Rachel Bonnifield

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

How Gavi 6.0 Can Take a Bigger Leap Gavi’s board and leadership must stretch scarce resources to fulfill a challenging double mandate: (1) stabilizing immunization outcomes and fiscal solvency in Gavi-eligible countries facing severe he...

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/...

A Lean World Health Organization for the Global Good In this brief—the first in the Tough Times, Tough Choices series that will target the major global health and development institutions and their funders—we propose a different approach: radically stre...

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/...

A Lean World Health Organization for the Global Good In this brief—the first in the Tough Times, Tough Choices series that will target the major global health and development institutions and their funders—we propose a different approach: radically stre...

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

White House to Cities: Good Luck Fighting Lead Poisoning Centers for Disease Control staff cuts leave cities to fight lead poisoning that endangers children without federal help.

"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 The US pays—by far—the highest prices for on-patent prescription drugs of any country on earth. The White House just issued an executive order purporting to fix this problem. But the proposed solution...

The Market for Prescription Drugs Is Broken. Here’s Why Trump’s Executive Order Would Make It Worse
www.cgdev.org/blog/market-...

The Market for Prescription Drugs Is Broken. Here’s Why Trump’s Executive Order Would Make It Worse The US pays—by far—the highest prices for on-patent prescription drugs of any country on earth. The White House just issued an executive order purporting to fix this problem. But the proposed solution...

📣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.

The Market for Prescription Drugs Is Broken. Here’s Why Trump’s Executive Order Would Make It Worse The US pays—by far—the highest prices for on-patent prescription drugs of any country on earth. The White House just issued an executive order purporting to fix this problem. But the proposed solution...

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."

But 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!

It is true that this price discrimination allows them to access foreign markets.

If they needed to set a single global monopolist price, it would be higher than many countries would be willing to pay – and therefore they would not have any market access or profit in those markets.

Pharma companies do not “discount” their prices in foreign countries.

They are monopolists.

In every country they set a profit-maximizing monopolist price.

Because other countries have lower willingness to pay, the monopolist profit-maximizing price is lower.

But here's where things go off the rails.

The EO asserts "a purposeful scheme in which drug manufacturers deeply discount their products to access foreign markets, & subsidize that decrease through enormously high prices in the United States."

That is a fundamental economic misunderstanding.

Third, pharma companies do price discriminate between countries. The ability to price discriminate allows them to charge lower prices to some countries, and higher prices to the US. And effectively, the ability to price discriminate also does allow them to enter and profit from foreign markets.

Second, pharma companies very much do benefit from American upstream subsidy of publicly funded R&D, and downstream public funding of medicines. And they do fight any efforts to regulate drug prices. The overall behavior is outrageous, and the government should intervene to address it.

First, the parts they get right (yes, there are some).

The EO correctly points out several true premises.

First, American spending on drugs does fuel global pharmaceutical R&D. Other countries do effectively "free ride" on that innovation -- it's a public good from which they benefit.

Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered: Section 1.  Purpose.

New Trump EO on drug pricing just dropped and there's...a lot going on there. A breakdown 👇 www.whitehouse.gov/presidential...

Feeling *inspired* to renew my Canadian passport 🍁

"I'm going to govern in econometrics" is a winning campaign slogan for the ages.

"We've been left no choice but to this week suspend treatment for 650,000 malnourished women and children — simply because we've run out of commodities and funding," Zlatan Milisic, WFP Country Director in Ethiopia told a Geneva press briefing by video from Addis Ababa.