Speaker 1: Pushkin, this is solvable. I'm Jacob Weisberg. In my lifetime too,
Speaker 1: and I'm sixty one. I have never seen this level
Speaker 1: of engagement in attention to the social pathologies that face
Speaker 1: us and also the pathogens that face us beyond the
Speaker 1: social pathologies. According to the UN, disruptions resulting from the
Speaker 1: global pandemic could push an estimated seventy one million people
Speaker 1: back into extreme poverty. That represents the first rise in
Speaker 1: extreme poverty since nineteen ninety eight. With every ounce of
Speaker 1: our energy, we need to direct ourselves to making this
Speaker 1: a temporary setback. Today we're bringing you the first episode
Speaker 1: in our Setback series, a collection of conversations about the
Speaker 1: pandemics impact on education, hunger, and of course global health.
Speaker 1: And it's fitting that we're starting today with one of
Speaker 1: my personal heroes, doctor Paul Farmer. As much as anyone
Speaker 1: I can think of, Farmer has changed the way the
Speaker 1: world looks at the unequal distribution of healthcare. He has
Speaker 1: spent the last forty years committed to improving health equity
Speaker 1: across the world, most notably establishing long running medical support
Speaker 1: services for communities in Haiti and Rwanda. He's the author
Speaker 1: of a fascinating new book that I'd call a medical
Speaker 1: and moral thriller. It's titled Fevers, Feuds, and Diamonds, about
Speaker 1: the twenty fourteen Ebola outbreak in West Africa. It's intensely
Speaker 1: relevant to understanding the global impact of COVID nineteen. Everyone
Speaker 1: knows that COVID vaccines are being distributed unequally. What's less
Speaker 1: appreciated is that disruptions from the pandemic are increasing inequality
Speaker 1: in the distribution of other health resources. This could ultimately
Speaker 1: lead to hundreds of thousands of additional deaths for children
Speaker 1: under five, and caused tens of thousands of additional maternal deaths.
Speaker 1: And I retain plenty of optimism. We have tools at
Speaker 1: our disposal that would have been unimaginable just a couple
Speaker 1: of decades ago, but the will to deploy them and
Speaker 1: deploy them justly still has to be summoned. In April
Speaker 1: twenty twenty, the World Health Organization, along with the European
Speaker 1: Commission and the Bill and Melinda Gates Foundation, launched a
Speaker 1: plan to get COVID vaccines to low income countries. It's
Speaker 1: referred to as covacs. There are many reasons to do
Speaker 1: this and The best ones, in my view are that
Speaker 1: science and the fruits of science ought to be evenly
Speaker 1: distributed like human capacity is. For all the devastation he seemed,
Speaker 1: Farmer remains hopeful that the setbacks from the pandemic don't
Speaker 1: have to mean a more unequal distribution of healthcare going forward.
Speaker 1: I'm Paul Farmer. The inadequate health resources of pork in
Speaker 1: a poor underserved people in affluent ones are a problem
Speaker 1: we can solve. Paul Farmer is a professor at Harvard
Speaker 1: Medical School, chief of Global health Equity at Brigham and
Speaker 1: Women's Hospital in Boston, and the co founder of the
Speaker 1: organization Partners in Health. I began by asking him to
Speaker 1: describe the global healthcare situation in his own words. Well,
Speaker 1: I mean, right now, we could focus almost entirely on
Speaker 1: the setbacks. You know, one of the biggest problems we've
Speaker 1: faced all over the world is that with a shutdown,
Speaker 1: obviously people aren't able to readily access their care. What
Speaker 1: if they have cancer, what if they have diabetes, what
Speaker 1: if they have severe hypertension. So you know, those are
Speaker 1: ranking problems I think to anybody who's involved in global health.
Speaker 1: But that's just the tip of the Iceberg. A lot
Speaker 1: of the efforts that we have engaged in to address
Speaker 1: social determinants of ill health are also being setback. Economic
Speaker 1: educational programs, cultural endeavors, employment opportunities. There's been a major
Speaker 1: contraction and anti poverty efforts overall. So it's going to
Speaker 1: be a troubling reflection on what's happened this past year
Speaker 1: and a last I'm worried it's going to be projected
Speaker 1: forward into a future as well. Paul. There are two
Speaker 1: different ways to think about the future in this setback.
