4 Reflections from the Paul Farmer Symposium on Global Health Equity

At the third annual Paul Farmer Symposium on Global Health Equity, hundreds of individuals across clinical care, research, and education gathered—in person and virtually—to honor Dr. Paul Farmer’s legacy.

Farmer co-founded Partners In Health (PIH) in 1987 and led the organization until his unexpected passing in 2022. Every year since, we’ve gathered to honor him and explore how we can advance his vision for health equity. The November 18 event was centered around mental health, a topic that Farmer cared deeply about.  

Below, we’ve highlighted four reflections about PIH's beloved Co-founder, shared during the symposium:

1. In 1981, Paul Farmer wrote a letter to his mentor about mental health research.

Farmer’s longtime mentor, Dr. Arthur Kleinman, shared that mental health was one of Farmer’s original interests. On June 26, 1981, Farmer wrote a letter to Kleinman about studying transcultural psychiatry with the plan of going to Senegal or the Ivory Coast to conduct research. The professor whom Farmer was working with at the time was severely ill, noted Kleinman. If he had not been sick, Kleinman suggests it’s possible that Farmer’s career would have been centered around mental health.

“At the very start of things, he was aware of why mental health was important,” said Kleinman, Esther and Sidney Rabb Professor of Anthropology at Harvard University and professor of psychiatry and global health and social medicine at Harvard Medical School (HMS).

2. Paul Farmer deeply understood social forces and respected lived experiences.

In 1996, Paul Farmer published a paper in Dædalus, the Journal of the American Academy of Arts and Sciences, addressing the question: “By what mechanisms do social forces ranging from poverty to racism become embodied as individual experience?”

“Despite being an expert in understanding these social forces, Paul’s touchstone and ground truth was always the lived experience for those who suffered due to those forces,” said Dr. Joseph Rhatigan, associate professor of medicine and global health and social medicine at HMS and associate chief of the Division of Global Health Equity at HMS. “His ethnographies are written with a deep respect, in fact, a reverence for the ways individuals struggle daily to endure their mental and physical suffering.”

In the paper, Farmer highlights the life histories of Acéphie Jospeh and Chouchou Louis, two Haitians living in poverty, whose lives were cut short by forces beyond their control.

“Despite the enormity of these forces, Paul was the eternal optimist and perpetual clinician,” said Rhatigan.

This year’s symposium content was inspired by a mental health-focused issue of Dædalus, published in 2023, which explores the frontiers of knowledge and issues of public importance—and cites Farmer and PIH throughout the articles. 

3. Paul Farmer’s teachings and lessons continue to inform global health delivery.

Farmer often talked about the importance of health system strengthening in the context of the “five S’s”: staff, stuff, space, systems, and social support.

During the symposium, Professor Theresa S. Betancourt spoke about training non-specialist workers to do home visits to strengthen families, promote early childhood development, and prevent intergenerational violence in Rwanda.

“We see [home visitors’] trajectories improve over time when you take an intentional approach. That is the five S’s, the social support, backed by the systems and the human resources strategies,” said Betancourt, Salem Professor in Global Practice at Boston College School of Social Work and director of the research program on children and adversity.  

“I learned a lot in my years with Paul, and Jim Kim, and others in global health delivery and [take] that to my work on mental health,” said Bentancourt.

4. Paul Farmer’s optimism and beliefs guide PIH, every day.

During the closing remarks, PIH Chief Executive Officer Dr. Sheila Davis reminded us that transformation is possible—and together, we can carry forward Farmer’s work.

“We know that Paul is with us today, as he is every day. And as the past week, as the executive directors and leadership council of PIH came together, I knew Paul was with all of us and echoed in all of the plans and optimism we have for the future,” said Davis. “Our call to action is to let that belief guide us to see health as a human right and accompaniment as the way we achieve it.”

The 2025 Paul Farmer Symposium on Global Health Equity was hosted by PIH, the Department of Global Health and Social Medicine at Harvard Medical School, the Division of Global Health Equity at Brigham and Women’s Hospital, and the Harvard Global Health Institute.