I’m one of six kids, and the eight of us lived for over a decade in either a bus or a boat.

But if you’re asking my opinion, I would argue that a social justice approach should be central to medicine and utilized to be central to public health. This could be very simple: the well should take care of the sick.

I think we will see better vaccines within the next 15 years, but I’m not a scientist and am focused on the short-term – what will happen in the interim.

In fact, it seems to me that making strategic alliances across national borders in order to treat HIV among the world’s poor is one of the last great hopes of solidarity across a widening divide.

I’m one of six kids, and the eight of us lived for over a decade in either a bus or a boat.

Civil and political rights are critical, but not often the real problem for the destitute sick. My patients in Haiti can now vote but they can’t get medical care or clean water.

We’ve taken on the major health problems of the poorest – tuberculosis, maternal mortality, AIDS, malaria – in four countries. We’ve scored some victories in the sense that we’ve cured or treated thousands and changed the discourse about what is possible.

I mean we grew up in a TB bus and I became a TB doctor.

Since I do not believe that there should be different recommendations for people living in the Bronx and people living in Manhattan, I am uncomfortable making different recommendations for my patients in Boston and in Haiti.

But as for activism, my parents did what they could, given the constraints, but were never involved in the causes I think of when I think of activists.

So I can’t show you how, exactly, health care is a basic human right. But what I can argue is that no one should have to die of a disease that is treatable.

I’m not an austere person.

Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that’s where you see the sharp limitations of market-based health care.

I critique market-based medicine not because I haven’t seen its heights but because I’ve seen its depths.

I’ve been impressed, over the last 15 years, with how often the somewhat conspiratorial comments of Haitian villagers have been proven to be correct when the historical record is probed carefully.

The poorest parts of the world are by and large the places in which one can best view the worst of medicine and not because doctors in these countries have different ideas about what constitutes modern medicine. It’s the system and its limitations that are to blame.

The human rights community has focused very narrowly on political and civil rights for many decades, and with reason, but now we have to ask how can we broaden the view.

The thing about rights is that in the end you can’t prove what should be considered a right.

The only way to do the human rights thing is to do the right thing medically.

For me, an area of moral clarity is: you’re in front of someone who’s suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, and you act.

I recommend the same therapies for all humans with HIV. There is no reason to believe that physiologic responses to therapy will vary across lines of class, culture, race or nationality.

It is clear that the pharmaceutical industry is not, by any stretch of the imagination, doing enough to ensure that the poor have access to adequate medical care.

I would say that, intellectually, Catholicism had no more impact on me than did social theory.

Again, conventional Catholicism does not much appeal to me.

At the same time, it is obvious that clinicians in Haiti are faced with different, and, in fact, greater, challenges when attempting to treat complications of HIV disease.