Speaker 1: One is that it's just a temporary setback where we
Speaker 1: lose a year and quickly get back to where we were.
Speaker 1: The other is that it's a twenty year setback. How
Speaker 1: do you see it, well, I mean I see it
Speaker 1: as a struggle between those two options. With every ounce
Speaker 1: of our energy, we need to direct ourselves to making
Speaker 1: this a temporary setback. That's going to require rapid engagement
Speaker 1: in responding to some of these social problems and medical
Speaker 1: problems and health problems. But every week, month, season that
Speaker 1: goes by where we can't point to a resumption of
Speaker 1: some of these economic and social activities is going to
Speaker 1: mean more likelihood that the setback will endure, and so
Speaker 1: I mean, I retain plenty of optimism. We have tools
Speaker 1: at our disposal that would have been unimaginable just a
Speaker 1: couple of decades ago, but the will to deploy them
Speaker 1: and deploy them justly still has to be summoned. There's
Speaker 1: certainly more consciousness about healthcare disparities in this country on
Speaker 1: the basis of race and socioeconomic status. Then I remember
Speaker 1: in the conversation for a long time, do you see
Speaker 1: the pandemic as any kind of awakening, either in the
Speaker 1: United States or globally about the disparities between the global
Speaker 1: North and the global solve wealthier countries and poorer countries.
Speaker 1: For sure. I mean in my lifetime too, and I'm
Speaker 1: sixty one, I have never seen this level of engagement
Speaker 1: in attention to the social pathologies that face us, and
Speaker 1: also the pathogens that face us beyond the social pathologies.
Speaker 1: So you know they're they're from the very beginning, even
Speaker 1: before the murder of George Floyd, there was reason to
Speaker 1: think that, you know, such a catastrophic series of events
Speaker 1: could awaken a lot of people about the need for
Speaker 1: a better safety net, for example, health insurance, unemployment, insurance
Speaker 1: protection for vulnerable workers, prisoners, people who've been you know,
Speaker 1: shoved around onto reservations and meat packing plants. I think
Speaker 1: that sense of possibility is still very much alive, this
Speaker 1: heightened awareness of our vulnerability, of our collective vulnerability, but
Speaker 1: also our heightened awareness of the inequalities of vulnerability. So
Speaker 1: you know, I would proceed up domistically even if I
Speaker 1: weren't convinced, because that may be just psychologically necessary. But
Speaker 1: I think this is very real, and we have to
Speaker 1: act promptly while people are still alive to some of
Speaker 1: these challenges before they fade away. Your new book, Fevers, Feuds,
Speaker 1: and Diamonds is about the Ebola epidemic that broke out
Speaker 1: in West Africa in two fourteen, and one of my
Speaker 1: takeaways reading it was that a lot of the harms
Speaker 1: we think of as coming from the disease are really
Speaker 1: the harms coming from the underlying healthcare system, in place
Speaker 1: or not in place. What I mean is that, right
Speaker 1: that we are attributing things to the novelty of a
Speaker 1: virus that in many case just project reflections of what
Speaker 1: was there in terms of our capacity to deal with
Speaker 1: a healthcare crisis of any kind. You know every time
Speaker 1: there is a health crisis, and a pandemic is the
Speaker 1: classic example. Once you're sick, who lives and who dies?
Speaker 1: And on both scores, I think we're seeing, not just
Speaker 1: in the United States but across the world, a reflection
Speaker 1: not just of the novelty of the pathogen, but what's
Speaker 1: the opposite of novelty, the longstanding nature of our social pathologies.
