Howard Hiatt, former Harvard dean who championed global health efforts, dies at 98

“There may be things unknown to you in the medical area that we know and you should know,” he asserted in a later interview.

For the renowned medical researcher, controversy was no barrier to fighting to improve public health globally. Dr. Hiatt, who helped advance the practice of medicine in myriad ways during his long career, was 98 when he died Saturday in his Cambridge home.

He practiced and taught at many leading institutions, mentoring thousands of students and physicians in the United States and abroad. In the 1960s, he worked on a team that discovered messenger RNA, the type that carries genetic information for cellular protein synthesis, in a Paris laboratory.

At what is now Harvard’s T.H. Chan School of Public Health, where he survived a faculty insurrection in the 1970s, he made the institution significantly more analytics driven and policy oriented. It would become a model for other teaching institutions.

Dr. Hiatt also directed a landmark investigation of medical malpractice and founded what is now the Division of Global Health Equity at Brigham and Women’s Hospital, where he held the title of senior physician.

Generations of globe-trotting pioneers benefited from his tutelage, among them Paul Farmer, who died in 2022, and Jim Yong Kim, who cofounded Partners in Health, a Boston-based nonprofit that works to bolster health care systems in some of the most distressed corners of the world.

“He really was a surrogate father to both of us,” Kim said Sunday, describing how Dr. Hiatt introduced him and Farmer to powerful medical leaders and helped them secure key funding, such as a $45 million grant from the Gates Foundation.

“Howard really championed us in a way that, if we hadn’t had him, I don’t think Partners In Health would be as big as it is now,” said Kim, a former president of Dartmouth College and the World Bank. “He literally transferred his global status to us, a bunch of young upstarts.”

Outspoken yet soft-spoken, earnest yet self-effacing, Dr. Hiatt addressed critical public health issues, decade after decade, with great passion and a deep belief in basic science.

“Howard is probably the finest mentor I’ve ever known,” said Dr. Donald Berwick, whom Dr. Hiatt hired as an assistant at the School of Public Health and who later directed the Centers for Medicare and Medicaid services under President Barack Obama and ran for Massachusetts governor. “His biggest impact was probably in the evaluation of clinical processes, what is now conventional thinking about how to evaluate the performance of health and health care systems. He’s also a globalist and thinks that way. I don’t think the global health scene would be the same without him.”

Among Dr. Hiatt’s greatest legacies, said Berwick, was finding and nurturing talented colleagues such as former Harvard Public Health dean Harvey Fineberg, health policy expert Milton Weinstein, economist Marc Roberts, statistician Frederick Mosteller, and global health leader Mark Rosenberg.

“What Howard taught us is that mentoring the next generation is absolutely one of our responsibilities,” Kim said. “For Howard, it was a sacred commitment to support others in the work they were passionate about.”

Berwick said Dr. Hiatt was “the epitome of graciousness” who “set a standard for what it’s like to be civil, gracious, thoughtful. Often when I’m faced with a tough interaction I think, how would Howard handle it?”

Born on July 22, 1925, in Patchogue, N.Y., Howard Haym Hiatt grew up in Worcester, the eldest of three children born to Alexander Hiatt, a Jewish shoe manufacturer, and Dorothy Askinas Hiatt.

At age 12, he set his sights on a medical career. After high school, he spent two years at Harvard College before entering the Army, where he underwent basic training before returning to Harvard, this time as a medical student. He graduated from Harvard Medical School in 1948 and did his internship and residency at Boston’s Beth Israel Hospital (now Beth Israel Deaconess Medical Center).

While in medical school, he met Doris Bieringer, a Wellesley College student and future librarian. The couple married in 1948 and had three children. Mrs. Hiatt, a writer who cofounded a bimonthly review magazine that helped high school librarians nationally choose paperbacks for students, died in 2007.

The couple established a residency in global health equity and internal medicine at Brigham and Women’s. Kim said there are now dozens of “Doris and Howard Hiatt fellows and they are literally running the world” — leading departments of medicine and conducting key research.

A job at the National Institutes of Health lab in Bethesda, Md., awakened in Dr. Hiatt an interest in biochemical science and, more specifically, in cellular research and cancer management.

