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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.
A large and growing body of scholarship now suggests that many household outcomes, including children’s education and nutrition, are associated with a wife’s bargaining power and control over household decision-making. In turn, bargaining power in a household is theorized to be driven by a wife’s financial and human capital assets – in particular the degree to which these assets contribute to household productivity and/or to the wife’s exit options. This paper draws on the detailed Farmer First dataset in Tanzania and Mali to examine husband and wife reports of a wife’s share of decision-making authority in polygynous households, where multiple wives jointly contribute to household productivity, and where exit options for any single wife may be less credible. We find that both husbands and wives assign less authority to the wife in polygynous households relative to monogamous households. We also find that a wife’s assets are not as strongly associated with decision-making authority in polygynous versus monogamous contexts. Finally, we find that responses to questions on spousal authority vary significantly by spouse in both polygynous and monogamous households, suggesting interventions based on the response of a single spouse may incorrectly inform policies and programs.
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.
By examining how farmers respond to changes in crop yield, we provide evidence on how farmers are likely to respond to a yield-enhancing intervention that targets a single staple crop such as maize. Two alternate hypotheses we examine are: as yields increase, do farmers maintain output levels but change the output mix to switch into other crops or activities, or do they hold cultivated area constant to increase their total production quantity and therefore their own consumption or marketing of the crop? This exploratory data analysis using three waves of panel data from Tanzania is part of a long-term project examining the pathways between staple crop yield (a proxy for agricultural productivity) and poverty reduction in Sub-Saharan Africa.
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.
A growing body of evidence suggests that empowering women may lead to economic benefits (The World Bank, 2011; Duflo, 2012; Kabeer & Natali, 2013). Little work, however, focuses specifically on the potential impacts of women’s empowerment in agricultural settings. Through a comprehensive review of literature this report considers how prioritizing women’s empowerment in agriculture might lead to economic benefits. With an intentionally narrow focus on economic empowerment, we draw on the Women’s Empowerment in Agriculture Index (WEAI)’s indicators of women’s empowerment in agriculture to consider the potential economic rewards to increasing women’s control over agricultural productive resources (including their own time and labor), over agricultural production decisions, and over agricultural income. While we recognize that there may be quantifiable benefits of improving women’s empowerment in and of itself, we focus on potential longer-term economic benefits of improvements in these empowerment measures.
Previous research has shown that men and women, on average, have different risk attitudes and may therefore see different value propositions in response to new opportunities. We use data from smallholder farm households in Mali to test whether risk perceptions differ by gender and across domains. We model this potential association across six risks (work injury, extreme weather, community relationships, debt, lack of buyers, and conflict) while controlling for demographic and attitudinal characteristics. Factor analysis highlights extreme weather and conflict as eliciting the most distinct patterns of participant response. Regression analysis for Mali as a whole reveals an association between gender and risk perception, with women expressing more concern except in the extreme weather domain; however, the association with gender is largely absent when models control for geographic region. We also find lower risk perception associated with an individualistic and/or fatalistic worldview, a risk-tolerant outlook, and optimism about the future, while education, better health, a social orientation, self-efficacy, and access to information are generally associated with more frequent worry— with some inconsistency. Income, wealth, and time poverty exhibit complex associations with perception of risk. Understanding whether and how men’s and women’s risk preferences differ, and identifying other dominant predictors such as geographic region and worldview, could help development organizations to shape risk mitigation interventions to increase the likelihood of adoption, and to avoid inadvertently making certain subpopulations worse off by increasing the potential for negative outcomes.