Kidder begins by describing an epidemiological map. A standard map of this kind shows the regions that are particularly susceptible to a disease, with the map color-coding how at-risk the population is. In Haiti, for example, the majority of the country is color-coded “at risk” for TB and typhoid, among other diseases. In the U.S., the map looks a little different: the country as a whole is very low-risk, but there are small areas, such as Harlem or South Boston, in which public health is even lower than in many third world countries.
Kidder makes an important point: the distinction between the Third World and the First World isn’t as straightforward as it might seem. Although the U.S. is clearly a first-world country, there are large chunks of the U.S. where poverty is rampant and the quality of life is horrible—just as bad as it is in Haiti. In other words, it’s an oversimplification to divide the world up between the rich and powerful U.S. and poor, weak Haiti—there are rich and poor people everywhere on the planet.
Tuberculosis, or TB, is one of the deadliest killers in the world. A fairly effective drug treatment for TB has been in existence for decades, and yet much of the third world doesn’t have access to it, Kidder writes. As a result, pharmaceutical companies don’t invest money in researching a TB vaccine, and so billions of people carry TB bacilli in their bodies. In the majority of cases, the bacilli don’t cause any health problems, but the onset of HIV or AIDS can cause these bacilli to grow and cause full-fledged TB.
It’s chilling to think that pharmaceutical companies don’t invest in life-saving treatments simply because the suffering patients live in a poverty-stricken country, but it’s hard to argue otherwise. Because pharmaceutical companies’ priority is making money, not saving lives, large numbers of people across the world suffer from treatable diseases like TB.
In Haiti, Farmer faces a serious problem: multidrug resistant tuberculosis bacilli. MDR-TB (i.e., multidrug resistant tuberculosis) was common in Haiti in the 90s. In 1995, Kidder says, MDR-TB claimed the life of one of Farmer’s close friends, who was living in Lima, Peru.
This is interesting because it suggests that Farmer is motivated by his personal life—his Peruvian friend—as well as his more abstract sense of right and wrong. After all, there are diseases, poverty, and corruption in every country on earth, but Farmer can only do so much at a time—and for now, that means expanding his focus from Haiti to include Peru as well.