Speaker 1: Social disparities are our social pathologies make things worse. The
Speaker 1: good news is that means we can alter that risk,
Speaker 1: because although we don't alter the shape of viruses, yet,
Speaker 1: we can't alter the shape of our social conditions. I
Speaker 1: think often about an article you wrote some years ago
Speaker 1: that I think might have had that title, who Lives
Speaker 1: and Who Dies? And you talked about, if I remember
Speaker 1: it right, what you called stupid death, and you told
Speaker 1: the story of a traffic accident you had I think
Speaker 1: maybe when you were still a medical student or many
Speaker 1: years ago, when you were hit by a car and
Speaker 1: it was theorious but because you've got high quality medical care,
Speaker 1: we lived, and probably it didn't it didn't do you
Speaker 1: the kind of permanent harm it would have somewhere else
Speaker 1: in the world. And then you talked about another accident
Speaker 1: to someone you knew, I think in Haiti. You know
Speaker 1: the term that I got, that expression stupid deaths from
Speaker 1: from Haiti. I heard it in my first years there,
Speaker 1: and I went there in nineteen eighty three for the
Speaker 1: first time, and I'm still working in the same parts
Speaker 1: of Haiti. And you know, in those early years, not
Speaker 1: only did I hear about stupid deaths, I saw some
Speaker 1: of them. And those happened to be the years in
Speaker 1: which I was hit by a car in Cambridge, Massachusetts,
Speaker 1: and knew right there lying in the street that you know,
Speaker 1: I would be okay, you know, And I was comparing
Speaker 1: that to the kind of circumstance that is faced by
Speaker 1: all too many to this day. You know. It's it's
Speaker 1: as if, you know, someone would say to you after
Speaker 1: you've been hit by a car, well, you should have
Speaker 1: looked both ways before you crossed the street, right, And
Speaker 1: it's not very helpful to look back and explain away
Speaker 1: these disparities of risk and outcome without making an intervention
Speaker 1: to lessen that risk. Here we're facing a respiratory pathogen
Speaker 1: and it's a different set of needs, but I think
Speaker 1: the needs are nonetheless material as well as social meaning,
Speaker 1: you know, do we have the staff, the stuff, the space,
Speaker 1: and the systems to respond to our health crisis. So
Speaker 1: right now we're talking about COVID, but we could be
Speaker 1: talking about surgical trauma, or AIDS, or ebola or any
Speaker 1: one of a series of maternal mortality and Sierra leone.
Speaker 1: Each of those problems requires and always has a set
Speaker 1: of material responses, which you know, I've just summarized as staff, stuff, space, systems,
Speaker 1: and support. And I got all that, you know, as
Speaker 1: a medical student transferred from one hospital to another and
Speaker 1: then to rehab and then to having surgical care that
Speaker 1: I needed, except I knew I would those disparities staff stuff, systems.
Speaker 1: It's a bit of a tongue twister. I think I
Speaker 1: got it right. Are not exactly reflected with COVID nineteen
Speaker 1: the way you might expect. There's an article in The
Speaker 1: New Yorker that Sanartha Mukherjee wrote that looks into that
Speaker 1: a little bit. Nigeria, for example, one of the countries
Speaker 1: you talk about in your book in relation to ebola,
Speaker 1: doesn't seem to be getting hit at hard. United States,
Speaker 1: obviously wealthiest country, you know, most expensive systems, has gotten
Speaker 1: hit very hard, but focusing particularly on the question that
Speaker 1: why some poorer countries, some countries in the developing world,
Speaker 1: are not having the experience of the pandemic that's a
Speaker 1: severe Why do you think that is? Well, you know,
Speaker 1: I'm going to try and resist the conventional explanations. I
Speaker 1: will mention them. They include the age structure of the population.
Speaker 1: There's less obesity, there's asthma, diabetes, hybrid tension, there's perhaps
Speaker 1: less of it in a largely younger population. But instead
Speaker 1: of focusing on the susceptibility or the nature of the
Speaker 1: virus alone, it's also a risk to focus on the
Speaker 1: nature of the individual and the physiology of an individual alone,
Speaker 1: and instead we have to also bring into other questions
Speaker 1: like it's not unthinkable, of course, that some of these
Speaker 1: places have had very robust public health responses to COVID,
Speaker 1: and that they deserve some of the credits, the credit
Speaker 1: the humans deserves some of the credits for having been
Speaker 1: the architects of this response. Let me just take Rwanda,
Speaker 1: a country where I lived on and off for a decade.
Speaker 1: The quality of their response to COVID, both in terms
Speaker 1: of prevention and in care, has been pretty pretty damn good.
