Infections and Inequalities: The Modern Plagues,   ISBN:9780520229136

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If you are interested in public health and infectious diseases, this is a must read. Paul Farmer has a way of explaining things that just make sense and provides solutions that seem so simple.... if only it were that easy. There was little I could disagree with in this book, Dr. Farmer is spot on. This read is worth the time.

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The context of epidemics is important. What happens to the poor people who have drug resistant tuberculosis? Market mechanisms do not serve the interest of global health equity. The cost-efectiveness argument is weak. Poverty limits freedom of choice. AIDS education falls short. Arguments about limited resources should not prevail. There is a global web of unequal relationships. Structural violence and cultural difference have been conflated in AIDS studies.

Anthropology and medicine have blind spots. Virchow understood medicine had biologic and social underpinnings. There is not enough high-tech medicine to go around. Inequality itself is a pathogenic force. The author's interpretation of modern plagues has been shaped by work in Haiti and Peru. As scientific and medical communities tried to make sense of AIDS, the author was drawn into the discipline of the sociology of knowledge. World systems theory, one of the newer anthropological theories, could posit that Paul Farmer of Harvard and Haiti is a conduit for resources.

In many instances of disease emergence, social topography is more important than geographic topography. The differential political economy of risk is described. The major risk factor for AIDS is poverty. Personal agency has been exaggerated. From typhoid to tuberculosis to AIDS, blaming the victim is a theme in the literature. Being sick results from structural violence, not from bad personal choices. The author lived in a village in rural Haiti when both AIDS and political violence arrived. Haitian cases of AIDS defied the risk-grouping descriptions prevalent in the 1980's. The Haitian epidemic of AIDS originated in the United States.

Recent circumstances in Haiti include deepening poverty, gender inequality, instability. The author and other physicians and health workers have learned that a belief in sorcery among Haitians does not preclude adherence to a biomedical regimen. Furthermore, high cure rates for tuberculosis, (often a twin affliction of AIDS), are possible in settings of extreme poverty. Juxtaposing treatment with prevention are false debates.

The author has traced the march of inequality as it affects health care in a myriad of ways. Endnotes and an extensive bibliography follow the text of this excellent work. Everyone should buy it, everyone should read it.

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An enlightening and insightful book that passionately sets a higher standard for those involved in medicine or any type of humanitarian work. He is passionate about what he says, but careful not to make assumptions that have not been well documented and researched. The book challenged my thinking when it comes to health care, poverty, and our social duty to take action against injustices in the world.

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Too long . Written with sientific dicipline & detail and burdened by too much specialized medical terminology for the popular reader . The idealism is admerable and the conclusion are justified but it speaks to the medical profession more than to the general public . A slow diffucult book to read . Sombody else should write the same book for the popular reader and for leaders in public policy .

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By claiming "social reform," Farmer contradicts his stance as an American citizen: Haiti has no money to support its own citizens, that's why the US and others are doing Haiti's job. But, the US has to care for its own citizens as well therefore has to first work on its own AIDS patients within its boundary. If the US does that as its social reform, Haiti instantly dries up.

Irritating mistakes somehow got through inspection: PAligre Dam? PEligre? (P. 174) PuertO Plata? PueltA? (P. 119)