Why Global Health Experts Rely on Geneva Health Files’ In-Depth Analysis

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The field of global health has changed — is changing — so rapidly, it’s hard to keep up. Journalist Priti Patnaik, editor of the Geneva Health Files newsletter, saw an opportunity in the newsletter world to share carefully reported, analyzed analysis from her home in Geneva. 

After working for over a decade as a freelance global health reporter, Priti launched a newsletter in 2020 with the intent to send out actionable public health information to diplomats and negotiators in Geneva, which is where the World Health Organization (WHO) is based and where the United Nations has a significant presence. “My initial assumption was that global health as we see it, is massively underreported,” she said, an assumption that was borne out by the number of paid subscribers willing to support the newsletter. Five years later, more than 6,000 people in 150 countries read the Geneva Health Files for its analysis of topics like global health negotiations on pandemic prevention, the field’s financial crunch, restructuring at the WHO, and how industry affects global food consumption.  

There are plenty of legacy outlets that cover global health. What sets Geneva Health Files apart is that their core audience are the people actually working in the global health space. Subscribers to the newsletter include policymakers, global health experts, diplomats, academics, and members of the private sector. “To my mind, we are the only reader-funded global health journalism initiative where experts are paying for the information that we are providing,” Priti says. Eighty percent of her readers are located outside Geneva, mostly based in the U.S., the U.K., Germany, Switzerland, France, India, and South Africa.

Since launching, Priti has diversified her product, her income stream, and her team, including a five-member advisory board, three-person editorial board, four annual fellow contributors, and part-time help on strategy, law, and business development.

A paid subscriber base is the newsletter’s primary funding model, but Geneva Health Files has also received grants to support it. In addition to the newsletter, Priti also publishes podcasts, books, hosts live events, and even does some consulting within the health space. Since their audience are professionals in this space, their pricing looks a little different than other indie newsletters. Their most recent book is selling, as of this writing, for more than $70 per copy. An annual subscription to Geneva Health Files costs about $350 per year, and this month, they rolled out GHF Plus, a premium subscription offer that features four exclusive research reports per year. (This quarter’s report is on geopolitics and biomedical investments.) Access to GHF Plus costs $585 per year.

I spoke to Priti in May. In this edition of the International Inbox — a series where we profile newsletter operators and businesses around the world — I talked with Priti about:

• Lessons she’s learned from launching her newsletter.
• The importance of being clear about the value of a newsletter.
• How to pull in outside experts and support to improve your core product.
• Balancing parenting and entrepreneurship.
• The challenges of publishing a public health newsletter in a time of vaccine denial and disinformation.

This interview has been condensed and edited.

You probably don’t have much wiggle room for errors in your newsletters. What is the typical timeline in terms of a piece getting approved versus it being sent out?

In a good week, I know what’s coming because I work on stories in advance, considering that they are at least 3,000 to 4,000 words long. I typically have at least two or three days from the time that I decide to work on it until the point I hit publish. At any given time, I’m working on at least three stories in parallel. I also commission pieces on the side. The goal is not to be first, but the goal is also not to be too late

Just this morning, we had a whole plan for what to publish for this week, and we are expecting major announcements from President Trump on drug pricing in the U.S. That is going to have a cascading impact on global health and on other countries. I’m trying to keep pace with how that will pan out, but we have to be open to surprises.

My emphasis is to provide a value addition to our readers. There’s a reason it’s behind the paywall. It’s my effort to bring them perspective, numbers, and news that is difficult to find elsewhere.

What’s the workflow for a typical newsletter issue?

The workflow is quite intense. At the end of 2024, I was like, “I’m going to take it slightly easy.” Then with President Trump coming into office, there was a seismic change for global health. A series of his announcements are connected to financing for global health and the World Health Organization. That has kept us busy.

One of our priorities this year has been to understand not only the impact of American foreign policy on global health, but also the role of multilateralism in global health, and how other countries are responding to it.

A lot of the work we do is about how geopolitics unfolds in global health. Much of this is technical and legal, but it is also very political. A lot of the discussions happen behind closed doors in Geneva, between countries, between the private sector and countries, and lots of different influences.

Keeping track of all that is almost 24/7, but our focus is on providing this long-form analysis that people won’t find elsewhere. It’s not something quick; it’s much more about going behind the scenes, trying to understand the implications.

I’m curious about the vetting process and the fact-checking that goes on before you send out each issue.

I’ve been reporting and writing most of it. I also commission articles from freelancers. We also have requests for guest essays from experts in global health because they want to reach our readership.

We are part of the Swiss journalism association here. We are also a United Nations-accredited media organization. We meet the standard criteria expected of U.N. correspondents both here in New York and in Geneva. We have affiliations and professional accreditations that have been issued based on the standard of our work. I have 20 years of experience as a journalist, and for much of that period, I worked independently.

