Paul Farmer
structural violence and the embodiment of inequality
pp. 675-690
in: Fran Collyer (ed), The Palgrave handbook of social theory in health, illness and medicine, Berlin, Springer, 2015Abstract
Paul Farmer is one of the most influential advocates for health equity in the world today. His analyses — rooted in both social science and medicine, owing to his training in anthropology and infectious disease — highlight the importance of the social determinants of health. His work has challenged existing orthodoxies in medicine and global health, including the belief — widely held in the 1990s — that treatment for HIV or multi-drug-resistant tuberculosis (MDRTB) was impossible in poor settings. Farmer has questioned the reliance on "cost-effectiveness' as a decision-making process in healthcare delivery, arguing instead for the centrality of equity. At the same time, his work has critiqued medical anthropology, medical ethics, and related fields, including human rights, for ignoring the fundamental causes of global health inequities. Farmer's vision of "geographically broad and historically deep' analysis offers a framework for a political economy of global health equity, a way of working that respects the tremendous benefits of biomedicine, yet highlights the social "fault lines' that negate its discoveries for the majority of the world's poor.