@rachelbonnifield.bsky.social
Director of Global Health Policy & Senior Fellow @Cgdev. Global health, lead poisoning, R&D, AMR, pandemic prep, pharma, econ, and development, with a side of foster kittens. Views are my own.
Millions of kids need a life-changing drug that could prevent permanent brain damange from lead poisoning.
The medicine is off-patent, on the WHO Essential Medicine List, and cheap to make.
So why is it still unaffordable & out of reach?
w/Theo Mitchell
www.cgdev.org/blog/million...
Millions of kids need a life-changing drug that could prevent permanent brain damange from lead poisoning.
The medicine is off-patent, on the WHO Essential Medicine List, and cheap to make.
So why is it still unaffordable & out of reach?
w/Theo Mitchell
www.cgdev.org/blog/million...
Global lead poisoning makes the cover of the NYT -- documenting how dirty battery recycling in Africa powers the US automobile industry. Important read 👇
www.nytimes.com/interactive/...
The US really can protect PEPFAR’s legacy while also reducing its financial & geographic footprint.
We urge Congress and the administration to do so w/fiscal, technical, & human resources to deliver on the promise of the Global Health Strategy. /end
Track 2 – Extended transition timelines for poorer, higher-burden countries
Track 3 – Sustained PEPFAR investment and service delivery in the poorest and most fragile countries 6/x
We propose a three-track framework:
Track 1 – Quick (3yr) graduation for wealthier and stable partner countries able to feasibly absorb PEPFAR funding on a relatively rapid timeline. 5/x
Tl;dr: The overall direction is great for many countries, but the pace + scale of proposed changes are unprecedented in global health history w/real risks.
And the poorest, most dependent, & fragile countries will need longer transition timelines/a differentiated approach. 4/x
Janeen Manan Keller and I are out today with a new edition of "Tough Times, Tough Choices," considering the question of how to operationalize the Administration's Global Health Strategy for a responsible PEPFAR transition. 3/x
www.cgdev.org/publication/...
Sustainability really matters here. Country-led service delivery is a reasonable (overdue?) step for some countries, and a medium-term goal for others.
Many administrations past have tried and failed to localize PEPFAR, so ambition here is very welcome. 2/x
PEPFAR is at a great American success story at a crossroads.
The Trump Administration's Global Health Strategy offers a broadly reasonable blueprint for PEPFAR's next chapter: more country ownership, deliverty by national governments, and spending cuts. 1/x
How do you find $2.5 B in savings when every decision has consequences for access to life-saving vaccines? With Center for Global Development colleagues, here are 2 core principles and 5 suggestions. Give it a read and let us know what you think. #gavi
18.07.2025 18:48 — 👍 4 🔁 2 💬 2 📌 0
Amid a broader global health financing crisis, @gavi.org faces a $2.5B budget shortfall
Read our new @cgdev.org brief on how Gavi 6.0 can take a bigger leap w @rachelbonnifield.bsky.social @peterbaker17.bsky.social @tomldrake.bsky.social & @orinlevine.bsky.social
www.cgdev.org/publication/...
WHO faces immediate fiscal crisis, w/ a 35% budget gap of $1.5bn.
@peterbaker17.bsky.social, @rachelbonnifield.bsky.social, & @jmadankeller.bsky.social argue that WHO’s leadership must chart a path of retrenchment to global leadership, health security, & public goods:
www.cgdev.org/publication/...
1st edition of our @cgdev.org series "Tough Times, Tough Choices" is hot off the press
Facing budget cuts, we argue WHO's leadership must chart a path of retrenchment to a lean @who.int for the global good
w/ @peterbaker17.bsky.social & @rachelbonnifield.bsky.social
www.cgdev.org/publication/...
Cutting US funding for @gavi.org which leads on global vaccination efforts is incredibly shortsighted and misguided
@charlesjkenny.bsky.social & I argued why in this @cgdev.org blog 👇
www.cgdev.org/blog/why-tru...
Usual caveats, obviously not all pro Palestinian people are anti Semitic, there’s lots of people outraged for very good reasons, right wing equally bad or worse, etc.
But you’re delusional if you think there’s no meaningful anti semitism or safety risk in lefty spaces.
And I am firmly in the “anti-Israel is not the same as anti-Semitism” camp, for the record.
But also not cool with setting Jewish grandmothers on fire for wrongthink, or people telling me why they think actually that’s great. (Which yes, does happen.)
Yeah you’re very, very wrong on this one.
You are aware that there have been two separate terrorist attacks on American Jews* from pro-Palestinian individuals in the past two weeks? So we’re not talking just some overheated college rhetoric.
And plenty on the far left cheering or justifying them
Fantastic news that Switzerland have now submitted the paperwork triggering the start of the process that could eventually lead to better regulation on lead paint exports
ipen.org/news/lead-ch...
Starting now! Tune in on CGD YouTube
03.06.2025 17:07 — 👍 4 🔁 3 💬 1 📌 0
"In Cleveland, where 20% of children have elevated lead levels, Dave Margolius, director of the Cleveland Department of Public Health say they’ve also lost CDC assistance for lead prevention.
“The percentage of children poisoned by lead in Cleveland is higher than Flint, Michigan was at its peak”"
The Market for Prescription Drugs Is Broken. Here’s Why Trump’s Executive Order Would Make It Worse
www.cgdev.org/blog/market-...
📣New @cgdev.org blog on the latest Trump EO to curb high drug prices
We breakdown why the proposed policy prescription of "reference pricing" is misguided... with a healthy dose of econ101 🤓
w/ @charlesjkenny.bsky.social & @rachelbonnifield.bsky.social
www.cgdev.org/blog/market-...
We *can* negotiate and get a lower price, albeit trading off against some future innovation.
But insisting we pay the lowest price available to others will just lead pharma to raise prices elsewhere.
And that will mean we pay the same price, others get no medicine, and pharma loses money.
The key point is that other countries don’t receive a “discount” against the “real” US price.
There is no “real” or “fair market” price in monopoly.
Pharma is already profit-maximizing in every market—but other countries are willing to pay less and will walk away at the US price.
US drug prices are way too high—but the Trump EO to “fix” them would make things worse for everyone.
We break down the economics of reference pricing here — and explain why it’s a bad approach for the US 👇
With @charlesjkenny.bsky.social and @jmadankeller.bsky.social
www.cgdev.org/blog/market-...
And if we lower prices, it will just lead to overall lower pharma profits (ok) and lower private R&D spending (debatable). There is no world where other countries pay more to make up their "share" of current R&D support -- because they do not value it as much as we do.
/end
Yes, we should absolutely regulate pharma prices. But there is no version of the world where other countries paying more leads to us paying less. That's not how any of this works.
What we do has nothing to do with other countries.
And in monopolist pricing, there is no “fair market price” to discount--there is just a price agreed between the seller and any given buyer. And there is no version of market capitalism that forces buyers to buy something for more than they are willing to pay."
12.05.2025 16:40 — 👍 0 🔁 0 💬 1 📌 0But there is no subsidizing, and there is no “overcharge” in monopoly pricing.
If you can (perfectly) price discriminate, there is just what each market is willing to bear.
Because in monopoly pricing the monopolist keeps the the economic surplus from perfect price discrimination!