As an independent publisher, I’m extremely careful about what we publish. We do hope that when we have more resources, we can find help for me to clear all this vast amount of information that we process.

We want to inform policymakers in Geneva, but we are not insulated by what’s happening in the regions. We want to bring the flavor to our readers: “This is how things are unfolding at the national level, and you need to read about this because you determine global policies that will ultimately impact people on the ground.”

Tell me a little bit about how you set your subscription model pricing.

It’s a diverse revenue stream, with approximately 30-40% coming from subscriptions. We also provide research work and consulting services based on our editorial expertise. I give lectures, and that also makes up for a small part of the annual revenue flow.

Subscriptions have increased steadily, but we cannot live off subscriptions as of now. I hope that one day we will be fully reader-funded. We have an accountant; we have an IT company we work with on our corporate website. We also have costs to pay for Substack, Stripe, and all of that.

The funds we raise are modest. It’s a small newsroom, and we want to consolidate what we are already doing and do it better. We are also diversifying our revenue in terms of reaching out to institutional subscribers and adapting our journalistic content in a way that’s helpful for them.

Do you compare yourself to other Swiss newsletters?

Not really. Geneva is super international, and our readership is international, our voice is international. The whole goal is to provide a tone analysis that is useful for everybody. Geneva gives you the sense that all the 200 countries in the world are represented here, and our readership includes both developing and developed countries.

I’ve observed that international diplomacy is a deeply unequal field, and information is power. One of our goals is to increase not only accountability in global health policymaking, but also to contribute information that is useful for everybody, both developed and developing countries. Because we are independent and we are also critical, there’s no one breathing down our neck. We can say what we want; we report what we see.

How much do your readers engage with you?

We do surveys at least once a year, mostly on pricing. We also have online events. We have several events in the course of the year.

I speak at global health conferences, so there’s an occasion to meet readers there. We host a number of events in Geneva, including policy dialogues, where we convene policymakers to discuss issues. Two of these have been around the launch of our books. It’s always good to meet readers in person.

We don’t enable a comments section for the simple reason that Substack is also a place where there are a lot of voices that are anti-science, and there are big, powerful forces of disinformation on Substack. We don’t want to be flooded by anti-vaxxers, and we provide accurate information, but we simply do not have the time to engage with anti-vaxxers and people who attack science. People are free to email us, and they do email us.

When we first began, we were taking baby steps in understanding audience preferences, but every year, we’ve had a better indication of the value that we provide. Currently, it’s priced at €300 per year, or €25 per month. [That’s the equivalent of about $350/year or $30/month.] Because we are read in developing countries, we cannot price it too high.

We get responses that this is too low for the information we produce, and some say that it’s too expensive, so we have to strike a chord. We’re not able to offer two differently priced newsletters for the moment, but this is something that we are trying to address. Almost 80% of our content is behind the paywall. Journalism is expensive, and Geneva is one of the most expensive cities in the world. What we do is a public service, and it simply cannot be priced lower or given away for free.

What made you decide to expand into publishing books?

We do see this as an extension of our brand equity, and it’s something more tangible. The first book was on a set of negotiations at the World Trade Organization that happened during the pandemic. It was a tough experience on self-publishing. I knew nothing about book publishing, but it was quite an experience to get that out at about 700 pages long. The second one is basically a compilation. It’s what’s behind the paywall, in the newsletter, in the archives. The idea is to present something that is for scholars, universities, and practitioners.

I was speaking to a media investor recently, and he asked, “Why would you do books? It’s such a waste of time.” For us, it is an additional offering for our readers, and there is value in this because this is also for posterity. It’s all in one place, and it makes a lot of sense and a fairly creatively fulfilling journey to see everything you’ve done in a tangible asset. We will have one more coming, maybe in the next one or two years.

What’s your strategy with the Geneva Health Files podcast?

We are very focused on what we pursue as far as podcasts go. There are occasional interviews, but it’s also driven by what readers want. It’s people who cannot read 3,000 words every week, but maybe you want to listen to a podcast which is 15, 20 minutes or 30 minutes long. You get up to speed with six months’ worth of newsletter content. It’s packed with insights. If someone wants to listen to this because they don’t have time to read, it makes for a good format.

Could you tell me about your board and fellows? What do they do for you and how do you select these people to work with?

We have two boards. One is an advisory board that focuses on strategy, fundraising, and governance. It’s composed of five people who have experience in both global health and journalism. We also have a professor of entrepreneurship who’s also guiding us on this journey. It’s a combination of me sharing our operational updates and strategy. 

We also have an editorial board. It’s also advisory in nature, but it’s always helpful because these are subject-matter experts who bring a wealth of experience and their views on the issues. They have very useful advice, and they are practitioners in the field of global health and how information is consumed.

