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Infections and Inequalities: The Modern Plagues

4.09  ·  Rating details ·  2,617 ratings  ·  87 reviews
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 per ...more
Paperback, 424 pages
Published February 23rd 2001 by University of California Press (first published 1999)
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Mario the lone bookwolf
Were the microorganisms only longer than the people on earth or would they stay longer?

Please note that I put the original German text at the end of this review. Just if you might be interested.

I would like to focus on the theoretical part of the book. Paul Farmer is a shining example of with his commitment to the poorest and the weakest. His approaches and ideas for better medical care, more distributive justice and a restructuring of inefficient and corrupt systems are visionary. He describes
...more
Libby
May 20, 2012 rated it liked it
I have some mixed feelings about this book. First of all, I've been spoiled recently by some good, readable non-fiction, and this missed that mark. He does sprinkle in personal stories to his dense discussion of health initiatives, but even those come off as clinical. I also had a hard time with his complete disregard of making these programs financially feasible, and it occurs to me that this is because he has plenty of donors to his work. He is setting an impossible standard for the rest of th ...more
edenstephen
Dec 08, 2010 rated it it was amazing
This book, like all of Farmer's, is an excellent piece of scholarship. Much of the work is centered around the "pathogenicity of poverty," the idea that poverty, more than cultural or other anthropological factors, is crucial in examining the causes and transmission of infectious diseases. A medical anthropologist himself, Farmer frequently criticizes the anthropologist's obsession with "culture" -- in doing so, one often accuses voodoo, witchcraft, and animal sacrifice of being the instigator o ...more
Elizabeth Huff
Mar 26, 2013 rated it really liked it
While I was aware at the drastic healthcare disparities that exist between nations, this book put a face and a name to those people and really quantified the magnitude of the disparity. We know that many diseases are treatable, even preventable with the proper infrastructure and medicine, but we don't want to spend money to help treat other people, even when it would help us in the long run. Let's just spend the money and deal with it all and be better off for it.
Katherine Sacksteder
Sep 02, 2007 rated it it was ok
I put this in my "read" section, only because I'm never going to finish it. It's terribly written and pretentious. I'm more interested in the biography of Paul Farmer than I am of actually have to slog through his overwritten prose.
Natalie
May 02, 2012 rated it it was ok
This book goes into painstaking detail. The book is summed up as wealth equals health. I was thrilled during the intro, and less thrilled as I finished it.

We are tossing ineffective or inappropriate drugs at populations, or no treatment at all, that don't have the money. It's called "cost effective". It wouldn't be cost effective to treat everyone the same. Which is a sick joke. At the same time we are all sharing the same micobacteria. Politics, poverty, lower standard of living, war, ineffect
...more
Robsy
Nov 11, 2014 rated it really liked it
Fascinating book blowing many poverty and disease myths out of the water. Found this book on the Bill Gates reading list and glad I picked it up. As other reviews have stated, it might be a tad academic and scattered, but an excellent, illuminating read. I am very interested in his other books since I learned so much with this one.

Not only is it the ethical thing to help all the world's people deal with treatable, deadly diseases, it's enlightened self interest to do so as boundaries and border
...more
Andy
Aug 04, 2012 rated it it was ok
This is an odd book. One of the bizarre aspects is a running diatribe about the way that global health money is spent on prevention instead of on treatment. First of all, it's not either/or. Secondly, if you had to choose, why not overweight prevention, which would save more lives than treatment? Thirdly, what is he talking about? In AIDS, for example, the global health money has been disproportionately spent on treating people with anti-retrovirals vs. preventing infection with condoms, etc. Th ...more
Bologna_frog
Apr 15, 2011 rated it it was ok
Jake suggested it although he did not get through it.

Stories were interesting the first time, but they get rehashed to make the same point repeatedly. I would have been good after maybe 50 pages. That may be the result of this being a compilation of essays.

