How a Boston-area Funder is Continuing the Legacy of a Champion of Global Health

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In the modern field of global health, few names are as well-known as Paul Farmer, the physician, humanitarian and Harvard Medical School professor who pioneered innovative strategies to improve health in lower-income countries like Haiti, Peru and Rwanda. Even people outside the sector may recall that Farmer, along with colleagues and volunteers, was among the first of the medical teams to arrive in Haiti after an earthquake devastated that country in 2010, killing more than 200,000.

Farmer contributed to important work related to global health threats like drug-resistant tuberculosis and HIV/AIDS — work that prompted international health organizations to integrate treatment and prevention of such diseases in resource-poor settings around the world. He also served as chair of Harvard’s Department of Global Health and Social Medicine.

But Farmer is perhaps best known as co-founder of Partners in Health, a health-focused social justice organization that addresses not just medicine and medical care, but also access to food, transportation, housing and other essential elements of healthy lives and communities. Since its creation in 1987, Partners in Health has grown into a global nonprofit with 18,000 mostly local staff serving marginalized communities in 10 countries.

Farmer died unexpectedly about a year ago of cardiac arrest at age 62 in Rwanda while teaching at the University of Global Health Equity (UGHE). Farmer and Partners in Health had helped create UGHE almost a decade ago, with key support from the Bill & Melinda Gates Foundation and the Cummings Foundation, a Massachusetts-based (and mostly Massachusetts-focused) grantmaker established by Joyce and Bill Cummings, which they funded initially with nearly $1 billion from wealth generated by their commercial real estate business.

Now the Cummings Foundation is maintaining and building upon its global health work with a new $50 million, 10-year commitment that will be evenly divided between UGHE in Rwanda and Harvard Medical School. The funding also establishes an endowed professorship in global health equity at Harvard Medical. Another $2 million in funding will go to UGHE toward construction of faculty residential housing on the university’s campus in Butaro, Rwanda. The new grants follow previous Cummings gifts over the years to UGHE totaling more than $27.5 million.

In a news release, Joyce Cummings described Farmer as the “vital physical link” between Harvard and UGHE, adding that the new funding aims to ensure that connection for the future, in the late doctor’s absence. The funds will build upon the existing partnership between Harvard Medical and UGHE, going toward programs such as student and faculty exchanges, joint research projects, an annual global conference focused on health equity and clinical training opportunities for medical students and residents, with an initial focus on building surgical capacity in low-resource settings.

The overall goal is to help researchers at both Harvard and UGHE to advance exploration of social medicine­ — a field of public health focused on the many factors influencing a person’s health, and to pursue questions about social determinants of health. This broader, more expansive approach toward improving a community’s health is a growing trend we’ve seen among funders in the United States, serving vulnerable populations in rural and urban settings alike. The Cummings grant is a unique take on that strategy, with a regional funder giving big to serve the Global South. Ultimately, of course, the hope is that successful models of care can be developed and reiterated for underserved populations around the world.

As noted, the Cummings Foundation primarily focuses on giving back to the communities in Eastern Massachusetts where the family’s commercial real estate business originated and thrived. Typical recipients include a variety of community organizations, including those working on youth, local development, education and health, and special interests in retirement communities and universities. The foundation gives about $30 million each year, including some hefty grants maxing out at $1 million, although still a far cry from their latest big gift. International giving is narrow: It supports a few national and international organizations through invitation-only grants, such as UGHE, with that international giving directed almost exclusively to nonprofits working in Rwanda, as well as a few other global charities. Other support goes to Holocaust and genocide education projects outside its home region.

Joyce and Bill Cummings are not unique in their desire to share their financial success in the form of charitable help for the people and communities where they built their business, and with others around the world. But the couple went a step further than most philanthropists: Over the years, they have gradually transferred the majority of their Cummings Properties buildings to their foundation. Now, nearly all of the company’s properties are owned and operated by the Cummings Foundation.

That shift of the lion’s share of their company to their philanthropy seems to have prefigured last year’s surprise decision by Patagonia founder Yvon Chouinard, along with his wife and two children, to transfer their ownership of the vastly successful high-end outdoor apparel and equipment maker to a trust and a nonprofit that will work to fight climate change and protect undeveloped land.

It’s yet another example of wealthy donors, even those hovering a bit below the stratosphere, shifting norms in high-dollar philanthropy, both in the way they allocate their money, and in widening their focus just beyond the local institutions family philanthropies traditionally gravitate toward. The Cummingses might not have received the coverage that the Chouinards received, but they nevertheless serve as a striking philanthropic model, including for those who have promised through the Giving Pledge to eventually commit the bulk of their wealth to philanthropy but maybe are being a little too eventual about it.