Speaker 1: So all this to say, Jacob, I think that when
Speaker 1: we go back, or when we start to explore this
Speaker 1: even now, we're going to be called to come up
Speaker 1: with lists of factors that could explain these disparities and
Speaker 1: also sort them out and put them in order. I
Speaker 1: imagine that folks in Singapore and China and Taiwan are
Speaker 1: justifiably proud of their ability to bring this their fraction
Speaker 1: of the pandemic under control. We could be justifiably proud,
Speaker 1: for example, in the United States, of our ability to
Speaker 1: martial scientific research to come up with vaccines in such
Speaker 1: short order. But we're probably not called to be proud
Speaker 1: of our public health delivery system, which is very patchwork
Speaker 1: and it's also underfunded massively. If you were to compare
Speaker 1: Rwanda to the United States, not just in terms of
Speaker 1: their programmatic response to the pandemic, but the fraction of
Speaker 1: their public treasury that they put into public health and healthcare,
Speaker 1: it's much much larger than the United States the public treasury.
Speaker 1: So they're also prioritizing public health very high up on
Speaker 1: their agenda. It's not some black box mystery where we
Speaker 1: have to say, well, what is it about Rwandans that
Speaker 1: makes them so invulnerable to disease. It's not the case
Speaker 1: at all. It's rather, what is it about their response
Speaker 1: that has made them able to do a better job
Speaker 1: than we have here in the United States. The reason
Speaker 1: to ask that is not to win an argument, but
Speaker 1: rather to learn from our colleagues and the experience of Rwanda. Paul,
Speaker 1: you've talked about a kind of nihilistic thinking which can
Speaker 1: take effect in relation to public health problems that seem insoluble. Recently,
Speaker 1: I've seen you use this term containment nihilism to talk
Speaker 1: about what we can't do in relation to the pandemic.
Speaker 1: Can you explain a little more what you mean about that.
Speaker 1: You know, one of the things that I've seen again
Speaker 1: and again in my clinical practice over the years is
Speaker 1: clinical nihilism. You know, the argument that, oh, we can't
Speaker 1: do anything for these people, they're too poor. It's not
Speaker 1: cost effective, not feasible, not sustainable, not even prudent. Now,
Speaker 1: of course, those are also predominantly black and brown people, right,
Speaker 1: So that's clinical nihilism, and it's a very hard sell
Speaker 1: in the United States, you know, I mean, would you
Speaker 1: openly argue for a different standard of care for the
Speaker 1: bronx than Manhattan. It would be a very difficult sell politically.
Speaker 1: It's the functional equivalent of Jim Crowe. But it's just
Speaker 1: not something that you can sell. But we do see
Speaker 1: a different kind of nihilism in the United States, and
Speaker 1: that's containment nihilism. And it was so striking, you know,
Speaker 1: every time we made a suggestion like we should do
Speaker 1: more contact tracing, we'd find takers, even governors of entire
Speaker 1: states like Massachusetts. Right, But it's not anything that ever
Speaker 1: became a national program yet. That's containment nihilism, right. And
Speaker 1: then after the really dramatic moment of having the President
Speaker 1: of the Republic gets sick, you remember the next day
Speaker 1: after his hospitalization, his chief of staff said, we are
Speaker 1: not going to contain the pandemic. We're going to only
Speaker 1: do this through vaccination. So again, that's about as eloquent
Speaker 1: a statement of containment nihilism as you can get. It's
Speaker 1: a great phrase for surrender. It's a great it's a surrender. Right. Unfortunately,
Speaker 1: even with great vaccines, we have to do contact tracing,
Speaker 1: we have to observe social distancing, we have to mask
Speaker 1: all of the conventional public health demands really are still
Speaker 1: out there and we'll be around for a while. But
Speaker 1: containment nihilism is not what we saw in the Ebola
Speaker 1: epidemic and West Africa. There was clinical nihilism, and I
Speaker 1: think here in the States we're seeing a lot more
Speaker 1: containment nihilism. Paul, How does the roll out of vaccination
Speaker 1: globally look to you in terms of equity? I mean,
Speaker 1: there are many developing countries where essentially no one has
Speaker 1: been vaccinated. As you said, the vaccination seems to be
Speaker 1: part of the success story. That say, it's both in
Speaker 1: terms of the development and the rollout. I don't know. Overall,
Speaker 1: it's not going badly. The numbers that are accelerating, you know,
Speaker 1: things seem pretty good. But we just see this vast gap.
