Trailblazers with Garry: a conversation with Priti Patnaik

"Trailblazers with Garry" is a series from Global Health Matters, where host Garry Aslanyan sits down with trailblazers — thinkers, leaders, and influencers shaping the future of global health — for short face-to-face conversations, available in both audio and video formats. It’s a chance to get to know the people behind the work and hear their perspectives on the current global health landscape.

For this episode, Garry sat down with Priti Patnaik, an independent investigative journalist and the founding editor of Geneva Health Files — a reader-funded newsletter that tracks the power and politics of global health. Founded in 2020, Geneva Health Files reaches 7,000 readers in 150 countries and has multiple contributors. In this conversation, Priti explains why global health cannot be understood disease by disease, and how her trade and finance lens reveals the money and power behind health decisions.  There GHF newsletter can be found here. 

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Welcome to Trailblazers With Garry, a series by Global Health Matters Podcast. I'm your host Garry Aslanyan. In this series, I sit down with trailblazers in global health for short, face to face conversations, which you can listen to in audio or watch the video. It's a chance to get to know the person behind the work, hear their stories, and gain their perspectives on current global health landscape. Join me as we explore the people, places and ideas driving global health forward. Let's get started. For this episode, I had the pleasure of sitting down with Preti Patnaik here in our hometown in Geneva. Preti is an independent investigative journalist and the founding editor of Geneva Health Files, a reader funded newsletter that tracks the power and politics of global health. She first trained in sciences, then spent years as a financial journalist in New Delhi and New York before launching her one person newsroom in April of 2020, just as the world was locking down. Today, Geneva Health Files reaches 7000 readers in 150 countries and has multiple contributors. In our conversation, pretty takes us outside the closed doors of global health diplomacy, where she reported the pandemic treaty negotiations, a topic we covered in our most recent signature episode. She did that by waiting in WHO corridors for hours, often being the only journalist on site. She explains why global health cannot be understood disease by disease, and how her trade and finance lens reveals the money and power behind health decisions. We also explore what we will take for independent, reader funded journalism not just to survive, but to thrive. Hi everyone. Welcome to the Trailblazers With Garry. Another episode. So today I am with Priti Patnaik. Preti is an independent investigative journalist and founder of Geneva Health Files. Welcome to trailblazers. Pretty. Thank you so much for the invite. I'm really honored. Great. So we're going to talk about various serious things. But before we do that and maybe it's just as serious is I wanted to start by asking if there is a book or a movie that changed how you think about your work. It could have been on or later on. I never actually ask these questions or my trailblazer guess. So I'm going to actually test this with you and see what kind of question this is. But for some reason I wanted to ask you this. So I don't watch a lot of movies, but I can come back, you know, answer your question. But I think truth is stranger than fiction, you know? So it was not a movie or a book that actually influenced my work in any significant way. But over the last few years, I two movies about journalism kind of stuck on in my mind. One is called spotlight. It's about how an investigation was conducted at the Boston Globe, and it was quite, quite interesting. And, you know, sort of reminded me of what it is to be in a, you know, physically in a newsroom. And the other one was, you know, a movie about Katharine Graham, the publisher of Washington Post. And the film was called The Post. And, you know, it showed all the complex decision taken by editors, reporters and publishers. And I think those two really stuck on and then going way, way back when I was growing up, there was this, American TV series that that was being shown on Indian television. You know, newly liberalized Indian television. It was called the X-Files. Right. You remember that? Yeah. Yes. Remember the music? Yes. Agent Mulder and Scully. And I think that when Geneva Health Files came about, I just sort of went back to the X-Files and trying to uncover. And that sort of, I think. Yeah, I think this this is what comes to mind when you ask this question. Okay. Well, interesting. So is has the X-Files called for royalties for using the files yet? Not yet, not yet. Thank you. Gary, what about these two movies? Do you think they were close to reality? Because X-Files. Definitely not close to reality. I think spotlight was was interesting, but it was, you know, set in a particular context. It was quite inspiring. And of course, the post was really iconic. I think it was really, really interesting to, to, to show to the public everything that goes, you know, behind journalistic decision making. Okay, interesting. So I'll need to check that out. Thanks for that. And I was worried about asking that question. So clearly that was needed really was called for pretty. You're trained in sciences so your degrees are in science. And then you became a financial journalist. And how did those two very different trainings or backgrounds, in a way, shaped your interest in global health and how you see global health today? Do you think that it's was useful? I've seen somewhere, I think someone say that a global health is really where science is in. Power and money come together may have been you