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Much literature discusses the importance of investing in human capital—or “the sum of a population’s health, skills, knowledge, experience, and habits” (World Bank, 2018, p. 42)—to a country’s economic growth. For example, the World Bank reports a “chronic underinvestment” in health and education in Nigeria, noting that investing in human capital has the potential to significantly contribute to economic growth, poverty reduction, and societal well-being (World Bank, 2018). This research brief reports on the evidence linking investment in human capital—specifically, health and education—with changes in economic growth. It reviews the literature for five topic areas: Education, Infectious Diseases, Nutrition, Primary Health Care, and Child and Maternal Health. This review gives priority focus to the countries of Bangladesh, Burkina Faso, Democratic Republic of Congo, Ethiopia, India, Kenya, Madagascar, Nigeria, Rwanda, and Tanzania. For each topic area, we report the evidence in support of a pathway from investing in human capital to economic growth.
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.
The share of private sector funding, relative to public sector funding, for drug, vaccine, and diagnostic research & development (R&D) differs considerably across diseases. Private sector investment in overall health R&D exceeds $150 billion annually, but is largely concentrated on non-communicable chronic diseases with only an estimated $5.9 billion focused on "global health", targeting diseases that primarily affect low and middle-income countries (LMICs). We examine the evidence for five specific disincentives to private sector global health R&D investment: scientific uncertainty, weak policy environments, limited revenues and market uncertainty, high fixed and sunk costs, and downstream rents from imperfect markets. Though all five may affect estimates of net returns from an investment decision, they are worth examining separately as each calls for a different intervention or remediation to change behavior.
Cash transfer programs are interventions that directly provide cash to target specific populations with the aim of reducing poverty and supporting a variety of development outcomes. Low- and middle-income countries have increasingly adopted cash transfer programs as central elements of their poverty reduction and social protection strategies. Bastagli et al. (2016) report that around 130 low- and middle-income countries have at least one UCT program, and 63 countries have at least one CCT program (up from 27 countries in 2008). Through a comprehensive review of literature, this report primarily considers the evidence of the long-term impacts of cash transfer programs in low- and lower middle-income countries. A review of 54 reviews that aggregate and summarize findings from multiple studies of cash transfer programs reveals largely positive evidence on long-term outcomes related to general health, reproductive health, nutrition, labor markets, poverty, and gender and intra-household dynamics, though findings vary by context and in many cases overall conclusions on the long-term impacts of cash transfers are mixed. In addition, evidence on long-term impacts for many outcome measures is limited, and few studies explicitly aim to measure long-term impacts distinctly from immediate or short-term impacts of cash transfers.
An ongoing stream of EPAR research considers how public good characteristics of different types of research and development (R&D) and the motivations of different providers of R&D funding affect the relative advantages of alternative funding sources. For this project, we seek to summarize the key public good characteristics of R&D investment for agriculture in general and for different subsets of crops, and hypothesize how these characteristics might be expected to affect public, private, or philanthropic funders’ investment decisions.
This research considers how public good characteristics of different types of research and development (R&D) and the motivations of different providers of R&D funding affect the relative advantages of alternative funding sources. We summarize the public good characteristics of R&D for agriculture in general and for commodity and subsistence crops in particular, as well as R&D for health in general and for neglected diseases in particular, with a focus on Sub-Saharan Africa and South Asia. Finally, we present rationales for which funders are predicted to fund which R&D types based on these funder and R&D characteristics. We then compile available statistics on funding for agricultural and health R&D from private, public and philanthropic sources, and compare trends in funding from these sources against expectations. We find private agricultural R&D spending focuses on commodity crops (as expected). However contrary to expectations we find public and philanthropic spending also goes largely towards these same crops rather than staples not targeted by private funds. For health R&D private funders similarly concentrate on diseases with higher potential financial returns. However unlike in agricultural R&D, in health R&D we observe some specialization across funders – especially for neglected diseases R&D - consistent with funders’ expected relative advantages.
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.
We review the current body of literature exploring the theories behind holistic human development measurements and the tradeoffs of different methodologies for the construction of human development indices. Through a systematic review of published and grey literature in the fields of human, international, and economic development we identify 22 current indices that aggregate measures from multiple dimensions of human development. We then analyze these indices to identify tradeoffs related to their unique characteristics and construction methodologies, considering ease of calculation, coverage of different measures of human development, ease of interpretation, comparability, and novelty. The report is accompanied by an appendix of summary tables for each index with further details regarding background information, methodology, index components, and evaluation criteria addressed within the report.
This paper is the third in EPAR’s series on Higher Education in Africa. Our research tasks in this phase build on Phase I, in which we sought to identify measurable rates of return on tertiary agricultural education in Africa and describe the current state of African higher agricultural education (HAE), and Phase II, in which we identified countries’ experiences with national higher education capacity building through partnership building, cross-border opportunities such as ‘twinning,’ and various retention and diaspora engagement strategies. In this phase we discuss successful regional education models, particularly in Sub-Saharan Africa. We have organized our findings and analysis into three sections.The first section organizes the literature under categories of regional higher education models or ‘hubs’ and discusses measurement of the regional impact of higher education. The second section provides bibliometric data identifying academically productive countries and universities in Sub-Saharan Africa.The final section provides a list of regional higher education models identified in the literature and through a web-based review of existing higher education networks and hubs. We also include a list of challenges and responses to regional coordination.
Our initial agriculture capacity building search revealed best practices including institutional partnership building, cross-border opportunities such as ‘twinning,’ and views that these practices are most effective when accompanied by appropriate policies and regulatory frameworks to incentivize return on education to home countries. In addition, the literature explained the historical and political context in which some countries successfully built higher educational capacity, suggesting a set of socio-political conditions necessary for a ‘surge’ in capacity building to occur. Our results raised questions about challenges shaping these best practices (e.g. “brain drain” leading to the need for cross-border opportunities) as well as possible approaches to address these underlying issues. To further examine identified challenges from our initial findings, we re-oriented our search to investigate retention strategies, regional or intra-national network capacity building approaches, and whether there is in fact a need for higher education capacity in all countries through comparative advantage or otherwise. This report presents a review of the literature on the best and worst practices for national agricultural capacity building when investing in a country's higher education system or when investing directly in national or relevant global research capacity. We find that several countries have successfully employed a variety of retention, return, and diaspora strategies to build capacity by capitalizing on the feedback loops of international mobility. In addition, several countries in Africa have employed strategies to address the rural-to-urban “brain drain” by prioritizing education of students with post-secondary rural agricultural work experience and strong ties to rural communities in order to return the benefit of this education to local communities. The report discusses these and other strategies as well as analysis related to the ‘whole system effect’ of higher education and subsequent ‘need’ for Higher Agricultural Education (HAE) capacity in all countries.