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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.
Studies of improved seed adoption in developing countries almost always draw from household surveys and are premised on the assumption that farmers are able to self-report their use of improved seed varieties. However, recent studies suggest that farmers’ reports of the seed varieties planted, or even whether seed is local or improved, are sometimes inconsistent with the results of DNA fingerprinting of farmers' crops. We use household survey data from Tanzania to test the alignment between farmer-reported and DNA-identified maize seed types planted in fields. In the sample, 70% of maize seed observations are correctly reported as local or improved, while 16% are type I errors (falsely reported as improved) and 14% are type II errors (falsely reported as local). Type I errors are more likely to have been sourced from other farmers, rather than formal channels. An analysis of input use, including seed, fertilizer, and labor allocations, reveals that farmers tend to treat improved maize differently, depending on whether they correctly perceive it as improved. This suggests that errors in farmers' seed type awareness may translate into suboptimal management practices. In econometric analysis, the measured yield benefit of improved seed use is smaller in magnitude with a DNA-derived categorization, as compared with farmer reports. The greatest yield benefit is with correctly identified improved seed. This indicates that investments in farmers' access to information, seed labeling, and seed system oversight are needed to complement investments in seed variety development.
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 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.
Relative to chronic hunger, seasonal hunger in rural and urban areas of Africa is poorly understood. No estimates are compiled, and limited evidence exists on prevalence, causes, and impacts. This paper contributes to the body of evidence by examining the extent and potential drivers of seasonal hunger using panel data from the Malawi Integrated Household Panel Survey (IHPS). Farmers are commonly thought to use various strategies to smooth consumption, including planting “off-season” crops, investing in post-harvest storage technologies, or generally diversifying farm portfolios including livestock products and/or wild crops. Similarly, when markets are available, farmers may diversify through off-farm income sources in order to purchase food in lean seasons. We investigate whether seasonal hunger – distinct from chronic hunger – exists in Malawi, drawing on two waves of panel data from the LSMS-ISA series. We examine the extent of seasonal hunger, factors associated with variation in seasonal hunger, and how recurring and longer-term seasonal hunger might be associated with various household welfare measures. We find that both urban and rural households report experiencing seasonal hunger in the pre-harvest months, with descriptive evidence suggesting male gender, age, and education of household head, livestock ownership, and storage of crops are associated with lower levels of seasonal hunger. In addition, we find that Malawian households with seasonal hunger harvest crops earlier than average – a short-term coping mechanism that can reduce the crop’s yield and nutritional value, possibly perpetuating hunger.