Thanks for sharing. He’s been one of my heroes for a long time, and I see him as having both strong overlap with certain EA ways of thinking and serious differences.
He was a person who had an unswerving commitment to justice and improving human flourishing. He recognized the utter injustice of health inequalities and was able to articulate that vision so that it could be understood by many folks who don’t typically care about the suffering of far-off people who look different than them. These ways of thinking are central to EA for me: the sense that we have no right to discount the suffering of far-off individuals, no matter who they are or what they look like; the sense that we have serious moral obligations that require serious commitment.
He was also a person who situated medical problems within sociopolitical contexts, and who believed that comprehensive solutions (i.e., investing in health systems across the board) were far superior to targeted interventions (i.e., bed nets). He was critical of approaches focused on cost-effectiveness, arguing that they were morally abhorrent. In this sense, he is obviously taking a very different approach to the traditional EA approach. But I think that some of his arguments are valuable counters to the EA emphasis on targeted interventions,illustrating as they do that targeted interventions are subsidized by existing infrastructure, and that some initiatives–such as the Partners in Health campaign against multi-drug resistant TB in Peru–can be initially non-cost effective but eventually change market pressures and norms such that, in toto, they are incredibly cost-effective. Farmer’s work reminds us that assessments of cost-effectiveness must take into account that inputs are not stable, and that initiatives can be transformative, and that if we zealously focus on short-term effects, we will miss out on opportunities for transformative change.
I don’t agree with everything that Farmer stated or fought for. But I think the EA community would benefit from the insights from his life and work. Paul Farmer is worthy of the utmost respect for his unwavering commitment to improving the lives of marginalized people, and his death is a tragic loss.
Thanks for sharing. He’s been one of my heroes for a long time, and I see him as having both strong overlap with certain EA ways of thinking and serious differences.
He was a person who had an unswerving commitment to justice and improving human flourishing. He recognized the utter injustice of health inequalities and was able to articulate that vision so that it could be understood by many folks who don’t typically care about the suffering of far-off people who look different than them. These ways of thinking are central to EA for me: the sense that we have no right to discount the suffering of far-off individuals, no matter who they are or what they look like; the sense that we have serious moral obligations that require serious commitment.
He was also a person who situated medical problems within sociopolitical contexts, and who believed that comprehensive solutions (i.e., investing in health systems across the board) were far superior to targeted interventions (i.e., bed nets). He was critical of approaches focused on cost-effectiveness, arguing that they were morally abhorrent. In this sense, he is obviously taking a very different approach to the traditional EA approach. But I think that some of his arguments are valuable counters to the EA emphasis on targeted interventions,illustrating as they do that targeted interventions are subsidized by existing infrastructure, and that some initiatives–such as the Partners in Health campaign against multi-drug resistant TB in Peru–can be initially non-cost effective but eventually change market pressures and norms such that, in toto, they are incredibly cost-effective. Farmer’s work reminds us that assessments of cost-effectiveness must take into account that inputs are not stable, and that initiatives can be transformative, and that if we zealously focus on short-term effects, we will miss out on opportunities for transformative change.
I don’t agree with everything that Farmer stated or fought for. But I think the EA community would benefit from the insights from his life and work. Paul Farmer is worthy of the utmost respect for his unwavering commitment to improving the lives of marginalized people, and his death is a tragic loss.