Speaker 1: You know, it seems that our whole country is going
Speaker 1: to be vaccinated before a lot of poor countries are
Speaker 1: vaccinated at all. Yeah, I mean, this is the great worry.
Speaker 1: I will say that there's a fairly massive coalition of
Speaker 1: people coming together to try and diminish vaccine inequality or
Speaker 1: vaccine apartheid, or wherever we call it. I mean, supply
Speaker 1: is the problem. There will be other problems with distribution,
Speaker 1: but you can't have the distribution challenges if you don't
Speaker 1: have the supply the mechanisms that have been pulled together
Speaker 1: to address this, and you've probably already heard of or
Speaker 1: spoken about covacs, but the targets are still not high enough.
Speaker 1: They're not as high as the R oneans want them
Speaker 1: to be. It's something like countries with barely more than
Speaker 1: ten percent of the world's population have already cornered the market,
Speaker 1: have already bought actually about half of all the doses.
Speaker 1: And you know there are going to be lots of
Speaker 1: complaints about that, of course, and legitimate complaints, so we're
Speaker 1: really going to have to again redouble our efforts to
Speaker 1: address this. The timeline of implementation, if you want to
Speaker 1: call it that, the time between the development of an
Speaker 1: effective technology that could be a medicine or a vaccine
Speaker 1: and its widespread distribution is usually measured in decades. But
Speaker 1: as people now know in the United States as well,
Speaker 1: if there's ongoing community transmission of the coronavirus, the novel coronavirus,
Speaker 1: then there's going to be ongoing mutation and the emergence
Speaker 1: of new and more troubling variants, which is already occurring,
Speaker 1: is sure to increase so that's one of the you know,
Speaker 1: one of the reasons that I'm not suggesting we use
Speaker 1: fear to stimulate more investment in vaccine equity. I'm just
Speaker 1: saying people should know that there is a There are
Speaker 1: many reasons to do this, and the best ones, in
Speaker 1: my view, are that science and the fruits of science
Speaker 1: ought to be evenly distributed, like human capacity is. We
Speaker 1: got the COVID nineteen vaccine really fast. The system worked
Speaker 1: in that case, but for other diseases that primarily affect
Speaker 1: the global South, we don't have vaccines, or at the
Speaker 1: very least, vaccine development can take a very long time.
Speaker 1: So how can we have a system that does a
Speaker 1: better job of eradicating diseases that primarily affect the developing
Speaker 1: world and not the rich countries. Sometimes we talk about
Speaker 1: the discovery science, right, the basic science, discoveries, the development
Speaker 1: of the new tools, A lot of that is done
Speaker 1: by pharma and biotech, right, and then finally the delivery.
Speaker 1: So getting from the first day of discovery to the
Speaker 1: third day of delivery requires the assistance. I'm sure a
Speaker 1: lot of these companies that you know are know how
Speaker 1: to make tools, whether those be medical treatments, or vaccines,
Speaker 1: So we just need to bring everybody on board. I
Speaker 1: don't want to sound like I'm singing kumbaya, but again,
Speaker 1: there's even a cold headed logic would say, well, if
Speaker 1: there's already COVID vaccine in rural Rwanda, that means that
Speaker 1: you could move quickly. It's possible to see vaccine in
Speaker 1: the field in the arms of people who in the
Speaker 1: past have been shut out of medical modernity. But they
Speaker 1: don't need to be. And that's one reason that my
Speaker 1: solvable problem is to argue that these are not insurmountable problems,
Speaker 1: none of them. Yeah, that's really interesting. I mean you've
Speaker 1: changed the terms of the debate from how do you
Speaker 1: do it? Instead of whether it can be done? You've
Speaker 1: made it. Yeah, I hope that. I hope. I mean
Speaker 1: I would love to claim that I put that on
Speaker 1: my tombstone, know because you know, how are you going
Speaker 1: to put a man on the moon with that kind
Speaker 1: of logic? You know, can we do this? It had
Speaker 1: to be how do we do this? I assume, I
Speaker 1: mean I wasn't there, but that's when you didn't take on. Yeah,
Speaker 1: in medicine and public health, it's hard to point to
Speaker 1: any example of sustained attention to a health problem that
Speaker 1: resulted in failure because you know, implementation was impossible. It's
Speaker 1: it wants you to say, how do we do this?
