Program in Global Public Policy and Social Change

“During my first years in Haiti I thought of accompaniment as an idea most applicable in medical care—doing whatever it takes to cure the sick. Yet I realized that if my role as a doctor was to really cure them, then I had to step outside the traditional confines of my profession and address the conditions in which [patients] lived...”
-- Dr. Paul Farmer, 2011


Our Mission:

The Program in Global Public Policy and Social Change (PGPP), an initiative in the Department of Global Health and Social Medicine, was created in the spirit and acknowledgement of Dr. Farmer’s understanding of “accompaniment.”  PGPP interrogates and informs the policies, structures and systems that determine the conditions in which patients live, and their vulnerability to disease and health crises.

Our work aims to address the three critical levers to creating an ecosystem of health security from the individual to the community to globally: health system strengthening, medical countermeasure access, and equitable and accessible health systems for individuals and communities.


We accomplish this by:

  •  Conducting research and disseminating policy analysis that highlights health system failures and illuminates the path to system reform to promote health access and equity.. Our focus is on individuals and populations who are disproportionately disadvantaged in terms of health care, whether due to armed conflict, natural disasters, pandemics, or simply poverty.
  • Our unique “practice to policy” approach brings practitioners together with academia to best understand how health-relevant institutions and systems are operating, and how they can change the way they function to improve the conditions in which patients live. 
  •   We convene multi-sector policy leaders with practitioners and patients to, together, examine the policy challenges at the heart of mitigating health crises such as pandemics, armed conflicts and climate-related disasters.  We help them identify and propose policy options for addressing these challenges and we evaluate their likely impacts and consequences.
  •   We educate students and professionals so the current and next generation of global health practitioners possess the tools to understand, interrogate, analyze, formulate and implement equity-centered health-related policies and health system strengthening strategies.


Our Approach:

Over the past decade PGPP’s work has addressed a wide range of issues at the inextricable nexus of health, security and equity, including military doctrine and health system protection; inequities in humanitarian aid and pandemic response; public health system reform; human resources for health; bioterrorism; global health security; climate change and health; and health, cyberwarfare and weaponized disinformation. Despite this wide range of topics, we approach each issue the same way: by first asking “What we can learn from the patients and practitioners who are most vulnerable or most affected by the issue?”  Guided by these patient and provider voices, we then explore and delineate the policy challenges, system breakdowns and structural forces at play. We move forward by putting practitioners and patients in conversation with decision makers and policy thinkers to generate alternative approaches and policy options that can mitigate or ameliorate the identified inequities or vulnerabilities.  We then assess the resulting impacts of changed policy or system reform, creating a feedback loop between practice and policy.

Current Portfolios:

The leading edges of our portfolio are four interrelated workstreams which focus on pressing challenges highlighted by the COVID pandemic. They are complemented by targeted, strategic, evidence-based policy reform pathways to support global health security, equity and health system strengthening. 

  1. COVID Academy & U.S. Public Health Enterprise Reform:
  2. Reforming R&D for Disease X Medical Countermeasures
  3. Redefining Workplace Safety in the time of COVID
  4. Threatened Health Systems:  In conflict and crisis affected states, we help health system leaders and policy makers from a wide array of sectors, think through policy options for protecting, recovering, reconstructing, and reforming health systems degraded or disrupted by crisis.
  5. Health system strengthening investment and health workforce policy reform.