Types of Research
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 brief reviews the literature and empirical evidence on waste extraction and treatment in the developing world. The brief assesses the quantity and quality of research supporting key components of program theory related to the extraction of sludge from on-site sanitation facilities and pre-disposal transport. In general, we find few empirical studies that directly evaluate the assertions of the program theory. Most of the evidence in the literature that addresses the target components of program theory is based upon case studies or general observational and experiential assertions by sanitation experts. Where appropriate, we have identified evidence in the literature according to whether case studies or informal observations formed the basis of the conclusion.
The purpose of this literature review is to provide qualitative and quantitative examples of technologies, constraints and incentives for efficient waste treatment and reuse in Sub-Saharan Africa and Southeast Asia. We present relevant case studies and expert observations and experiences on the nutrient content in urine and feces, contaminants frequently found in untreated sludge and wastewater, waste treatment technologies that may be relevant for low-income countries, risks associated with waste reuse, benefits to resource recovery in agriculture. We further discuss reasons for waste treatment failures, including urbanization, observations on challenges with market-driven reuse in less developed countries, and examples of net-positive energy facilities in Europe and the United States. Much of the evidence presented in the literature relates to wastewater treatment processes or the sludge produced from wastewater treatment as opposed to untreated fecal sludge. However, examples of risks, failures, and opportunities for raw sludge treatment and reuse are discussed when available. In some cases, empirical evidence or case studies were not available for developing countries and alternatives are presented. Overall we found the empirical evidence on waste treatment and reuse in developing countries is quite thin.