The world is focused as never before on averting millions of preventable deaths among poor people living in the developing world. For the first time, substantial funding is available to treat infectious diseases in impoverished settings. Funding alone, though, won’t be enough. For this massive investment to make a real impact on the twin epidemics of poverty and disease, a comprehensive and community-based approach is key.

Partners In Health’s success has helped prove that allegedly “untreatable” health problems can be addressed effectively, even in poor settings. Until very recently, it was conventional wisdom that neither multidrug-resistant tuberculosis (MDR TB) nor AIDS could be treated in such settings. PIH proved otherwise, developing a model of community-based care used successfully to treat MDR TB in the slums of Lima, Peru, and deliver antiretroviral therapy for AIDS in a squatter settlement in rural Haiti. National health authorities in both countries have now significantly expanded these pilot projects. Today, PIH has transplanted and adapted its model of care to the epicenter of the HIV pandemic in Africa, launching projects in Rwanda in 2005 and Lesotho in 2006. Elements of PIH’s community-based approach have been disseminated to and adapted by other countries and programs throughout the world.

The five fundamental principles of our work are:

1. Access to primary health care
A strong foundation of primary care is critical to successfully treating specific diseases, such as AIDS. People seek care because they feel sick, not because they have a particular disease. When quality primary health care is accessible, the community develops new faith in the health system, which results in increased use of general medical services as well as services for more complex diseases. Therefore, PIH integrates infectious disease interventions within a wide range of basic health and social services.

2. Free health care and education for the poor
The imposition of user fees has resulted in empty clinics and schools, especially in settings where the burden of poverty and disease are greatest. Because both health and education are fundamental routes to development, it is counterproductive (not to mention immoral) to charge user fees for health care and education to those who need these services most and can afford them least. PIH works to ensure that cost does not prevent access to primary health care and education for the poor.

3. Community partnerships
Health programs should involve community members at all levels of assessment, design, implementation, and evaluation. Community health workers may be family members, friends, or even patients who provide health education, refer people who are ill to a clinic, or deliver medicines and social support to patients in their homes. Community health workers do not supplant the work of doctors or nurses; rather, they are a vital interface between the clinic and the community. In recognition of the critical role they play, they should be compensated for their work. PIH doesn’t tell the communities we serve what they need—they tell us.

4. Addressing basic social and economic needs
Fighting disease in impoverished settings also means fighting the poverty at the root of poor health. Achieving good health outcomes requires attending to peoples’ social and economic needs. Through community partners, PIH works to improve access to food, shelter, clean water, sanitation, education, and economic opportunities.

5. Serving the poor through the public sector
A vital public sector is the best way to bring health care to the poor. While nongovernmental organizations have a valuable role to play in developing new approaches to treating disease, successful models must be implemented and expanded through the public sector to assure universal and sustained access. Rather than establish parallel systems, PIH works to strengthen and complement existing public health infrastructure.

The work of PIH has three goals: to care for our patients, to alleviate the root causes of disease in their communities, and to share lessons learned around the world. Through long-term partnerships with our sister organizations, we bring the benefits of modern medical science to those most in need and work to alleviate the crushing economic and social burdens of poverty that exacerbate disease. PIH believes that health is a fundamental right, not a privilege.

Through service, training, advocacy, and research, we seek to raise the standard of care for the poor everywhere.