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PACT: Prevention and Acces to Care Treatment


Health is more than just the absence of illness
Howard Hiatt Physician
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My first trip to Haiti with Paul was enlightening. It is difficult to describe adequately what he and Jim and a growing group of colleagues have done. In Haiti Paul, not only built a hospital, but he loves to... to describe himself as a gardener of great tenacity. Haiti is a country that has been completely despoiled. It is the most barren country I've ever been in, in... on any continent and I've been on, on all. The tree... the, the setting around the hospital, the first hospital that Paul built is... that hospital is surrounded by trees, by gardens and by people who are working in them. I mention that the, the people who have been trained as community health workers are paid members of the organization, but also in the organization are people who tend to the, to the grounds, people who are responsible for helping to find food for the hospital.

Paul and Jim have really redefined public health. In the days when I first was associated with people who were dealing with problems in third world settings, it wasn't uncommon for a group of deeply committed people to go to a place where there was an epidemic of malaria or of tuberculosis or of tropical illness of some kind, help identify the source of the problem, help treat the patients and then come back to this country. Paul and Jim's focus is on poverty, primarily. The diseases associated with poverty are the consequence, in most instances, of the poverty. Of course, they treat malaria with the appropriate drugs. They treat tuberculosis, as I've just mentioned, with appropriate drugs. But, they also treat these problems with food, with clean water, with education and with efforts to find jobs.

Paul - very early on in all of these places research is carried and I'll say a bit more about that in just a minute - but, one of the early studies Paul did in Haiti was to take two groups of patients with tuberculosis. He treated both with appropriate drugs, this was the, the drug, this was tuberculosis that responds to the primary drugs that are used for it; he treated one, both groups with the appropriate drugs and one group with milk as well, and I don't have to state, I'm sure, which group did very much better. Applied research of that kind is a very important part of the work that Paul and Jim encourage.

Born in 1925, American Howard Hiatt set up one of the first medical oncology research and training units in the US and has headed up some of America's most prestigious medical institutions. Hiatt attended Harvard College and received his MD from the Harvard Medical School in 1948. He was a member of the team at the Pasteur Institute, Paris, that first identified and described mRNA, and he was among the first to demonstrate mRNA in mammalian cells. From 1991 to 1997, he was Secretary of the American Academy of Arts and Sciences, where he began and directs the Academy's Initiatives For Children program. He is also committed to helping disadvantaged people access decent health care.

Listeners: Milton C. Weinstein

Milton C. Weinstein, Ph.D., is the Henry J. Kaiser Professor of Health Policy and Management at the Harvard School of Public Health and Professor of Medicine at the Harvard Medical School. At the Harvard School of Public Health he is Academic Director of the Program in Health Decision Science, and Director of the Program on Economic Evaluation of Medical Technology . He is best known for his research on cost-effectiveness of medical practices and for developing methods of economic evaluation and decision analysis in health care. He is a co-developer of the CEPAC (Cost-Effectiveness of Preventing AIDS Complications) computer simulation model, and has conducted studies on prevention and treatment of HIV infections. He is the co-developer of the Coronary Heart Disease Policy Model, which has been used to evaluate the cost-effectiveness of cardiovascular prevention and treatment. He is an author of four books: Decision Making in Health and Medicine: Integrating Evidence and Values; Cost-Effectiveness in Health and Medicine,the report of the Panel of Cost Effectiveness in Health and Medicine; Clinical Decision Analysis; and Hypertension: A Policy Perspective.He has also published more than 200 papers in peer-reviewed medical, public health, and economics journals. He is an elected member of the Institute of Medicine of the National Academy of Sciences, and a recipient of the Award for Career Achievement from the Society for Medical Decision Making. Dr. Weinstein received his A.B. and A.M. in Applied Mathematics (1970), his M.P.P. (1972), and his Ph.D. in Public Policy (1973) from Harvard University.

Tags: Haiti, Paul Farmer, Jim Yong Kim

Duration: 4 minutes, 43 seconds

Date story recorded: September 2006

Date story went live: 24 January 2008