Evans School Policy Analysis & Research Group (EPAR)

The private sector is the primary investor in health research and development (R&D) worldwide, with investment annual investment exceeding $150 billion, although only an estimated $5.9 billion is focused on diseases that primarily affect low and middle-income countries (LMICs) (West et al., 2017b). Pharmaceutical companies are the largest source of private spending on global health R&D focused on LMICs, providing $5.6 billion of the $5.9 billion in total private global health R&D per year. This report draws on 10-K forms filed by Pharmaceutical companies with the U.S. Securities and Exchange Commission (SEC) in the year 2016 to examine the evidence for five specific disincentives to private sector investment in drugs, vaccines and therapeutics for global health R&D: scientific uncertainty, weak policy environments, limited revenues and market uncertainty, high fixed costs for research and manufacturing, and imperfect markets. 10-K reports follow a standard format, including a business section and a risk section which include information on financial performance, investment options, lines of research, promising acquisitions and risk factors (scientific, market, and regulatory). As a result, these filings provide a valuable source of information for analyzing how private companies discuss risks and challenges as well as opportunities associated with global health R&D targeting LMICs.

In this report, we analyze the evidence that improved and expanded access to financial services can be a pathway out of poverty in Bangladesh and Tanzania. A brief background review of finance and poverty reduction evidence at the country, household, and individual level emphasizes the importance of a functioning financial system and the need to remove individual and household barriers to capital accumulation. We follow with an in-depth literature review on studies that link poverty reduction in Bangladesh or Tanzania with one or more of five financial intervention categories: remittances; government subsidies; conditional and unconditional cash transfers; credit; and combination programs. The resulting empirical evidence from these sources reveal a high share (61%) of positive reported associations between a financial intervention and outcome measure related to our five chosen financial interventions. The remaining studies found insignificant or mixed associations, but very few (3 out of 56) indicate that access to a financial mechanism was associated with worsened poverty. The heterogeneity of study types and interventions makes it difficult to draw conclusions about the efficacy of one intervention over another, and more research is needed on whether such approaches constitute a durable, long-term exit from poverty.

Household survey data are a key source of information for policy-makers at all levels. In developing countries, household data are commonly used to target interventions and evaluate progress towards development goals. The World Bank’s Living Standards Measurement Study - Integrated Surveys on Agriculture (LSMS-ISA) are a particularly rich source of nationally-representative panel data for six Sub-Saharan African countries: Ethiopia, Malawi, Niger, Nigeria, Tanzania, and Uganda. To help understand how these data are used, EPAR reviewed the existing literature referencing the LSMS-ISA and identified 415 publications, working papers, reports, and presentations with primary research based on LSMS-ISA data. We find that use of the LSMS-ISA has been increasing each year since the first survey waves were made available in 2009, with several universities, multilateral organizations, government offices, and research groups across the globe using the data to answer questions on agricultural productivity, farm management, poverty and welfare, nutrition, and several other topics.

Water is a critical input for significantly enhancing smallholder farmer productivity in Sub-Saharan Africa (SSA) where less than 5% of farm land is irrigated, and in India where 42% of farm land is irrigated.  For many years, donors have invested in human-powered treadle pump technologies as a point of entry for smallholder farmers unable to afford motorized pumps. In spite of some successes in treadle pump promotion, however, there is a widespread perception that as soon as smallholder farmers can afford to they quickly transition to motorized diesel- powered pumps. While diesel pumps substantially ease farmers’ workload, they pollute excessively (both in terms of local air quality and greenhouse gas emissions), pump excessive amounts of water, and put farmers at the mercy of cyclical spikes in fuel prices. This brief provides an overview of state-of-the-art alternative energy pumps, including technologies available and implementation lessons learned from China, India, Africa, South America and other regions. Through a literature review, written surveys and phone interviews with water pump producers and non-governmental organizations (NGOs) we evaluate the availability, affordability, and adoption rates of alternative energy technologies in developing countries. Our findings suggest that no single alternative energy water pumping system is a “silver bullet” for rural smallholder irrigation needs. Biofuels may prove a successful short- to intermediate-term solution for farmers who already have access to diesel pumps, but other problems associated with diesel engines, including high maintenance costs and excessive water use remain even when biofuels are used. Solar systems eliminate pollution almost entirely, reduce water consumption, and eliminate the need to purchase fuels. However solar systems are typically prohibitively expensive for smallholder farmers. Wind powered pumping solutions have not proven successful to date, with high costs and irregular wind patterns (either too little or too much wind) proving substantial barriers to widespread adoption.