Speaker 1: Rather than should we do this? I mean part of
Speaker 1: me wanted to say, you're halfway there. Bill Gates and
Speaker 1: the Gates Foundation, who played a very big role in
Speaker 1: the Kovac's program, he have thought a lot about this problem.
Speaker 1: He takes the position very explicitly all lives have equal value.
Speaker 1: I mean, he says something, you know, very similar to
Speaker 1: the kind of thing you say. But he also takes
Speaker 1: the view around vaccines that you need the profit motive
Speaker 1: and the private sector to drive the innovation and development
Speaker 1: around vaccines, and that they need patent protections, and often
Speaker 1: you hear criticism of that that the patent protections in
Speaker 1: particular keep vaccine prices high and keep vaccines out of
Speaker 1: the out of reach for the poorest countries. Do you
Speaker 1: think his approach is right or the best available solution
Speaker 1: or neither, Well, you know, I think, And first of all,
Speaker 1: I don't doubt that his work and the world I'm
Speaker 1: talking about the work of the foundation is premised on
Speaker 1: this notion that all lives have equal value, don't doubt it,
Speaker 1: and have some experience discussing these matters with him. I
Speaker 1: also don't doubt that a great titan of industry knows
Speaker 1: things that I would never know about things like patents.
Speaker 1: But I also I further believe that people like me
Speaker 1: have something to add even if we don't know a
Speaker 1: lot about trade agreements. When I say people, I mean
Speaker 1: I mean clinicians, nurses, doctors, community health workers. You know,
Speaker 1: we have responsibilities as well to communities that we're serving,
Speaker 1: and if those communities are not well served by current
Speaker 1: trade arrangements, including patent law, then we should suspend or
Speaker 1: wave them in the middle of crises like this. This
Speaker 1: is a global health emergency the likes of which we've
Speaker 1: not seen in our lifetime. I would imagine that many
Speaker 1: people in industry, and including in the farm industry, could
Speaker 1: agree there are moments when you would wave intellectual property
Speaker 1: rights in order to increase production. And you know, right
Speaker 1: now we're in a situation, as you know, where a
Speaker 1: production is, the chain is the chief barrier. It's supply
Speaker 1: as a chief barrier. And so if a country like
Speaker 1: Rwanda can convince those who do hold patent rights over
Speaker 1: new technologies like mrina vaccines, that they too could participate
Speaker 1: in the production of vaccines and in their distribution elsewhere
Speaker 1: in the world. I think that would be a good
Speaker 1: thing for the species. Meaning our spec Paul, I wanted
Speaker 1: to step back and ask you a more personal question.
Speaker 1: It's a question I'd like to ask all our guests, Unsolvable,
Speaker 1: which is essentially, how did this become your life's work?
Speaker 1: How did you end up devoting yourself to global health equity?
Speaker 1: I can answer in one word, which is uncharacteristic of
Speaker 1: me Haiti, meaning the brevity part is uncharacteristic. I went
Speaker 1: almost by accident to Haiti between college and medical school
Speaker 1: and learn things there in one year that I think
Speaker 1: it would have taken me many years to absorb in
Speaker 1: a classroom, for example. And that's where I learned both
Speaker 1: the devastating toll of not having a safety net, but
Speaker 1: also the almost shameful facility with which one could be
Speaker 1: put in place. The other regular question we like to
Speaker 1: ask Unsolvable Paul is what can listener do? And in
Speaker 1: this case, it's to make up for the setbacks brought
Speaker 1: by the pandemic. I might divide it into two separate answers.
