Dr. Paul Farmer is slated to be the next head of the United States Agency for International Development. Farmer, long known for his outspoken criticism of U.S. developmental and other policies, could quite possibly be the one making many of them. USAID has continuously implemented the rules of the Washington Consensus – stabilization, structural adjustment, and export-led growth in the developing world. Over and over this code of conduct has failed the Global South, leaving countries without adequate public infrastructure such as healthcare. Farmer made a name for himself in Haiti through his organization Partners in Health and their Haitian flagship project Zanmi Lasante. Though this work is humanitarian in nature, it is deeply rooted in thoughtful political analysis and has grown to include countries such as Rwanda, Russia, and even the U.S. Grassroots International and Partners in Health have been collegial organizations for years now. Our work in Haiti’s Central Plateau often crosses paths as Haitians organize to defend their rights, such as the basic right to health. As Farmer put it, “I would argue that a social justice approach should be central to medicine and utilized to be central to public health.” At a time where the U.S. is deep into a debate about making healthcare more progressive, giving the job to Farmer could provide visibility to this global struggle. If he were to push USAID to work more like his own organization, it could be one of the biggest shifts we have seen to date away from the Reagan/Thatcher doctrine that has been devastating countries like Haiti for far too long.