About

Maria Merritt, PhD, is an Associate Director for Faculty Affairs and a Professor at the Johns Hopkins Berman Institute of Bioethics. Her research interests focus on social justice in health-related policy decision making, with particular attention to health care equity and climate justice in decarbonizing health systems. She investigates how academic research institutions can effectively partner with communities to align scientific agendas with community members' visions of a healthy life, especially in the context of epidemiological research on infectious diseases sensitive to climate change. Dr. Merritt's work also explores questions of public health ethics in international research and practice, including considerations of social justice in economic evaluations of health policies and delineating ethical responsibilities of researchers and sponsors regarding community health needs in public health interventions. Additionally, her research involves nurturing the capacity for wonder in educational settings for health professionals and examining the ethical dimensions of climate solutions. She has served in various leadership roles, including Associate Chair for Student Matters at the Johns Hopkins Bloomberg School of Public Health and as a Visiting Scholar at the NIH Department of Bioethics. Her academic background includes a B.S. from Wake Forest University, a B.A. from Oxford University, and a Ph.D. from the University of California, Berkeley.

Research topics

• Business
• Sociology
• Medicine
• Economic growth
• Political Science
• Public relations
• Economics
• Marketing
• Nursing

Selected publications

• A Pragmatic Approach to Streamlining Single-Use Plastics in Health Care

  Annals of Internal Medicine · 2025-06-23 · 2 citations

  editorial
  PublisherDOI

• Exploring Wonder in Medical School Admissions: Correlations with Admissions Decisions

  International Journal of Medical Students · 2025-03-27

  articleOpen access

  Background: The capacity for wonder (CfW), which has been proposed as an important personal disposition for clinicians, may provide a meaningful picture of medical school applicants. The purpose of our study was to explore experiences of wonder among applicants and their association with components of the admissions process. Methods: The Johns Hopkins School of Medicine asks applicants to submit an essay about a time they experienced wonder in their everyday life. Among applicants who were interviewed in the 2021-2022 cycle, we analyzed an anonymized 50% random sample of essays (n = 224). Essays were coded using the validated CfW scale and categorized by topic. Standard bivariate statistical tests were used to assess whether the extent of wonder was associated with admissions decisions and interview scores. Results: Among applicants who were admitted, 80% had scores reflecting “high wonder,” 62% had “medium wonder” scores, and 27% had “low wonder” scores. Applicants’ extent of wonder was significantly associated with their admissions decisions (p < 0.0002), mean interview scores (p = 0.00025), and mean scores in research portfolio (p < 0.0001). Six broad essay topics were identified: connecting with others, engaging in art, experiences in nature, engaging in wellness, the pursuit of knowledge, and sports/exercise. Conclusion: Applicants’ capacity for wonder may be a relevant consideration in the admissions process. Future research should verify our findings at other institutions, investigate other components of the medical school application that may be associated with the capacity for wonder, and explore interventions to cultivate wonder throughout medical education.

  PublisherOA PDFDOI

• Implications of the fair processes for financing UHC report for development assistance: reflections and an application of the decision-making principles to PEPFAR

  Health Economics Policy and Law · 2025-01-01

  articleOpen accessSenior authorCorresponding

  The framework presented in the World Bank report Open and Inclusive: Fair processes for Financing Universal Health Coverage effectively connects proposed decision-making principles with practical examples that country governments can use to pursue greater fairness. In this commentary, we consider the suggestion that international development partners might use the report's criteria to examine their own processes. We consider what the report's primary Fair Process principles - equality, impartiality and consistency - imply for development partners. Specifically, we address two questions in turn: (i) how relevant the Fair Processes report is to development assistance for health; (ii) if it is deemed relevant, what practical implications does the report have for how aid works? We address the second question by briefly applying the framework to a particular global health initiative, namely the United States President's Emergency Plan for AIDS Relief (PEPFAR). Our analysis suggests that development partners' additional sets of accountabilities, particularly linked to funding sources, may pose more fundamental challenges to impartiality than to equality and consistency in decision-making processes. A question inviting further examination, then, is how development partners can redesign their processes to optimise impartiality given institutional constraints that bind them independently of the populations they purport to serve.

  PublisherOA PDFDOI

• Additional file 1 of Group-based trajectory models of integrated vaccine delivery and equity in low- and middle-income countries

  Open MIND · 2024-01-01

  dataset

  Additional file 1.

