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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.
We review the status and characteristics of 48 national identity programs and initiatives in 43 developing countries, and evaluate how these programs are being connected to—or used for—service provision. The identity programs we review are mainly government-issued national IDs. However, we also review other types of national identity programs with links to various services including voter cards, passports, and two programs targeting the poor and the banking population. Following a brief review of the roles of identity systems in development and recent identity system trends, we present an overview of the 48 national identity programs, including technical features (such as whether physical identities incorporate an electronic component or are embedded with biometric features), implementation status, population enrollment strategies, and coverage. We next review evidence of implementation challenges around accountability, privacy, data management, enrollment, coverage, cost, and harmonization of identity programs. Finally, we present the functional applications of national identity programs, reporting how these programs are linked with services in finance, health, agriculture, elections, and other areas, and analyzing whether particular identity program characteristics are associated with functional applications.
We review the literature on the status of interoperable payment schemes and regulations for financial services (particularly mobile money) in 46 developing countries, and identify examples of countries with interoperable mobile money schemes and/or regulations pertaining to mobile money and/or interoperability. Following a brief introduction to mobile money and interoperability, we present an overview of the status of mobile money in the 46 selected countries. We then review country regulations regarding both mobile money and payment systems as well as the form of these regulations (National Payment Law or Strategy, regulations, guidelines, etc.) for each country. We further discuss mobile money regulations, specifically regulations that pertain to bank-based versus non-bank based mobile money schemes, regulatory safeguards, and agent banking. In the final section we review regulations pertaining to interoperable mobile money services and outline where such regulations have been documented, highlighting countries with interoperable mobile money markets.
This report provides a summary of findings from six Financial Inclusion Insights (FII) data analysis reports conducted by various agencies for the Bill & Melinda Gates Foundation (BMGF). These reports investigate barriers to financial inclusion and use of digital financial services (DFS) in Bangladesh, India, Kenya, Nigeria, Pakistan, Tanzania, and Uganda. We compile comparable gender-specific statistics, summarize the authors’ findings to determine commonalities and differences across countries, and highlight gender-specific conclusions and recommendations provided in the studies.
This brief reviews the evidence of realized yield gains by smallholder farmers attributable to the use of high-quality seed and/or improved seed varieties. Our analysis suggests that in most cases, use of improved varieties and/or quality seed is associated with modest yield increases. In the sample of 395 trials reviewed, positive yield changes accompanied the use of improved variety or quality seed, on average, in 10 out of 12 crops, with rice and cassava as the two exceptions.
This report reviews the current body of peer-reviewed scholarship exploring the impacts of morbidity on economic growth. This overview seeks to provide a concise introduction to the major theories and empirical evidence linking morbidity – and the myriad different measures of morbidity – to economic growth, which is defined primarily in terms of gross domestic product (GDP) and related metrics (wages, productivity, etc.). Through a systematic review of published manuscripts in the fields of health economics and economic development we further identify the most commonly-used pathways linking morbidity to economic growth. We also highlight the apparent gaps in the empirical literature (i.e., theorized pathways from morbidity to growth that remain relatively untested in the published empirical literature to date).
After cereals, root and tuber crops - including sweetpotato and yam (in addition to cassava and aroids), are the second most cultivated crops in tropical countries. This literature review examines the environmental constraints to, and impacts of, sweetpotato and yam production systems in Sub-Saharan Africa (SSA) and South Asia (SA). The review highlights crop-environment interactions at three stages of the sweetpotato/yam value chain: pre-production (e.g., land clearing), production (e.g., soil, water, and input use), and post-production (e.g., waste disposal, crop storage and transport). We find that sweetpotato and yam face similar environmental stressors. In particular, because sweetpotato and yam are vegetatively propagated, the most significant (and avoidable) environmental constraints to crop yields include disease and pest infection transmitted through the use of contaminated planting materials. Published estimates suggest yield gains in the range of 30–60% can be obtained through using healthy planting material. Moreover, reducing pest damage in the field can greatly increase the storage life of root and tuber crops after harvest – currently losses from rot and desiccation can claim up to 100% of stored sweetpotato and yam on smallholder farms.