Disease treatment is disease prevention, for Infectious Disease.
If current best treatments are too expensive for use in developing countries, what does that mean about the value we place on life?
MDRTB needs to be treated as well as simple tube
...more
Mirna Sawyer
Jul 27, 2008 rated it really liked it
I highly recommend Paul Farmer in general. This book's thesis is that the infections are worse where poverty is worse. And that basically public health is not merely an issue of behavior but one tied very strongly to environments and conditions made possible by the way wealth and power are distributed. It does get a bit redundant and definitely nihilistic like Sheper-Hughes but non-fiction nevertheless.
Alicen
Jul 24, 2008 rated it really liked it
Farmer does an excellent job discussing some of the sheer complexities related to infectious disease (particularly HIV and TB) prevention and the role that inequalities have in such prevention. A must read for anyone interested in thinking about social issues and public health.
Muneeb Hameed
Aug 03, 2019 rated it really liked it
One of my favorite quotes from this book: "There is something unfair about using personal responsibility as a basis for assigning blame while simultaneously denying those who are blamed the opportunity to exert agency in their lives. A patronage that simultaneously grants 'victims' powerlessness and then assigns them blame for that powerlessness is nothing new."

It was enlightening but also disturbing to read this exposition about the nature of infectious diseases in the world. According to the W
...more
Hiroko
Aug 10, 2019 rated it it was amazing
It really made me rethink how the world is treating people from developing countries. I have never known that so many NTDs are still making people suffered in developing countries. For instance, TB is a signature disease as poor people. It has very high cure rate if they get earlier and proper treatment, however, things are not that straightforward. People from developed countries are ignorant and treat people from developing countries as if they are invisible and forgotten people. They stop cop ...more
Wendelle
Dr. Farmer's central argument in this book is that social inequalities lead to inequalities in outcomes among people who have infectious disease such as AIDS or tuberculosis, and indeed social inequality levels could be considered a pathogenic contributor. Therefore, infectious treatment must not be limited to medical intervention but a 'biosocial' intervention-- a holistic combination of medical and social assistance. He draws from his formidable decades-long experience as a clinician in Haiti ...more
Tom Ransohoff
Jul 19, 2019 rated it really liked it
I got a lot out of this book. It is While a bit dry, this is a very logical and sometimes passionate treatise and indictment on our society's ineffective approach to treating global epidemics of tuberculosis and HIV, particularly for the poor. There are so many fundamental "take aways" and lessons that I always felt like I was learning and that my thinking/precepts were being challenged. Farmer's incredible experience and dedication to the fields of infectious disease and medical anthropology/so ...more
Austin
May 26, 2020 rated it it was amazing
Read over several years. Started a bit before med school. Now finished amidst the hopeful downslope of the first wave of Covid--a devastating illustration of many of the concepts laid out years ago in this book.

This quote has always stayed with me:
"There is nothing wrong with underlining personal agency, but there is something unfair about using personal responsibility as a basis for assigning blame while simultaneously denying those who are being blamed the opportunity to exert agency over thei
...more
Bella
May 14, 2018 rated it did not like it
Paul Farmer writes like a PhD. Not a teacher, not a public health advocate, but a PhD, steeped in theory and fifty cent words that make his text pretty hard to engage with. I’m normally really interested in the subject of public health and inequalities but this book made my eyes glaze over. I disliked it more than I’ve ever disliked a book like this, mostly because of how hard it was to read. Not because the material was challenging but because Paul Farmer is that bad of a writer.
Kristina Goff
Jan 03, 2019 rated it really liked it
Although repetitive and agenda-oriented, Infections and Inequalities is certainly a worthwhile read. Life will never be "utopian" here on earth. I frequently ponder why I was given so much when others barely exist. I strive to live my life with the maxim "to whom much is given, much is expected" at my spiritual core. We can provide health care world-wide if it becomes a global priority. Meanwhile we can each do our part. We don't have to live in a Marxist society to reach out to those in need.
Monica Bustos
Apr 01, 2020 rated it really liked it
beyond the solid evidence consistently provided throughout the ethnography (although the author defies that the book is actually one), farmer's tenacity in addressing global health inequities through addressing the structural determinants of infectious diseases permeates through the pages and can definitely be felt as the reader. required reading for anyone in global health... definitely made me rethink some of my own misconceptions about the intersections around med anthropology and epidemiolog ...more
Macon Fessenden
Jan 31, 2020 rated it it was amazing
Meticulously researched (with both deep scholarship and first-person accounts from the author who has been *doing the work* for 30 years), heart breaking and extremely compelling. Although written 20 years ago, its descriptions and prescriptions ring true today and unfortunately will most likely continue to ring true well into the future. As inspirational a book as any
Sam Whitehill
Apr 28, 2020 rated it really liked it
Farmer argues against the logic that it is too expensive to treat infectious disease among the poor, and that they themselves are to blame for their bad treatment outcomes. Yes, that is an actual argument. As climate change also illustrates, some people are willing to risk the health of the world to make a buck.
Adrian Sarli
Aug 08, 2017 rated it it was amazing
Awesome book. I believe every healthcare provider as well as anyone who believes in any sort of moral duty to serve one's fellow man should read it.
Glenn
Jul 16, 2018 rated it it was amazing
informantive as of 1999............enlightening field work results..
Zachary Sokol
Jul 22, 2020 rated it really liked it
A seminal work in medical anthropology.
Brena
Aug 27, 2017 rated it it was amazing
Shelves: to-re-read
Extremely insight on how infection diseases have played into the international power dynamics of rich vs. poor, of what makes a first world country "first world" and what has imprisoned third world countries to their "third world" status. Highly recommended for anyone in the Public Health, Global Health, Medical, and Social Justice spheres.
MerryMeerkat
Jan 06, 2015 rated it it was ok