actually. So how tell me your side of that, how those worlds came together. So I do have my bachelor's degree in microbiology, genetics and chemistry. But at that point, growing up, I felt that science was getting too insular. And and this was the early 2000, and India was at at the cusp of a political transition, a lot of political turmoil. So I sort of felt drawn towards, towards journalism. And and looking back, it was also significant because it was a time also when India's patent law was amended. Okay. And this was under, you know, the commitments to the WTO Trips agreement. And for the first time, companies could file for product patents as opposed to just the process. So looking back, I made, you know, all these connections come, come to mind when you raise this question. But in any case, I ended up becoming a financial journalist, and I was working for two of the biggest financial dailies based out of New Delhi. And and during that period, I reported on banking and monetary policy. That really gave me an opportunity to understand how the economy functions, the political economy, of how decisions are made in a big emerging economy like India. And and then at some point, of course, I made a transition, you know, into development studies and global health. And that brought me to the field of global health. And I think that reporting on global health today, I think both both these trainings have been really helped me understand and put things in a larger context that this is not just about science, but there are so many other angles to global health. It is really interdisciplinary and really looking at how the money flows. And I think that that initial training really helped. And of course, going back to the science, I never thought when I left science that I would be, you know, brushing up on epidemiology and genetics while writing about global health today. Interesting. Yeah, that's a very, I mean, natural kind of path because, you know, even doing this podcast, we try to break those silos. So health is not seen just as a disease or one particular area. I'm sure this will come up later as we talk. Take me back to April of 2020 and really shut down with Covid. Then you decide to do one person newsroom here in Geneva. I forgot exactly, but I think this was also around that time we met online through email exchange and we spoke. So I actually didn't realize you were at that time that you were starting this kind of a project. Tell us what gave you the conviction that this was the right time and the right time to begin? And what was the major kind of switch that said, I'm going to get and do this? So I was, you know, before the pandemic as well. I was already reporting on global health for a few years as an independent journalist. And I had also worked very briefly at a UN public health agency that I did not like very much. And I quit. And then I decided to start writing about global health as a journalist. And but it was always a struggle because Geneva was really seen as a policy backwater. It was not dominating the headlines as it did during the pandemic and after. Right. And so when Covid came about. I was convinced about the the magnitude of the change and, and the story that was unfolding around us. And I decided to basically start self-publishing because I knew that at least some of the people who were already reading me would follow me. And I think that and there was this began really as a service for negotiators and diplomats in Geneva, who were then for the first time negotiating virtually on zoom and and a lot of the closed door decision making around the international response to Covid 19 was happening in Geneva. And and I and I thought that it is it is too important the story and too fluid and too complex. So it needed some kind of a consistent reporting approach. So we started self-publishing and and today we have, you know, more than 80% of our readers are outside of Geneva, right? We have about 7000 readers in 150 countries, which goes to show that there's so much of interest in global health. And at that point during the lockdown, a lot of people who would naturally travel to Geneva to participate in the different policymaking processes and at Gavi and elsewhere, they couldn't travel. And I think so there was an interest in what happens in Geneva. And I think that we sort of started with in April 2020, and we have been publishing ever since. And the conviction also was, was that I was convinced that Geneva deserved a new service that was interdisciplinary, you know, not just looking at the science of global health, but really looking at the governance, political and the diplomatic angles. And and that often not do not necessarily get captured in a global health story, which is always seen as technical. So we wanted to sort of challenge that, that yes, these are technical discussions, but, but, but really there are very strong political underpinnings to how decisions are made. And we wanted to sort of uncover some of that. And finally, of course, the fact that around 2020, it was possible for an investigative, for an independent journalist journalist to actually monetize the journalism by and we have a subscription model, meaning that we provide actionable information to our readers, and we are able to sort of charge fees for the services we provide and, and the technology and the cultural factors that, that, sort of that convince people that you must pay for journalism was was not always there, obviously. So it was, I think, a combination of factors. And that's how we began. Yeah. It's interesting because I mean, I think it was also maybe time because I mean, legacy media or whatever that term is perhaps, or that time started kind of disappear or having some trouble in terms of that. And there were a lot of that is much more obviously since 2020. But I must have also been the