng put to use by individuals and governments truly interested in solving, not sidestepping, life-threatening situations."—William Beatty, Booklist

“[Farmer's] message is urgent and relevant for saving millions of lives.”—Christian Century


"Farmer's work diverges strikingly from the current 'emerging infectious disease' literature, much of which misses essential points about causation that Farmer brings out very well. . . . It is sure to appeal to those general readers attracted to books like Garrett's The Coming Plague, as well as to readers in medicine, public health, and the sociomedical sciences."—Frederick L. Dunn, M.D.

"Farmer argues against those who would insist that the health problems of the poor require and must await structural changes, that underdevelopment negates the efforts of physicians. He believes there is much that doctors can do, not simply as activists but as physicians."—Randall Packard, author of White Plague, Black Labor

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