  DOI

• Group-based trajectory models of integrated vaccine delivery and equity in low- and middle-income countries

  International Journal for Equity in Health · 2024-01-09 · 5 citations

  articleOpen access

  BACKGROUND: Integrated vaccine delivery - the linkage of routine vaccination with provision of other essential health services - is a hallmark of robust primary care systems that has been linked to equitable improvements in population health outcomes. METHODS: We gathered longitudinal data relating to routine immunization coverage and vaccination equity in 78 low- and middle-income countries that have ever received support from Gavi, the Vaccine Alliance, using multiple imputation to handle missing values. We then estimated several group-based trajectory models to describe the relationship between integrated vaccine delivery and vaccination equity in these countries. Finally, we used multinomial logistic regression to identify predictors of group membership. RESULTS: We identified five distinct trajectories of geographic vaccination equity across both the imputed and non-imputed datasets, along with two and four trajectories of socioeconomic vaccination equity in the imputed and non-imputed datasets, respectively. Integration was associated with reductions in the slope index of inequality of measles vaccination in the countries analyzed. Integration was also associated with an increase in the percentage of districts reporting high measles vaccination coverage. CONCLUSIONS: Integrated vaccine delivery is most strongly associated with improvements in vaccination equity in settings with high baseline levels of inequity. Continued scholarship is needed to further characterize the relationship between integration and health equity, as well as to improve measurement of vaccination coverage and integration.

  PublisherOA PDFDOI

• Making the case for community involvement in research on climate and health: opportunities and lessons

  Frontiers in Climate · 2024-12-06 · 3 citations

  articleOpen access

  Advancing climate change is an urgent global driver of human disease with some of the world’s most marginalized communities being at highest risk. In response to this compound threat, scientific studies exploring the intersections of climate and health are gaining momentum, yet sparse attention is currently paid to models of research that engage and involve those who are most affected. This is a crucial moment for the global health field to take up valuable lessons from the relatively few climate-health studies that have purposefully brought scientists together with communities and members of the wider public, via established approaches such as community-based participatory research and citizen science, to reduce health risks and better understand the deeper determinants of disease. Through a scoping literature review of PubMed and qualitative framework analysis, we investigate scientific, ethical, and social justice rationales that have motivated scientists to involve communities, including Indigenous groups, and other public stakeholders in climate-driven health research to varying degrees in different global contexts. We also examine the benefits of diverse forms of engagement and show that involving communities in research at the climate-health nexus has, for example, generated co-produced adaptation strategies that respond appropriately and effectively to priority health hazards. In addition, our findings demonstrate limitations, challenges, and ethical considerations that can arise when engaging communities in climate-health research. We argue that ethically engaging and involving communities and the wider public in research at the intersection of climate change and health is imperative for identifying relevant research priorities, promoting responsiveness that can appropriately fill gaps in at-risk settings, and advancing social justice. Our paper offers a range of examples of research designs and activities to guide scientists working in this emerging interdisciplinary field, inform funders seeking to support innovative and potentially transformative research, and contribute to global health policy.

  PublisherOA PDFDOI

• Post-epidemic health system recovery: A comparative case study analysis of routine immunization programs in the Republics of Haiti and Liberia

  PLoS ONE · 2023-10-17 · 2 citations

  articleOpen accessSenior author

  Large-scale epidemics in resource-constrained settings disrupt delivery of core health services, such as routine immunization. Rebuilding and strengthening routine immunization programs following epidemics is an essential step toward improving vaccine equity and averting future outbreaks. We performed a comparative case study analysis of routine immunization program recovery in Liberia and Haiti following the 2014-16 West Africa Ebola epidemic and 2010s cholera epidemic, respectively. First, we triangulated data between the peer-reviewed and grey literature; in-depth key informant interviews with subject matter experts; and quantitative metrics of population health and health system functioning. We used these data to construct thick descriptive narratives for each case. Finally, we performed a cross-case comparison by applying a thematic matrix based on the Essential Public Health Services framework to each case narrative. In Liberia, post-Ebola routine immunization coverage surpassed pre-epidemic levels, a feat attributable to investments in surveillance, comprehensive risk communication, robust political support for and leadership around immunization, and strong public-sector recovery planning. Recovery efforts in Haiti were fragmented across a broad range of non-governmental agencies. Limitations in funding, workforce development, and community engagement further impeded vaccine uptake. Consequently, Haiti reported significant disparities in subnational immunization coverage following the epidemic. This study suggests that embedding in-country expertise within outbreak response structures, respecting governmental autonomy, aligning post-epidemic recovery plans and policies, and integrating outbreak response assets into robust systems of primary care contribute to higher, more equitable levels of routine immunization coverage in resource-constrained settings recovering from epidemics.