trend because a lot happened. Similar things happened with other other outlets or other arrangements. And people went into this not just for global health in general, in general, globally in terms of where the media is going. And maybe you became that local media that usually suffers in when the legacy media disappears because nobody is covering local. You became the local Geneva media. Yes and no. Yes. It's local because it's a very distinct readership of of diplomats and negotiators, policy makers. Yeah, but it's also international, which is why, because the relevance of global health and the interest in global health is, is worldwide. A lot of the action happens in Geneva, at least for the time being. But it's also the fact that anyone, anywhere can can shape global health and is interested in global health. And for me, the success of this initiative actually shows that people from all walks of life and exactly demonstrating the interdisciplinary nature of global health, you have social scientists, political scientists, and of course, doctors, logistics, the private sector and so on. But this is really for everyone. But you had the local presence. Maybe that's maybe that's the right word. Not a local media, but a local presence. I think we do have a strong locational advantage and we are on site. And, you know, this is very traditional. Schuler the reporting where we are on site and talking to people, people see us. So I think that that that really helps. That's right. I heard you describing reporting locally. Let's say if you take the pandemic talks that are almost continuing, at least for some parts of the treaty, although treaty is adopted, but the the appendix is not, you basically describe saying that you've been really standing outside for hours waiting to speak to people. And sometimes I'm sure you were the only one, right? Tell me, what does that mean? And what actually it means to be in Geneva, in W.H.O. or at different locations and, and really be in that position? And what do you learn from this corridor reporting. And you'll never actually. Well, maybe you could be in a briefing which is open to journalists, but you're not in the room sometimes where things are negotiated. Give our listeners a bit of that. And what kind of what kind of skills you had to use there, because clearly it's probably not the same when you were doing some previous work. Yeah, just just for sort of more context for for listeners, Geneva is a fascinating place. You have nearly 200 countries with their permanent missions to the UN here. You also have the big global health agencies and all the smaller organizations that feed into the work of these organizations and the private sector. So it's a place where the public and the private interests collide. And, and but a lot of these interactions are behind closed doors and the pandemic treaty negotiations and for that matter, most of the global health negotiations in Geneva, at the WTO and at the W.H.O. have been closed doors. So it's been a challenge. But that's how they are. That's how they are. It's not that's how or different it is not new or different. But I think because the pandemic occupied a captured public imagination, 20 million plus excess deaths, there was a lot of interest, you know, among people to follow these negotiations. But we were always faced with this, you know, we that these were closed door negotiations. Right? So we had to really adopt a, you know, a new, not so much new, but this kind of consistent. And, you know, we are going to be here. We want to see how this works. And we are standing outside the room and talking to a cross-section of delegations and always trying to sort of verify what people are telling us, sort of triaging the information, making sure that we have it right and as accurate as possible, mindful of the interests, why people are telling you things and so on and so forth. So I think that reporting in a sensitive diplomatic space around a closed door negotiation is something we we learned on the go. And of course, with with 20 years of journalism experience, you know, how to deal with sort of sources and and for the also for your listeners, a lot of the reporting in diplomatic spaces is usually attributed to anonymous sources because because people are not comfortable being identified, you know, this particular diplomat from a particular country said this or not, but we try to sort of be as accurate as possible with while protecting their identity. So I think that is something different from the usual reporting where you cite sources. We still cite official sources to the extent possible, but especially when it is about, you know, fluid positions and you don't want to sort of interfere too much, but you want to capture the direction, the general direction of the way the negotiations are unfolding. So I think that it's been quite a fascinating experience, and it's very different from a press briefing, because at a press briefing, yes, you get information you can access, you can ask questions, but it is also official speak. You you don't you don't necessarily are able to capture the undercurrents. So it's quite interesting to to interact with diplomats also because, you know, they tell you things with certain motivations or they are talking amongst each other and you're listening to the banter, which can be hilarious sometimes, but you can't write about that stuff. But it also sort of gives you a flavor of the tensions or not. So I think that it's certainly a unique experience, but it's also very time and resource intensive. Right to be. Yes, because you always be there. You are waiting and and some of these negotiations at W.H.O. have gone on, you know, past midnight right early in the morning. So it's been quite an experience. So that that I'm sure some of our listeners probably never imagine when they read things