Speaker 1: One is, you know, talking about those increased and highlighted
Speaker 1: disparities in the United States, but then in terms of
Speaker 1: the global gap, in the global shortfalls. You know, I
Speaker 1: would love to see people the age of my students
Speaker 1: grasp on to this as they're you know, a hankering
Speaker 1: that will endure, that they will keep pushing forward an
Speaker 1: equity agenda, and I don't mind calling a social justice agenda.
Speaker 1: What's wrong with social justice? That's almost asking people to
Speaker 1: make a stance part of their response, just a personal stance.
Speaker 1: I am against these kinds of health disparities. I am
Speaker 1: for their decrease. And then there are a specific tasks
Speaker 1: I mean partners in health of course, which is really
Speaker 1: the implementation arm of anything I have. I'd say in
Speaker 1: a lot of places I work requires pragmatic solidarity. In
Speaker 1: order to do this work, we need support. And it's
Speaker 1: not just in far off places. We need support in Massachusetts,
Speaker 1: in Nabel Nation, in new work and immacaly. You know,
Speaker 1: there's a long list of really pragmatic matters that we
Speaker 1: need to address. I'll just give one example. If in
Speaker 1: the state of Massachusetts, which is a very blessed state
Speaker 1: in terms of overall wealth. In terms of a safety net,
Speaker 1: the great majority of the people who we encounter in
Speaker 1: our work doing contact tracing in Massachusetts those who need
Speaker 1: social support, eighty percent of them cite food insecurity eight
Speaker 1: zero percent. And you know, we live in a country
Speaker 1: where there's enough to feed everybody. That's another very pragmatic
Speaker 1: example of the kind of assistance people need. And it
Speaker 1: also includes all the other things that you think about,
Speaker 1: like not being evicted, or having unemployment insurance, or help
Speaker 1: for the disabled who need to get their vaccines or
Speaker 1: in home care. On the global level, it's a very
Speaker 1: similar kind of set of concerns, at least for the
Speaker 1: patients I know best and the populations I know best.
Speaker 1: They are concerned with the same set of problems. Getting
Speaker 1: their kids back in school, resuming their activities, and opening
Speaker 1: up the clinical services and educational services that they want.
Speaker 1: Again requires a lot of pragmatic solidarity. And I only
Speaker 1: say that because you know, what is it the partners
Speaker 1: and Health is doing beyond that, not much. It's really
Speaker 1: pragmatic solidarity. Sometimes we're saying, Okay, we'll help you build
Speaker 1: a hospital, or we'll help you start a medical school,
Speaker 1: but it's still the pragmatic part of it's still there,
Speaker 1: and I just hope more and more people who are
Speaker 1: listening get involved in global health equity. That's kind of
Speaker 1: the term we use rather than public health. It's a
Speaker 1: role for everybody. Paul, It's an inspiration and always a
Speaker 1: pleasure to talk to you. Thank you so much for
Speaker 1: joining us, Unsolvable. It's great to see you, Jacob. Thank you.
Speaker 1: Paul Farmer is a professor at Harvard Medical School. He's
Speaker 1: Chief of Global Health Equity at Brigham and Women's Hospital
Speaker 1: in Boston and the co founder of the organization Partners
Speaker 1: in Health. His new book is called Fevers, Feuds and Diamonds,
Speaker 1: Ebola and the Ravages of History. To learn more about
Speaker 1: international health resources, disease prevention, and poverty eradication, please check
Speaker 1: out the links in our episode notes. Solvable Senior producer
Speaker 1: is Jocelyn Frank, Research in booking by Lisa Dunn. Catherine
Speaker 1: Girardou is our managing producer, and our executive producer is
Speaker 1: Mia Loebell. Special thanks to Heather Fame, Kadijah Holland, Maya Konig,
Speaker 1: Emily Rostak, Eric Sandler, Carly Mgliori, John Schnar's, Christina Sullivan,
Speaker 1: and Maggie Taylor. Solvable is a production of Pushkin Industries.
Speaker 1: If you like the show, please remember to share, rate,
Speaker 1: and review it. It helps us get the word up.
Speaker 1: You can find Pushkin Podcasts wherever you listen, including on
Speaker 1: the iHeartRadio app and Apple Podcasts. I'm Jacob Weisberg.