Infections and Inequalities: The Modern Plagues

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 memoir rife with stories about diseases and human suffering. Using field work and new scholarship to challenge the accepted methodologies of epidemiology and international health, Farmer points out that most current explanatory strategies, from "cost-effective treatment" 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 autobiography 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 and medical students determined to treat those in need: whether in their home countries or through medical outreach programs like Doctors without Borders. Infections and Inequalities weds meticulous scholarship in medical anthropology with a passion for solutions—remedies for the plagues of the poor and the social illnesses that have sustained them.