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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.
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.
We use OLS and logistic regression to investigate variation in husband and wife perspectives on the division of authority over agriculture-related decisions within households in rural Tanzania. Using original data from husbands and wives (interviewed separately) in 1,851 Tanzanian households, the analysis examines differences in the wife’s authority over 13 household and farming decisions. The study finds that the level of decision-making authority allocated to wives by their husbands, and the authority allocated by wives to themselves, both vary significantly across households. In addition to commonly considered assets such as women’s age and education, in rural agricultural households women’s health and labour activities also appear to matter for perceptions of authority. We also find husbands and wives interviewed separately frequently disagree with each other over who holds authority over key farming, family, and livelihood decisions. Further, the results of OLS and logistic regression suggest that even after controlling for various individual, household, and regional characteristics, husband and wife claims to decision-making authority continue to vary systematically by decision – suggesting decision characteristics themselves also matter. The absence of spousal agreement over the allocation of authority (i.e., a lack of “intrahousehold accord”) over different farm and household decisions is problematic for interventions seeking to use survey data to develop and inform strategies for reducing gender inequalities or empowering women in rural agricultural households. Findings provide policy and program insights into when studies interviewing only a single spouse or considering only a single decision may inaccurately characterize intra-household decision-making dynamics.