from you or they will learn about the Geneva health files and go find it. Now, you know how it's all done. You argued earlier that a lot of health is reported narrowly or disease by disease. And earlier when we talked about it, and I guess, sadly, it's partly true. Silos is a serious issue. Let's give a little bit more in depth into this lenses that you are able to bring trade and finance and traditional health story. How does that your background allowed you to actually do this differently, and what you heard from your audience in terms of what they thought, how is perceived to be reporting this way? I think that my own assessment and my own view was that a lot of global health journalism was very, you know, a had a had a very distinct science framing. And also a lot of the outlets where of course, in, in, in developed countries. And I thought that there were lots of different perspectives that were missing. And we cannot I think for me, science is technical, but it's also political. But there is not a lot of acknowledgment of that in the field. And somehow there is a tendency to wish away the very, the very political undertones also in global health and that reflects in the stories. But we were very keen to change that. So, for example, to give you sort of concrete examples, if you're talking about, let's say, the essential medicines list, or you want to talk about. You know, you pick any disease, most diseases, or you talk about the prices of drugs, these these are symptoms. But I think a lot of the stories we would often not read the structural factors that have contributed to these outcomes. Whether you talk about commercial determinants of health or, you know, the environmental determinants of health, there are historical reasons for for these factors contributing to disease conditions, right, and the persistence of disease conditions are the solutions or the solutions. Absolutely. So so I think definitely the fact that global health is so siloed in the way solutions are framed and suggested and talked about, it's extremely narrow. And I think we wanted to sort of also bring the flavor of, you know, yes, this is what we see. But it's like this because of certain historical reasons. And my my assessment also is that international diplomacy is a deeply unequal field. And we must sort of acknowledge that. So our reporting and what we have strived to do is to provide straight information, which is useful to, you know, all delegations, big and small countries. And we, you know, you try to connect the dots. And I think the reason why scores of countries readers is because they find this information valuable, particularly the small delegations, but not only because we also have the bigger countries reading us, because we're able to connect the dots and present as accurately as possible. And I think this is this is a service for, for, for, of course, not just the diplomats, but also others following these discussions, including scholars, students. The the goal is not only to bring accountability, greater accountability to global health policy making, but to also, you know, you know, contribute to greater public engagement in global health, particularly in times of disinformation and misinformation. So so I think that it's crucial to talk about the economic and trade angles of why we are faced with certain kinds of global health challenges today, and for various reasons. These are not talked about enough. And I think that we need to show the full picture that this is not just a scientific decision, but there are other considerations. Yeah. Can you tell more about this international diplomacy or global health diplomacy being deeply unequal field. Can you open the the brackets about it? I'm sure our listeners would want to know what you meant by that and how in which way is it an equal? So I think that one is, of course, the size of delegations. You have small countries for negotiations, for negotiations, and they have lots of competing dossiers. If you're working in Geneva, you do health, you do labor, you do lots of other things. And this is actually true. It's also a challenge for some of the bigger delegations. Right. So one is about well-resourced teams and for many smaller delegations, that's not the that's not the case. And I think it's it's difficult for them. But that's just from a resource point of view. But what I was also hinting at, and what we tried to cover in our reporting, is a lot of the processes, international organizations, they were they were set up in a certain context, and there are rules and there are structures that today our eyes glaze over it, but there are structural limitations on on how organizations respond. Do they respond in an equal manner to all countries? I think these are conversations that you hear a lot in Geneva and and that you don't necessarily read much about, but you could you can sense these sort of dynamics. You know, how certain narratives are elevated, the struggle to present certain proposals, why certain proposals get traction. A lot of the things are behind the scenes and which which may or may not get sort of reckoning or acknowledgment. So you can cover that, or you can shed light on that and do the extent possible. And of course, this is all of this is closed door and opaque and we are press and, and I think that the, the, the value of journalism, you know, the way some of the stakeholders and even governments see this has, has transformed and changed, not necessarily for the better. So another thing, a quick follow up to earlier comment about how what you're covering is not just science and and the way it has to be presented. Do you think those who would usually be global health readers or people who are health people, for lack of another word, do they find that interesting? Do you know and or you think this kind of reporting also helps