Duke Changed Paul Farmer. Then, Paul Farmer Changed Duke.

In 1983, a young Duke University graduate, on his first trip to Haiti, wrote a classmate to share his profound unease about the massive inequities in health he witnessed on the island.

"I am not at peace mentally,” Paul Farmer ’82 wrote in a letter to a Duke friend, Jenny Labalme ’82. “In places where government officials seem only interested in their own self-advancement, perhaps grassroots, community-level organization will be more effective.”

In his letters to Labalme, Farmer began to shape the contours of a philosophy that would fundamentally change the field of global health. Just four years later, he co-founded Partners in Health (PIH), a nonprofit that works to deliver high-quality healthcare to some of the world’s poorest citizens. Until his death in 2022, Farmer centered PIH’s efforts on that grassroots, community-driven approach he imagined four decades earlier.

But it was a worldview also deeply influenced by Farmer’s time at Duke, from his interdisciplinary studies in medicine and anthropology to his research documenting the experiences of Haitian migrant workers in eastern North Carolina.

“The way he looked at the world … 100 percent can be traced back to classes he took at Duke” said Todd McCormack ’82, who met Farmer on his first day at Duke and became a lifelong friend and co-founder of PIH. “I think that really formed his thinking that you couldn’t isolate health. It had to be taken in a more holistic approach.”

McCormack and others who knew and worked with Farmer shared their reflections about his legacy in a new 12-minute documentary video, “A Global Vision: Paul Farmer, Duke, and the Future of Global Health.” Produced by Legacy Film Group for the Duke Global Health Institute, the film explores how Duke shaped the goals and values of the global health pioneer, and how Farmer in turn shaped – and continues to shape – Duke’s approach to global health.

In addition to serving his alma mater as a trustee, Farmer was a founding member of the DGHI Board of Advisors and spoke at several DGHI events, including the Victor J. Dzau Distinguished Lecture in GlobalHealth in January 2022, just a few weeks before his death. But the clearest evidence of his influence may be in DGHI’s commitment to community-driven research and educational experiences for undergraduate, graduate and medical students.

“There’s a direct relationship between the way Paul approached global health and the ways we place students in the field,” said Aunchalee Palmquist, Ph.D. DGHI’s director of graduate studies, She said DGHI’s emphasis on cultural humility and mutually beneficial partnerships is rooted in Farmer’s values of health equity and the empowerment of disadvantaged populations. 

As DGHI looks ahead to its 20th anniversary in 2026, the institute’s leaders are exploring new ways to celebrate and strengthen Farmer’s legacy at Duke, including deepening partnerships with PIH and the University of Global Health Equity, a medical school in Rwanda that Farmer helped launch in 2015. DGHI has also identified increasing support for students and educational programs among its top priorities for Duke’s “Made for This” campaign.

But as global health faces unprecedented shifts in funding and governmental leadership, Farmer’s unfailing ambition to improve the lives of the world’s poorest communities feels even more urgent. 

“In a world of rising inequality, it has never been more important to focus on health equity” said DGHI director Chris Beyrer, M.D. “Paul Farmer’s vision matters more now than ever."