  PublisherOA PDFDOI

• How medicine becomes trash: disposability in health care

  The Lancet · 2022 · 21 citations

  Senior authorCorresponding
  • Medicine
  • Business
  • Economics
  PublisherDOI

• The Value of Explicit, Deliberative, and Context-Specified Ethics Analysis for Health Technology Assessment: Evidence From a Novel Approach Piloted in South Africa

  Value in Health Regional Issues · 2022-11-28 · 9 citations

  articleOpen access

  OBJECTIVES: This article explores the perceived value, including associated strengths and challenges, of using a context-specified ethics framework to guide deliberative health technology appraisals. METHODS: The South African Values and Ethics for Universal Health Coverage (SAVE-UHC) approach, piloted in South Africa, consisted of 2 phases: (1) convening a national multistakeholder working group to develop a provisional ethics framework and (2) testing the provisional ethics framework through simulated health technology assessment appraisal committee meetings (SACs). Three SACs each reviewed 2 case studies of sample health interventions using the framework. Participants completed postappraisal questionnaires and engaged in focus group discussions. RESULTS: The SACs involved 27 participants across 3 provinces. Findings from the postappraisal questionnaires demonstrated general support for the SAVE-UHC approach and content of the framework, high levels of satisfaction with the recommendations produced, and general sentiment that participants were able to actively contribute to appraisals. Qualitative data showed participants perceived using a context-specified ethics framework in deliberative decision making: (1) supported wider consideration of and deliberation about morally relevant features of the health coverage decisions, thereby contributing to quality of appraisals; (2) could improve transparency; and (3) offered benefits to those directly involved in the priority-setting process. Participants also identified some challenges and concerns associated with the approach. CONCLUSIONS: The SAVE-UHC approach presents a novel way to develop and pilot a locally contextualized, explicit ethics framework for health priority setting. This work highlights how the combination of a context-specified ethics framework and structured deliberative appraisals can contribute to the quality of health technology appraisals and transparency of health priority setting.

  PublisherDOI

• GLIDE Wellcome Open Research Gateway

  Wellcome Open Research · 2022-06-24

  preprintOpen accessCorresponding

  The Global Infectious Disease Ethics (GLIDE) Collaborative is launching a new Wellcome Open Research (WOR) Gateway, and we as the leaders of GLIDE hope to encourage submissions to this timely and necessary new platform for publishing open access peer-reviewed articles focusing on this area.

  PublisherOA PDFDOI

Recent grants

• Assessing Social Value in Economic Evaluation to Scale Up Novel TB Drug Regimens

  NIH · $302k · 2014–2015

• Assessing Social Justice in Economic Evaluation to Scale up Novel MDR-TB Regimens

  NIH · $1.6M · 2015–2021

Frequent coauthors

• Adnan A. Hyder

  Milken Institute

  63 shared

• Luke C. Mullany

  61 shared

• Loretta Brabin

  Manchester Academic Health Science Centre

  56 shared

• Jackie Cattani

  University of Oxford

  56 shared

• Herbert Gillies

  University of Oxford

  56 shared

• Hassan Mshinda

  56 shared

• Steve Bennett

  56 shared

• Chris Grundy

  56 shared

Education

• PhD, Philosophy

  University of California Berkeley

  1999

• BA First Class, Philosophy and Modern Languages

  University of Oxford

  1990

• BS, Biology

  Wake Forest University

  1987

Awards & honors

• Hastings Center Fellow, elected December 2020
• Student Assembly Special Recognition Award for Outstanding C…
• Greenwall Faculty Scholars Program in Bioethics career devel…
• Faculty Innovation Fund, 2007-08, Johns Hopkins Bloomberg Sc…
• Faculty Fellow, Edmond J. Safra Foundation Center for Ethics…