Today’s news of the invasion in Ukraine was preceded this week by another piece of shocking news for the global health community: Dr. Paul Farmer, physician, medical anthropologist, and co-founder of nonprofit organization Partners in Health, passed away in his sleep in Rwanda.
For us at Devex, the loss is personal. As a fierce advocate of equity in global health, Farmer was also a champion of our work. “I’ve seen so many great stories first on devex and am so grateful for your work!” he told our President and Editor-in-Chief Raj Kumar back in December.
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As many global health practitioners around the world mourn his loss, we are taking a look at his lasting legacy.
• Farmer didn’t focus solely on one disease, confronting HIV, Ebola, and COVID-19, among others. He was committed to addressing their impact on people “both as a physician committed to treating sick patients, but also as a medical anthropologist determined to understand the political and social causes that created the ‘medical deserts’ in which the emergencies occurred,” Andrew Green writes for Devex.
• “He moved easily between settings of poverty and places of power and he was able to make those connections,” says Dr. Arachu Castro, a public health specialist at Tulane University, who worked closely with Farmer on community-based approaches to HIV treatment. He saw these networks being important “in a world that had basically decided that the poor were not worth investing in.”
• Farmer knew that inequity was at the crux of the problem he was trying to solve. “Do we want global health … to be radically different from colonial health or tropical medicine?” he asked in an interview last year. “If so, then let’s stop referring to it as ‘global public health’ or ‘global health security,’ and start calling it ‘global health equity.’”
• His demands to decolonize global health were integrated into his lectures at Harvard Medical School, his books, and his practice at Partners in Health. But he also remained conscious of his position as a white man educated in elite U.S. institutions, as he sought to reimagine and decolonize global health, welcoming critiques, and fighting to elevate others, colleagues said. In 2020, he was awarded the $1 million Berggruen Prize for “[reshaping] our understanding not just of what it means to be sick or healthy but also of what it means to treat health as a human right and the ethical and political obligations that follow.”
Paul Farmer's lasting legacy: The quest for equity in global health
Doctor’s orders
The problem: Kenya has a robust system of community health volunteers who ensure that patients get health access even though some may avoid health facilities due to a lack of information or motivation, or other social and cultural barriers. But these volunteers are also supposed to collect data on the ground — and often are not equipped to translate the data into digital formats, which limits its use and value in planning health programs for the country.
The solution: The Ministry of Health and other partners are piloting a community health digitization program in Kisumu county, following the launch of a national community health digitization strategy in 2020. As per that national plan, which lasts through 2025, the data generated at the community level is crucial for decision making, planning, and monitoring progress toward universal health care.
How it works: The community health digitization program borrows from an application called Smart Health developed by Living Goods, a health systems nonprofit. The program, referred to as an electronic community health information system, helps volunteers digitally track drug stocks, pregnancies, and which households have been screened for cervical cancer. When the pilot ends in a few weeks, it will inform the launch of a national rollout, which officials say will start before June.
Devex Pro: Can Kenya's digitization of community health improve data collection?
WHO’s next
South Korea will be home to a new global biomanufacturing training hub that will support low- and middle-income countries wishing to produce biologicals such as vaccines, insulin, monoclonal antibodies, and cancer treatments, WHO announced Wednesday.
The WHO Academy, established last year to provide lifelong education for health workers, policymakers, and WHO staff, will work with South Korea’s Ministry of Health and Welfare to develop a “comprehensive curriculum on general biomanufacturing.” Trainings at the new hub will start in July, with 370 participants from Asia, Africa, and Latin America.
WHO Director-General Dr. Tedros Adhanom Ghebreyesus said lack of a skilled workforce and weak regulatory systems are among the key barriers to successful technology transfers in LMICs.
“Building those skills will ensure that they can manufacture the health products they need at a good quality standard so that they no longer have to wait at the end of the queue,” he said in a news release.
WHO announcement: A new biomanufacturing training hub in Korea
Tigray's troubles
“The solidarity the world showed health workers during the COVID-19 pandemic has been missing toward health workers in Tigray.”
—Dr. Hagos Godefay, head, Tigray’s Bureau of HealthIn an op-ed for Devex, the longtime leader of Tigray’s health agency writes of the situation on the ground in Tigray — and what could happen there without international support.
Opinion: In Tigray, we are demanding food and medicine, not bombs
Deep dive: Devex global health reporter Sara Jerving documents how the conflict in Ethiopia has deliberately left the health systems in Tigray in a state of collapse.
2 questions
Last week, Rebecca Root and Jenny Lei had an exclusive story on vaccines that were supposed to be delivered to refugees in Thailand but never made it there. Digging deeper, Jenny Lei reached out to UNHCR Chief of Public Health Ann Burton. Their conversation below has been edited for length and clarity.
What are the latest figures on how many displaced or refugee populations have been vaccinated?
We are aware that 162 countries have included refugees in their national COVID-19 vaccination plans as of the end of 2021. As of the 17th of February, 7,658,859 doses have been given to refugees and other forcibly displaced people in 68 countries. An additional 82 countries confirmed they had started vaccinating refugees, asylum seekers, stateless people, and internally displaced people, but the data on numbers vaccinated is not available to UNHCR.
What are the current challenges in vaccinating these vulnerable groups of people despite current narratives that supply is no longer an issue, and what specific actions can be taken to get them these vaccines?
We have been advocating for the full funding and implementation of the Access to COVID-19 Tools Accelerator … and that all countries fully include refugees, internally displaced, and stateless people in their COVID-19 response and vaccination plans. There must be greater investment in local delivery mechanisms and capacity, to guarantee that vaccines are delivered quickly and fairly, but also to strengthen national health systems for more effective pandemic preparedness and response — particularly in low- and middle-income countries.
In parallel, more needs to be done to address barriers to vaccinations. To register for or receive vaccinations, some states require identity documents, which refugees often do not have. Other countries have set up online systems that can deter or prevent people without access to the internet or who are not computer literate from registering for vaccines. Elsewhere, vaccination sites are located far from where refugees live, or there are requirements that health care seekers [need to report to] immigration authorities.
ICYMI: COVAX vaccine delivery deal to Thailand canceled
Lasting consequences
Children born with defects linked to the Zika virus are 11 times more likely to die by the age of 3 than the general population, according to a new study published Wednesday in The New England Journal of Medicine. Researchers behind the study called for more stringent protection against Zika for women of childbearing age.
Read: Study finds babies with Zika-linked defects at greater risk of death
What we’re reading
Governments are considering compensating families who lost loved ones to rare side effects of COVID-19 vaccines. [WSJ]
Deaths due to tuberculosis continue to climb in the Pacific even as funding has shifted to focus on tackling COVID-19. [SBS]
As logistics challenges and vaccine hesitancy trump supply challenges, the African continent asked the world to pause vaccine donations. [Politico]
About the authors
Amruta Byatnalamrutabyatnal
Amruta Byatnal is a Senior Editor at Devex where she edits coverage on global development, humanitarian crises and international aid. She writes Devex CheckUp, a weekly newsletter on the latest developments in global health. Previously, she worked for News Deeply in the United States, and The Hindu in India. She is a graduate of Cornell University where she studied international development. She is currently based in New Delhi.
Jenny Lei Ravelo@JennyLeiRavelo
Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
