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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.
The Government of Kenya (GoK) has historically encouraged its farmers to use fertilizer by financing infrastructure and supporting fertilizer markets. From 1974 to 1984, the GoK provided a fertilizer importation monopoly to one firm, the Kenya Farmers Association. However, the GoK saw that this monopoly impeded fertilizer market development by prohibiting competing firms from entering the market and, in the latter half of the 1980s, encouraged other firms to enter the highly regulated fertilizer market. This report examines the state of fertilizer use in Kenya by reviewing and summarizing literature on recent fertilizer price increases, Kenya’s fertilizer usage trends and approaches, market forces, and the impact of government and non-government programs. We find that most studies of Kenya’s fertilizer market find it to be well functioning and generally competitive, and conclude that market reform has stimulated fertilizer use mainly by improving farmers’ access to the input through the expansion of private retail networks. Overall fertilizer consumption in Kenya has increased steadily since 1980, and fertilizer use among smallholders is among the highest in Sub-Saharan Africa. Yet fertilizer consumption is still limited, especially on cereal crops, and in areas where agroecological conditions create greater risks and lower returns to fertilizer use.