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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.
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.
The concept of global public goods represents a framework for organizing and financing international cooperation in global health research and development (R&D). Advances in scientific and clinical knowledge produced by biomedical R&D can be considered public goods insofar as they can be used repeatedly (non-rival consumption) and it is difficult or costly to exclude non-payers from gaining access (non-excludable). This paper considers the public good characteristics of biomedical R&D in global health and describes the theoretical and observed factors in the allocation R&D funding by public, private, and philanthropic sources.
This brief presents an overview of EPAR’s previous research related to gender. We first present our key takeaways related to labor and time use, technology adoption, agricultural production, control over income and assets, health and nutrition, and data collection. We then provide a brief overview of each previous research project related to gender along with gender-related findings, starting with the most recent project. Many of the gender-related findings draw from other sources; please see the full documents for references. Reports available on EPAR’s website are hyperlinked in the full brief.
This brief presents an overview of EPAR’s previous research on nutrition and food security and outlines summaries and key findings from 15 technical reports and research briefs. Key findings are drawn from our own original analyses as well as from other sources, which are cited in the individual reports. We also include appendices briefly summarizing EPAR’s research on health and climate change, topics somewhat related to nutrition and food security, and EPAR’s confidential work on nutrition and food security.
Labor is one of the most productive assets for many rural households in developing countries. Despite the importance of labor—and time use more generally—little research has empirically examined the quality of time-use data in household surveys. Many household surveys rely on respondent recall, the reliability of which may decrease as recall length increases. In addition, respondents often report on time allocation for the entire household, which they may not know or recall as clearly as their own time allocation. Finally, simultaneous activities such as tending children while preparing dinner, may lead to the systematic underestimation of certain activities, particularly those that tend to be performed by women. This paper examines whether the identity of the survey respondent affects estimates of time allocation within the household. Drawing on the Ugandan LSMS-ISA household survey, we find that individuals responding for themselves report higher levels of time use over the previous week than when responding for other household members. Moreover, male respondents tend to underreport time allocation for females over the age of 15 as compared to female respondents, especially time spent on domestic activities. In addition, an analysis of the effects of two economics shocks—having a baby and floods or droughts—suggests that the identity of the respondent can affect substantive conclusions about the effects of shocks on household time use.
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.