Public health crusader Paul Farmer could join Obama team

By James F. Smith, Globe Staff

Dr. Paul Farmer, the global health crusader who has crafted life-saving projects from Haiti to Rwanda, has told colleagues privately that he is mulling a possible appointment by the Obama administration to coordinate growing US overseas health initiatives.

Farmer told faculty members at Harvard Medical School on Monday that he is in discussions with the State Department, which this month proposed a surge in funding over the next six years for global programs to fight AIDS, tuberculosis and tropical disease, and to improve children's health.

It could not be confirmed today exactly what job Farmer is being considered for, but one person who was present at the medical school meeting said Farmer described it as a position overseeing all foreign health aid. Farmer told the gathering that he hadn't decided whether to accept the appointment if it is formally offered but that he was considering it seriously.

Farmer did not respond to email and phone messages seeking comment. Partners in Health also declined to respond, as did Harvard Medical School's Department of Global Health and Social Medicine, where Farmer is vice-chairman.

A State Department spokesman refused any comment on personnel discussions in progress or on potential new positions. It could not be confirmed today whether Farmer is being considered for a full-time policy position or an advisory role, or whether an appointment would be to a new job or an existing one.

The top positions at the US Agency for International Development are vacant, including the administrator and deputy administrator as well as assistant administrator in charge of global health. The top positions are presidential appointments and require Senate confirmation. There could also be health policy roles within the State Department, which this month announced a plan to spend $63 billion over the next six years to fight global diseases including HIV/AIDS, malaria, tuberculosis and other preventable diseases. That would build on an ambitious effort launched by the Bush administration.

Farmer has gained international acclaim for more than two decades of work treating the poorest villagers in the poorest countries, while also carrying out groundbreaking medical research and reshaping health policies in the Third World. When he was still a Harvard medical student he co-founded Partners in Health, the Boston-based nonprofit that supports an array of global health efforts and pushes governments to provide better care.

In 2003, Tracy Kidder published a best-selling book, "Mountains Beyond Mountains," about Farmer.

He remains very active in Partners in Health and its initiatives, including the remaking of Rwanda's health system amid the twin ravages of AIDS and the aftermath of genocide, as well as building programs in other countries -- Russia and Peru among them -- to counter multi-drug-resistant tuberculosis.

One person who was at the Harvard gathering said some colleagues suggested to Farmer that he was being given an opportunity to make a real impact on US policy, and they urged him to take up the challenge.