I began a fellowship program in 2021, a year after we started publishing. It basically started as an internship, but I was amazed at the quality of applications we received from PhDs, post-docs, and global health professionals. We also get interest from global health students, and they are enrolled as interns. The fellows are from all over the world. Most have day jobs, but they want to get a sense of global health journalism.

Many of them are epidemiologists, doctors, but not only that. They come from a wealth of people from a humanities background, because global health is truly interdisciplinary. They write for us, and they also aid us as per their interest in other areas of business development. For us, the biggest value addition is the expertise they get and the stories that they want to tell, based on where they’re located.

How do you avoid burnout?

It’s not always easy, because media entrepreneurship is 24/7. When the editorial is over, then you’re onto business development.

The initial years were very difficult, but I believe now I have an idea of the size of the beast, and I’m beginning to manage that stress well. I did not take a holiday in the first two years. I don’t think anyone who worked in global health did during those pandemic years. I try to go on hikes, I read fiction, and I try to spend time with my son. I don’t watch stuff at all. I don’t have time.

The goal is to get shorter breaks every now and then as opposed to long breaks, which is difficult because I’m also working on the business. Things need to be done; you have to work five steps in advance, both for editorial and business development.

It’s not at all easy, especially if you have a young child, because that’s non-stop. You are a mother, but you’re also an entrepreneur. It’s one of the hardest challenges. You’re trying to keep everything together, and both motherhood and entrepreneurship are so urgent in so many different ways.

What do you do to market the newsletter?

This also has been a learning experience. Initially, it was just word of mouth for the first two or three years. I took this aspect of promotions more seriously. We were on Twitter, and we still are, but we’ve also moved to Bluesky and LinkedIn. A big part of promotions is also getting seen and getting heard, speaking at conferences or lecturing at universities.

I’m not spending a lot of energy doing overall outreach, but being specific. That helps because it’s a pretty niche thing to do. I do hope that we ramp up our communications in journalism because we are well known in global health, but for the journalistic folks, we are still quite technical and niche. It has a public service mission, but you’re also trying to make it into a viable business. There are no easy answers, especially for independent journalists.

What numbers do you hope to hit in the next year or two?

Subscriptions are a cornerstone, and our overall list has been growing steadily. We are trying to focus on optimizing our conversion strategy, getting more readers to become subscribers, and also getting more institutions to become supporters. The goal is to become a commercially viable reader-funded media initiative. That would be a game-changer. Without grants, we are about 20 to 30% away from full financial viability.

We’ve hired a business development associate starting this year. I’ve been working on it from the beginning, but I need help. We are very keen on working with media innovation experts.

I also want to expand our team. I’m hoping to raise more funds, more grants, because I want to be able to hire at least a full-time reporting hand. I love journalism, but I can also see that I have to dedicate increasing amounts of my time also on strategy and business. 

What is an insight or recommendation you got from your business development expert that made sense for you?

She was a fellow three years ago, and she came back to work with us. We did a large-scale analysis of our audience, and we did a deep analysis on the sectors who read us, and we realized that 1,000 institutions around the world that work in global health read us. We are working on products tailored to this readership.

So the segmentation of the audience based on the audience analysis was insightful. It is informing our overall strategy going forward. That has been a marked change. We are working with other experts on how to use this information and the buckets and the readership that we must reach out to to encourage conversion.

Five things newsletters can learn from Geneva Health Files

1.) There’s still value in serving specific niches — Geneva Health Files is never going to reach a mass audience, but it doesn’t need to. They serve readers who work in this field, and that allows them to build a product — and price it — to deliver value for that core audience. Are there members of the general public on their list? Absolutely, but they haven’t gotten distracted in trying to write for them.

2.) You have to diversify your revenue streams, especially in the first few years of your newsletter — Few newsletters reach sustainability right away. Smart operators, like Priti, try to find multiple revenue streams to keep the business afloat while the core revenue stream — in her case, subscriptions — continues to grow. 

3.) Listen to your audience when it comes to pricing — Readers aren’t going to be shy when it comes to the cost of a paid offering. But if readers are telling you that you’re undercharging for your product, particularly in cases where they may be able to expense a subscription to work, listen to them and be open to raising your rates.

4.) Don’t be afraid to say “no” — Platforms often nudge users to take advantage of every offering. In Substack’s case, that means encouraging writers to engage readers in comments on their Twitter-like channel, Notes. Priti’s been intentional about avoiding those spaces, as her core audience isn’t spending time engaging there. Plus, saying “no” to those opportunities helps her keep her focus on the parts of the business that matter most.

5.) Find ways to pull in outside help — Priti has two different boards, each of which provide different types of support for her business. One provides business support; the other helps with the editorial side of things. Even if you’re running your newsletter solo, you may be able to get support from friends or colleagues to help you make big decisions about the future of your newsletter.

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