them shape their thinking differently? Do you have any any reflections on that or you've heard anything? You mean people outside of global health? People who are usually health type of readers because they read it now in a more comprehensive manner? Have they have they continued reading or have, you know, if they've actually appreciated that more holistic kind of reporting? So we we analyzed our readership, actually, and we found out that about a different about 1000 institutions, readers globally. And it's what we do is niche. But there are several niches within global health. As you would know, you have the technology folks, you have the IP folks, and, you know, the lobbies, people working on food, people working on environment. So and, and tax justice, for example. So increasingly a lot of the global health conversations when you talk about financing, you're also talking about tax justice for. So I think that there is an overall appreciation of, of the fact that global health is situated in a much wider story and context, particularly now. Okay. So if you talk about, for example, if you talk about geopolitical geopolitics since the last two years, a lot of the our work as actually how foreign policy unfolds in global health. So so I think that there is there is an appreciation of the fact that we are talking about global health also in a wider sort of prism, but I must say that everything around us is going niche. Everything around us is going super specialized. So we try to make a balance about, you know, yes, we are reporting on pathogen access benefit sharing, which is a big part of our coverage over the last 12 months, for example. But but we are also trying to understand, you know, the big picture themes of global health financing reforms. You know, and I think that, yeah, there's always this challenge that there are lots of different kinds of people reading us, the specialists, but also folks in global health who want to know plastic treaty, for example. It's a classic example, plastic plastic treaty. And or, you know, of course, increasingly the climate crisis. So is it about health? Is it about environment? So these these boundaries are blurring and they will blur even more. And also with AI. So I think that, in general, it's a very sophisticated audience readership because it's written for experts. But at the same time even experts want to make connections on the broader picture. So maybe we're really difficult times or I'm sure not everybody always liked what you reported on or the way you reported on. Maybe you can help us understand what kind of trade offs you have to make, or you things may get a bit more dicey. And how do you decide? How do you make a decision? I'm going to do it. I'm going to publish it. How do you go about it? I think that we we have upset both developed and developing countries over the last couple of years, and that tells me that we are doing something right. And I think that no matter, you know, global health is a political landmine, as you know Gary, very well. So no matter what you write and how you write, you're going to step on toes. You upset civil society organizations, you upset global health scholars, lots of different communities. So yes, we have received a lot of pushback and but a lot of the pressure actually comes post publication. It's not before the publication because the decision to publish his ours and we take it very seriously, we are very deliberate. We're very we are very cautious and responsible. Like I said, it's a sensitive space, right? But we are not self-censoring in that sense. But we are being cautious because we are also self publishers. So the buck stops at my tables will have to be responsible for everything we publish. And I think that that that judgment is, is very much a creative process as well. But but yes, they have been there has been pressure, particularly around the negotiations and even outside. Right. And mostly we can anticipate how it's going to land. But sometimes you don't know, things can catch you off guard and it could be some of the smallest things. So it's a, it's a, it's a tightrope. But we take every single edition, every single word we publish very seriously. And, and also remember that because this is international and multilateral people bring their own media cultures to Geneva. So depending the country and the context. And so yeah. So you have countries who will believe in the freedom of the press, who, who, who think journalists are important, who will talk to you or not. Right. You know, lots of different factors. Right. And then it is also curious that you see democracy defenders sort of dropping their pretenses about the freedom of the press, because, you know, what we have written does not suit political narratives. So so I think like every publisher, we do watch our back. But, but, but I think one of the traction we have had is because it is independent and it is reader funded, and that gives us a lot of latitude. We do not have institutional support, and bulk of our revenues come from subscription revenues. Right. So that gives us that gives us independence. Right. Interesting. So that was very interesting point about media cultures and how sometimes they might also collide here. Right. So I think was a is a very unique situation one would think to, to be and and you, you must have done something right to be able to, to continue and kind of walk that tightrope that you mentioned. You said that you really, on principle, reader funded and readers are who are your supporters and they make you go as Geneva health files. As an organization, it keeps you independent. But I'm sure it's not easy, right? It's probably hard in terms of how to kind of keep the business going in this era, and there's a lot of that kind of reader funded experiments, but there's a lot of disinformation that are also funded