Types of Research
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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.
Water supply and sanitation is the responsibility of sub-national state governments under the Indian Constitution. At present, the national government sets water supply and sanitation policy while states plan, design, and execute water supply schemes accordingly. Furthermore, while state governments are in charge of operation and maintenance, they may pass the responsibility to village or district levels. Given the highly decentralized provision of water and sanitation services, there is no autonomous regulatory agency for the water supply and sanitation sector in India at the state or national level. This report reviews literature on India’s urban sanitation policy. The methodology includes Google, Lexis-Nexis, and University of Washington Library searches, searches of two major Indian newspapers, and searches of websites and blogs sponsored by non-governmental organizations. Sources also include the India Sanitation Portal, a forum on sanitation in India used by governmental and nongovernmental organizations, and WASH Sanitation Updates, a sanitation news feed with considerable material on India. We find that urban sanitation policy, as embodied in the National Urban Sanitation Plan of 2008, remains focused on decentralized approaches. Our research reveals no evidence of a change in official policy, nor evidence suggesting that government sanitation programs conflict with official policy.
How development organizations, NGOs, and governments can best allocate scarce resources to those in need has long been debated. As opposed to universal allocation of resources, a more targeted approach attempts to minimize program costs while maximizing benefits among those with the greatest need or market opportunity. Drawing on literature from several sectors,this brief presents two categories of beneficiary targeting in the development context: administrative targeting and self-targeting. The paper includes a brief overview of targeting and segmentation in development, a summary of reasons for targeting, theoretical and practical critiques of targeting, and a discussion of targeting methods in research and practice, including examples from the literature. Implementation examples cited in this body of research include food aid program targeting by self-reported household income in Egypt; fertilizer use in low-potential zones of Uganda; and seven strategic initiatives to improve drought and disease resistance in crops in Asia and Sub-Saharan Africa. We find that beneficiary segmentation has several theoretical advantages. Improved targeting may increase the efficiency and equity of organizational and program efforts and help better match interventions to recipient preferences, increasing the likelihood of adoption and participation. Development organizations may improve the focus of both their strategic priorities and budgets through customized targeting methods. However, concerns exist regarding the accuracy, reliability, cost, and time-constraints of targeting methodologies. Creating valid and reliable target groups with implementation potential remains a significant challenge.
Limited sanitation infrastructure, poor hygienic practices, and unsafe drinking water negatively affect the health of millions of people in the developing world. Using sanitation interventions to interrupt disease pathways can significantly improve public health. Sanitation interventions primarily benefit public health by reducing the prevalence of enteric pathogenic illnesses, which cause diarrhea. Health benefits are realized and accrue to the direct recipients of sanitation interventions and also to their neighbors and others in their communities. In a report to the United Nations Development Programme (UNDP), Hutton et al. (2006) estimate that the cost-benefit ratio of sanitation interventions in all developing countries worldwide is 11.2. This literature review summarizes the risks of inadequate sanitation to public health and presents the empirical evidence on the public health benefits of complete, intermediate and multiple factor sanitation interventions. We find that complete or improved sanitary systems can offer concrete public health benefits by reducing exposure pathways to a variety of infectious diseases contained in human feces and wastewater. Substantial complementary economic gains are also predicted to accrue as a result of providing increased sanitation. In addition, community-wide sanitation interventions seem to offer the greatest promise for reducing pathogenic health risks from feces.
Without availability and access to a variety of foods, populations in the developing world are suffering from deficiencies in iron, zinc, iodine, vitamin A, and other micronutrients in addition to deficiencies in energy and protein. Supplementation and fortification programs have demonstrated effectiveness, but there is an increasing interest in potentially more sustainable solutions via agricultural interventions. The review examines the literature regarding agricultural interventions and pathways to diet diversification and whether desired nutritional outcomes are achieved. We find a strong sentiment that agricultural interventions can improve dietary diversity, and that dietary diversity can improve nutrition and related health outcomes. The programs with demonstrated ability to improve nutrition outcomes are most often cross-cutting interventions, borrowing from the agriculture, nutrition, and public health traditions. While these multi-platform programs can be costly to evaluate and difficult to implement, the evidence supports their potential to create sustainable quality-of-life improvements in target regions. The pathways by which agricultural interventions achieve impact are not fully clear, however. The greatest knowledge gaps are directly related to the lack of integration between program design and evaluation. Many evaluations are based on small sample sizes, lack control groups or baseline data, are subject to selection bias, or face other challenges to rigorous statistical analysis.
Market-oriented agricultural production can be a mechanism to increase smallholder farmer welfare, rural market performance, and contribute to overall economic growth. Cash crop production can allow households to increase their income by producing output with higher returns to land and labor and using the income generated from sales to purchase goods for consumption. However, in the face of missing and underperforming markets, African smallholder households are often unable to produce efficiently or obtain staple foods reliably and cheaply. This literature review summarizes the available literature on the impact of smallholder participation in cash crop and export markets on household welfare and rural markets. The review focuses exclusively on evidence from Sub-Saharan Africa regarding top and emerging export crops, with the addition of tobacco and horticulture due to the volume of research relevant to smallholder welfare gains from the production of these crops. It includes theoretical frameworks, case studies, empirical evidence, and historical analysis from 42 primary empirical studies and 112 resources overall.
How development organizations, NGOs, and governments can best allocate scarce resources to those in need has long been debated. As opposed to universal allocation of resources, a more targeted approach attempts to minimize program costs while maximizing benefits among those with the greatest need or market opportunity. Many international development organizations strategically target clients based on geographic location (e.g., community, region, country) or socio-economic indicators, such as the World Bank’s “$1 a day” poverty line. Drawing on literature from several sectors, this brief presents additional methods of beneficiary targeting that international development organizations might consider. We find that beneficiary targeting/segmentation has the potential to make organizational and program efforts more equitable and efficient. With limited resources, smaller organizations have tended to use single robust indicators or simple heuristics, whereas agribusinesses and private sector firms have used more data-intensive marketing tools to position their products. Technological innovation and better access to data have made targeting more prevalent and potentially more affordable in agricultural development. However, creating valid and reliable target segments remains the most significant challenge.
Contract farming (CF) is an arrangement between farmers and a processing or marketing firm for the production and supply of agricultural products, often at predetermined prices. This literature review builds on EPAR's review of smallholder contract farming in Sub-Saharan Africa (SSA) and South Asia (EPAR Technical Report #60) by specifically examining the evidence on impacts and potential benefits of contract farming for women in SSA. Key takeaways suggest women’s direct participation in contract farming is limited, with limited access to land and control over the allocation of labor and cash resources key constraints hindering women’s ability to benefit from CF. Further, we find that the impact of contract farming on women is often mediated by their relative bargaining power within the household.
This literature review provides a summary of the risks that potentially limit private sector agribusiness investment in Sub-Saharan Africa (SSA), and some responses to those risks. The report reviews risks that limit private sector investment and interventions used to mitigate risk to agricultural investment including government policy, international financial institutions, philanthropic efforts and other private initiatives. Risk is defined as a potential negative impact to assets, investments, or profitability of investments in the agricultural industry that may arise from some present process or future event. There is currently limited information examining how particular risk factors influence private-sector agribusiness investment in the region. However, the information that is available suggests that economic and political instability are among the most significant risks to agribusiness investors in SSA. Further, the literature notes that agricultural risks in SSA are particularly pronounced due to environmental risks that contribute to unreliable cash flows and uncertain profitability. We find that these risk factors are compounded by a lack of data and information for investors to use in assessing and pricing risks appropriately.