Maize has expanded through the 20th and into the 21st century to become the principle staple food crop produced and consumed by smallholder farm households in Sub-Saharan Africa (SSA), and maize production has also expanded in South Asia (SA) farming systems. In this brief we examine the environmental constraints to, and impacts of, smallholder maize production systems in SSA and SA, noting where findings apply to only one of these regions. We highlight crop-environment interactions at three stages of the maize value chain: pre-production (e.g., land clearing), production (e.g., fertilizer, water, and other input use), and post-production (e.g., waste disposal and crop storage). At each stage we emphasize environmental constraints on maize production (such as poor soil quality, water scarcity, or crop pests) and also environmental impacts of maize production (such as soil erosion, water depletion, or chemical contamination). We then highlight best or good practices for overcoming environmental constraints and minimizing environmental impacts in smallholder maize production systems. Evidence on environmental constraints and impacts in smallholder maize production is uneven. Many environmental concerns such as biodiversity loss are commonly demonstrated more broadly for the agroecology or farming systems in which maize is grown, rather than specifically for the maize crop. And more research is available on the environmental impacts of agrochemical-based intensive cereal farming in Asia (where high-input maize is a common component) than on the low-input subsistence-scale maize cultivation more typical of SSA. Decisive constraint and impact estimates are further complicated by the fact that many crop-environment interactions in maize and other crops are a matter of both cause and effect (e.g., poor soils decrease maize yields, while repeated maize harvests degrade soils). Fully understanding maize-environment interactions thus requires recognizing instances where shortterm adaptations to environmental constraints might be exacerbating other medium- or long-term environmental problems. Conclusions on the strength of published findings on crop-environment interactions in maize systems further depend on one’s weighting of economic versus ecological perspectives, physical science versus social science, academic versus grey literature, and quantity versus quality of methods and findings.
In this brief we examine the environmental constraints to, and impacts of, smallholder sorghum and millet production systems in Sub-Saharan Africa (SSA) and South Asia (SA). Millet in this paper primarily refers to pearl millet (Pennisetum glaucum), although a number of other millets of significance to smallholder production and food security are also discussed. Sorghum and millets are known for being more tolerant of major environmental stresses including drought and poor soil quality than other major cereals. But water availability is still among the greatest constraints to increased grain production, and soil fertility also significantly limits yields, especially in cases where cultivation occurs on marginal lands and where crop residues are removed for alternative uses. Ultimately sorghum and millets’ relatively higher tolerance to abiotic stresses is expected to promote an increase in global cropping area for sorghum and millets as an adaptation to climate change. Sorghum and millet exhibit relatively few of the environmental impacts commonly associated with more intensively cultivated crops such as fertilizer runoff, pesticide contamination, or water depletion, since both of these crops are overwhelmingly grown by smallholder farmers with few, if any, chemical or irrigation inputs. Nevertheless, the tendency to grow sorghum and millet on marginal and heavily sloped lands does pose some environmental risks – including soil degradation and erosion – that can be mitigated through the adoption of best practices as described in the brief.
Rice is the most important food crop of the developing world and is grown on over 155 million ha worldwide. Food security of the poor, especially in Asia, depends critically on rice availability at an affordable price. In this brief we examine the environmental constraints to, and impacts of, smallholder rice production systems in South Asia (SA) and Sub-Saharan Africa (SSA), noting where the analysis applies to only one of these regions. We highlight crop-environment interactions at three stages of the rice value chain: pre-production (e.g., land clearing), production (e.g., water and other input use), and post-production (e.g., waste disposal). At each stage we emphasize environmental constraints on production (e.g., poor soil quality, water scarcity, crop pests) and also environmental impacts of crop production (e.g., soil erosion, water depletion, pest resistance). We then highlight best or good practices for minimizing negative environmental impacts in smallholder rice production systems. Evidence on environmental issues in smallholder rice production is uneven. Far more research is available for Asian rice production systems, as compared to African rice systems. And with the possible exception of the evidence on water limits to increasing productivity, conclusions on the strength of published findings on crop-environment interactions in rice depends on one’s weighting of economic versus ecological perspectives, physical science versus social science, academic versus grey literature, and quantity versus quality of methods and findings.