Upon earning his medical degree, he focused on teaching and research, notably in the field of molecular biology. In the mid-1950s he joined the staffs of Harvard Medical School and Beth Israel. In the early 1960s, he spent a year at the Pasteur Institute, where the RNA research was conducted, before returning to Boston to become chair of medicine at Beth Israel. In 1972, Harvard president Derek Bok appointed him dean of the university’s public health school, an unconventional choice — Dr. Hiatt lacked a background in public health — and a controversial one, as became evident.

In 1978, the school’s faculty publicly challenged Dr. Hiatt’s management style and leadership, circulating a petition, signed by two-thirds of the group, that called for his ouster. The group criticized his financial management — a proposed $40 million fund drive had been largely shelved — and what it called “administrative ineptitude.” Many criticized Dr. Hiatt for having de-emphasized several of the school’s traditional strengths, such as tropical medicine and epidemiology, in favor of an interdisciplinary curriculum drawing upon expertise in many fields, including statistics, engineering, business, and economics.

Bok stood behind Dr. Hiatt, and the revolt fizzled. Dr. Hiatt remained dean until 1984. Years later, Harvard’s president, in a letter to Dr. Hiatt, wrote of the school being “better in every way” for his “lifting its aspirations and its standards.”

At the school and afterward, Dr. Hiatt continued to focus on what he saw as critical public health issues. In 1977, as costly new lifesaving procedures and technologies were becoming more widely used, he co-published a paper questioning the need for many nonemergency surgical procedures. The paper recommended training physicians and medical students in cost-benefit analysis. A newspaper headline summed it up this way: “Harvard Team Challenges View That a Human Life is Priceless.”

In 1980, Dr. Hiatt led a symposium sponsored by Physicians for Social Responsibility on the medical consequences of nuclear war. He traveled to Rome to discuss the issue with the Papal Academy of Sciences. At the pope’s behest, he then met with Reagan in the Oval Office, where Dr. Hiatt reminded the president of the lifesaving care he’d received at George Washington University Hospital after being shot by a would-be assassin. Imagine, Dr. Hiatt said, thousands of severely injured citizens seeking emergency care at the same time — without any functioning hospitals. The meeting was brief.

“The president was not very comfortable,” Dr. Hiatt recalled, saying “something about Armageddon” before the group was ushered out.

Dr. Hiatt continued pressing the issue, however. In a 1982 New England Journal of Medicine article, he sharply questioned the large sums being spent on nuclear weapons, at the expense of other priorities such as public health. It’s time for Americans, he wrote, “to consider more carefully what really constitutes our national security.”

In 1984, Dr. Hiatt left the School of Public Health to resume his teaching and research. Among the many papers — he published nearly 100 in leading scientific and medical journals — and books he wrote or co-wrote were “America’s Health in the Balance: Choice or Change?”; “Medical Lifeboat: Will There Be Room For You in the Health Care System?”; and “A Measure of Medical Malpractice: Medical Inquiry, Malpractice Litigation, and Patient Compensation.”

Among the organizations with which he was affiliated are the Association of American Physicians, American Society for Clinical Investigation, and American Academy of Arts and Sciences, for which he served as secretary from 1991-97 and began its Initiatives for Children program.

Dr. Hiatt, whose son Frederick died in 2021, leaves a son, Jon of Washington, D.C.; a daughter, Deborah of Dedham; a brother, Arnold of Boston, the former president of Stride Rite footwear; eight grandchildren; and four great-grandchildren. He also leaves his companion, Penny Janeway of Cambridge.

In 2007, the Institute of Medicine bestowed upon him its Gustav O. Lienhard Award for improving global health services. “Many of today’s leaders in health can trace the roots of their accomplishments” to Dr. Hiatt’s inspiration and guidance, the citation read.

A few years earlier, in a speech paying tribute to Dr. Hiatt, Berwick quoted Mohandas Gandhi’s observation, “You must be what you wish to see in the world.”

“Howard,” he said, “is what he wants to see in the world.”

Bryan Marquard can be reached at bryan.marquard@globe.com.