in a different way, and monetizing the social media or other parts. And the newsrooms are shrinking in terms of you might be the only one here present. The big, you know, big legacy media is not here covering it. What will it take for you to, for to survive or to have for this kind of journalism to survive? Pretty. What is your prediction? What do you think must be done or you're doing, or you're going to do to make sure that this kind of approach survives? I think it's a it's a very difficult endeavor, I must say. And it's been about it's been about six years and we are not commercially viable yet. So yes, we have been successful. It's an editorial success, but it's not a commercial success in that sense. But but we have a very small team, a, you know, a lot of the people who work with us, work with us on a fractional basis, and it's been challenging, but we are very grateful for, for, for readers. And I think that you must also look at this in the wider context of the evolution in the media. So in the language of media entrepreneurship outfits, outlets like Geneva Health Files are called creator newsrooms. You know, with with a with a very distinct relationship with the audience and so on and so forth. You know, that's a whole different conversation. But just to say that there's a lot of premium on how you engage with your audience and how they trust you and, and the and how your product distinguishes itself from others. And from day one, my every effort has been to provide information that people will be willing to pay for because they find it valuable. So so we definitely need more readers to pay for us, particularly because we don't have institutional support. It's been very difficult to get grant funding for the for the journalism funders. We are too technical. It's exactly the same reason why, you know, global health is seen as a technical field, but it's the fact it's the fact that it's everybody's business. It touches us, touches every single person on earth. But but somehow there's a disconnect on, on, on how they see the value of global health journalism among journalism funders and among the global health funders. We are too political. And of course, we have to steer clear of conflicts of interest. So it's been a challenge to find the right kind of funders who see value in in this kind of, you know, what, what I call one of the last outposts for multilateralism, particularly W.H.O. in the context of global health. So I think I would say the going has not been easy, but I do think that we have created a created and curated this community. And I do hope that this will sort of continue, because there is clearly a need for a product like this that that looks at global health in its entirety and, and the fact that it's independent. So I do hope that, you know, we not only survive but thrive. And, you know, we are able to convince more people to join this movement towards reader funded global health journalism. And that's the surest way actually to make this lasting. I understand, I understand. Well, I mean, some of these things are to be seen how things go, because in this kind of field, a lot of is still uncertain where and how things are going. And then I'm sure you have a motivation because after six years, as you said, and producing what I checked 500 deep dive pieces already in this period of time, sometimes early mornings and late nights and all of that. What does what keeps you going that way? That would be my last question. Pretty thanks for that. I think that I do think that we we are the approach to our work is is unique in the sense that I feel that the way we tell our stories, only we can. I feel that only we can sort of connect the dots and look at the picture. It's very it's very personal in some sense. But, you know, I think we have been able to share that personal vision with a with a wider group of people. And I think there's value in it. And I feel that if you don't tell stories the way we do, a lot of the stories will not get told. And, and because it's, it's uncomfortable to to sort of discuss some of these topics and, and of course, a lot of media organizations are reporting on these issues. But, but I think that, we are not shy about getting a hands dirty with the technical details. We are not shy about dealing with complexity in the stories, and it's a commitment to really demystify this and to basically convince the readership that, you know, you have a stake in this, you have a stake in this. And what we are giving you is, is really no holds barred, because as, as a media organization, we have no skin in the game. And, and we have discussed this before, Gary, that in global health, everyone as a stakeholder and for me that that that's that's difficult to untangle some of these interests. And I feel that we have been able to sort of present, to the extent possible, say it the way we see it. Okay. Great. Thanks for that. Preti again. Thank you for doing this Trailblazer episode and joining our audience and sharing your thoughts and the work and really unique kind of work that you're doing. Thank you so much, Garry. I really enjoyed talking shop. Great, great. So thank you again. So join us for the future episodes of Trailblazers With Garry and follow us on YouTube, on Spotify, Apple, etc. wherever you get your podcasts. Thank you for joining me for this episode of Trailblazers With Garry. The audio and video versions of this episode are available wherever you get your podcasts. Be sure to visit the Global Health Matters web page for more information about my guests in this series. Don't forget to get in touch with us via social media, email, or by sharing a voice message, and be sure to subscribe or follow us. Global Health Matters is produced by TDR, a United Nations cosponsored research program based at the World Health Organization. Thank you for listening.