Partners in Health allies with former allies and adversaries to secure a $45 million grant from the Gates Foundation for its anti-TB program in Peru. Farmer must convince existing donors that their contributions are still necessary, and PIH sells its corporate offices to pay for AIDS antiretrovirals for 250 patients in Haiti. As PIH expands from 20 employees to 50, it adopts industry labor standards while maintaining 5% administrative costs and preventing newcomers from imitating Farmer’s schedule.

PIH also takes on the Soros Foundation’s pilot program in Tomsk, Siberia, after Goldfarb helps a KGB agent escape from Russia. Farmer only wants to take on clinical duties and becomes furious when Kim asks him to go to Russia to cover meetings for him. Kim brings up the fact that Farmer never meets him at the airport, and Farmer misunderstands his grievance. Kim ends up going to Russia with Kidder, where the PIH manager uses karaoke to win over generals and “singing gulagmeisters.” Farmer arrives the next day for treatments and a banquet, and he tells Kidder about how PIH is spending $150,000 on drugs to treat 35 patients now instead of waiting for drug prices to fall.