Last Thursday, many of us attended Paul Farmer’s talk at the Reynolds lecture
series on social entrepreneurship. Dr. Farmer covered a lot of varied and
disparate ground in his lecture – everything from the mechanics of Haitian disaster
relief to a philosophical rendering of the development community’s obligations to
the poor.
In between his many asides, anecdotes and shout-outs to NESRI, he spoke with a moral clarity and force that was markedly different from many other development speakers. This was especially apparent in his ability to make unequivocal statements that were still entirely convincing: public health is a public good. Healthcare for the poor is a right, not a privilege.
It was a nice change of pace from the occasionally measured, detached or dispassionate ‘narratives’ that comprise quite a bit of development literature and many development events. In particular, Dr. Farmer’s comments about the vastly oversimplified ‘health systems’ debate were a great example of how we need more inspirational, big-picture thinking that moves beyond the tired debates over vertical and horizontal systems.
He spoke of the various discourses around health systems and how the community has really lost the kernel of the debate – what the different approaches mean for the poor – in favor of a false dichotomy. The bloggers at CGD recently spent some time and effort debating whether the human body is the best metaphor for debating health systems, which I think provides some clear evidence for Dr. Farmer’s point.
It’s challenging to even articulate what the problem is here (and if, in fact, it highlights a more systemic discursive issue in development literature). But seeing Dr. Farmer speak, I couldn’t help but wonder whether the difference in narratives (the way we talk) can also lead to a difference in outcomes (the way we work). Partners in Health has been a relatively indisputable programmatic success characterized by the unequivocal, uncompromising values present in the speech – so I think the answer is yes.
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