Types of Research
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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.
Donor countries and multilateral organizations may pursue multiple goals with foreign aid, including supporting low-income country development for strategic/security purposes (national security, regional political stability) and for short-and long-term economic interests (market development and access, local and regional market stability). While the literature on the effectiveness of aid in supporting progress on different indicators of country development is inconclusive, donors are interested in evidence that aid funding is not permanent but rather contributes to a process by which recipient countries develop to a point that they are economically self-sufficient. In this report, we review the literature on measures of country self-sufficiency and descriptive evidence from illustrative case studies to explore conditions associated with transitions toward self-sufficiency in certain contexts.
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.
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.
Donors and governments are increasingly seeking to implement development projects through self-help groups (SHGs) in the belief that such institutional arrangements will enhance development outcomes, encourage sustainability, and foster capacity in local civil society – all at lower cost to coffers. But little is known about the effectiveness of such institutional arrangements or the potential harm that might be caused by using SHGs as ‘vehicles’ for the delivery of development aid. This report synthesizes available evidence on the effectiveness of Self-Help Groups (SHGs) in promoting health, finance, agriculture, and empowerment objectives in South Asia and Sub-Saharan Africa. Our findings are intended to inform strategic decisions about how to best use scarce resources to leverage existing SHG interventions in various geographies and to better understand how local institutions such as SHGs can serve as platforms to enhance investments.
Anderson, C. L., Gugerty, M. K., Biscaye, P., True, Z., Clark, C., & Harris, K. P. (2014). Self-Help Groups in Development: A Review of Evidence from South Asia and Sub-Saharan Africa. EPAR Technical Report #283. Evans School of Public Policy & Governance, University of Washington. Retrieved <Day Month Year> from https://epar.evans.uw.edu/sites/default/files/epar_283_shg_evidence_review_brief_10.23.20.pdf
This report draws on past and present peer-reviewed articles and published reports by institutions including the World Health Organization (WHO), the UK Department for International Development (DFID), and others to provide a scoping summary of the household-level spillovers and broader impacts of a select group of health initiatives. Rather than focusing on estimates of the direct health impacts of investments (e.g., reductions in mortality from vaccine delivery), we focus on estimates of the less-often reported spillover effects of specific health investments on household welfare or the broader economy. The brief is designed to give a concise overview of major theories linking health improvements to broader social and economic outcomes, followed by more in-depth summaries of available local- and country-level estimates of broader impacts, defined as project spillovers offering local, regional and national social and economic benefits not typically reported in project evaluations.
This brief draws on recent reports by the OECD, the World Bank, the Overseas Development Institute (ODI), the Climate Policy Initiative (CPI) and others to provide an overview of climate finance in developing countries. The brief is divided into three sections: (i) sources of global climate finance; (ii) country-level flows of climate finance; and (iii) applications of climate finance in developing countries. The brief is designed to give a concise overview of financial flows directed at climate change mitigation and adaptation globally and in developing countries, with an introduction to climate finance accounting such that climate financial flow volumes can be compared to aid volumes in other sectors. Total global climate finance flows were approximately USD $364 billion in 2011 (Buchner et al., 2012) and $359 billion in 2012. However the vast majority of these flows - 76%, or $275 billion - was finance generated and spent within a country’s own borders (domestic finance) (Buchner et al., 2013). The “Fast-Start Finance” period from 2010-2012 saw $35 billion in new aid mobilized for climate finance in developing countries. Developed countries have recently committed to mobilize an additional $100 billion per year by 2020.
The commercial alcohol industry in Africa may provide opportunities to increase market access and incomes for smallholder farmers by increasing access to agriculture-alcohol value chains. Despite the benefits of increased market opportunities, the high costs to human health and social welfare from increased alcohol use and alcoholism could contribute to a net loss for society. To better understand the tradeoffs between increased market access for smallholders and societal costs associated with harmful alcohol consumption, this paper provides an inventory of the societal costs of alcohol in Sub-Saharan Africa (SSA). We examine direct costs associated with addressing harmful effects of alcohol and treating alcohol-related illnesses, as well as indirect costs associated with the goods and services that are not delivered as a consequence of drinking and its impact on personal productivity. We identified resources using Google Scholar and the University of Washington libraries, and utilized the Global Burden of Disease (GBD) database by the Institute for Health Metrics and Evaluation (IHME) and the World Health Organization’s Global Information System on Alcohol and Health (GISAH) database. We also utilized FAOSTAT to retrieve raw data on national-level alcohol production and export statistics. We find that hazardous alcohol use contributes to early mortality and morbidity, loss of productivity, property damage, and other social costs and harms for drinkers and those around them. Drinking also affects vulnerable segments of the population disproportionately. Policymakers, local authorities, and donor agencies can use the information presented in this paper to plan and prepare for the higher consumption levels and subsequent social costs that may follow through agricultural development and economic growth in the region.
Cassava (Manihot esculenta Crantz) is a widely-grown staple food in the tropical and subtropical regions of Africa, Asia, and Latin America. In this brief we examine the environmental constraints to, and impacts of, smallholder cassava production systems in Sub-Saharan Africa (SSA) and South Asia (SA), noting where the analysis applies to only one of these regions. We highlight crop-environment interactions at three stages of the cassava value chain: pre-production (e.g., land clearing), production (e.g., soil, water, and input use), and post-production (e.g., crop storage). At each stage we emphasize environmental constraints on production (poor soil quality, water scarcity, crop pests, etc.) and also environmental impacts of crop production (e.g., soil erosion, water depletion and pesticide contamination). We then highlight good practices for overcoming environmental constraints and minimizing environmental impacts in smallholder cassava production systems. Evidence on environmental issues in smallholder cassava production is relatively thin, and unevenly distributed across regions. The literature on cassava in South Asian smallholder systems is limited, reflecting a crop of secondary importance (though it is widely found elsewhere in Asia such as South East Asia), in comparison to cassava in much of SSA. The majority of the research summarized in this brief is from SSA. The last row of Table 1 summarizes good practices currently identified in the literature. However, the appropriate strategy in a given situation will vary widely based on contextual factors, such as local environmental conditions, market access, cultural preferences, production practices and the policy environment.
This overview introduces a series of EPAR briefs in the Agriculture-Environment Series that examine crop-environment interactions for a range of crops in smallholder food production systems in Sub-Saharan Africa (SSA) and South Asia (SA). The briefs cover the following important food crops in those regions; rice (#208), maize (#218), sorghum/millets (#213), sweet potato/yam (#225), and cassava (#228).
Drawing on the academic literature and the field expertise of crop scientists, these briefs highlight crop-environment interactions at three stages of the crop value chain: pre-production (e.g., land clearing and tilling), production (such as water, nutrient and other input use), and post-production (e.g., waste disposal and crop storage). At each stage we emphasize environmental constraints on crop yields (including poor soils, water scarcity, crop pests) and impacts of crop production on the environment (such as soil erosion, water depletion and pest resistance). We then highlight best practices from the literature and from expert experience for minimizing negative environmental impacts in smallholder crop production systems.
This overview (along with the accompanying detailed crop briefs) seeks to provide a framework for stimulating across-crop discussions and informed debates on the full range of crop-environment interactions in agricultural development initiatives.