��2 Stars, don���t bother


Self Purchase for Kindle.


First Impression: Unremarkable


I hate it when books in series don���t take time to reintroduce the characters to you. I waited a long time between the first and second book and couldn���t remember everyone. This book just drops you back in and I found that annoying.


I liked the first one in the series ok, ����3.5 Stars but boy this one just was bad. You are dropped right back in with no reintroduction and there isn���t

...more
Lindsay Wilson
This book was surprisingly good, despite the fact that it's now almost fifteen years old, and I've already noted the difficulty of reading about current events that aren't current anymore. However, this book has actually held up pretty well, mainly because the problems outlined by Farmer are still completely relevant, sad though that is.

I thought Farmer did a really great job pointing out the need for a balanced approach to HIV and TB treatment/prevention. While it is of course important to foc
...more
Shela Putri Sundawa
Sep 11, 2014 rated it it was amazing
Shelves: favorites
"Upon reflection, perhaps we physicians are the ones who need to clean up our act. In saying this, I do not wish to exaggerate the power of doctors and other providers; increasingly, it is the pharmaceutical and health care industries, and also federal governments, who call the shots on questions of access to effective medical care. But the power of medicine stems not merely from the wonders of science. It stems, too, from the power of moral suasion. We can call for certain measures not because ...more
Peter Chindavong
Sep 10, 2016 rated it really liked it
This is by-far the densest book I've read. I found myself having to lookup every other word. Paul Farmer beautifully hybridizes anthropology and medicine. He brings to light some important social-determinants of health, which he believes are poverty, racism, and social inequality. However, I didn't think Dr. Farmer proposed a clear and concise solution to this. He criticizes professionals in both fields. I get a slight sense of sarcasm in some parts of his writing. I personally love Paul Farmer ...more
Andrew
Sep 02, 2007 added it
Farmer attacks the fatalistic and morally flawed view that expensive therapies for multiple-drug-resistant TB and HIV/AIDS should not be employed in developing countries because they are not "cost-effective." As one who has worked for years in rural Haiti, Farmer no doubt knows about the scarcity of resources that development and health workers (not to mention Haitians themselves) face, his point is rather that we cannot afford not to treat those cases, first of all because we have a moral imper ...more
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Paul Farmer is Professor of Medical Anthropology at Harvard Medical School and Founding Director of Partners In Health. Among his books are Infections and Inequalities: The Modern Plagues (1999), The Uses of Haiti (1994), and AIDS and Accusation: Haiti and the Geography of Blame (1992). Farmer is the winner of a MacArthur Foundation "genius" award and the Margaret Mead Award for his contributions ...more

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