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Much literature discusses the importance of investing in human capital—or “the sum of a population’s health, skills, knowledge, experience, and habits” (World Bank, 2018, p. 42)—to a country’s economic growth. For example, the World Bank reports a “chronic underinvestment” in health and education in Nigeria, noting that investing in human capital has the potential to significantly contribute to economic growth, poverty reduction, and societal well-being (World Bank, 2018). This research brief reports on the evidence linking investment in human capital—specifically, health and education—with changes in economic growth. It reviews the literature for five topic areas: Education, Infectious Diseases, Nutrition, Primary Health Care, and Child and Maternal Health. This review gives priority focus to the countries of Bangladesh, Burkina Faso, Democratic Republic of Congo, Ethiopia, India, Kenya, Madagascar, Nigeria, Rwanda, and Tanzania. For each topic area, we report the evidence in support of a pathway from investing in human capital to economic growth.
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 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.
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.
This research considers how public good characteristics of different types of research and development (R&D) and the motivations of different providers of R&D funding affect the relative advantages of alternative funding sources. We summarize the public good characteristics of R&D for agriculture in general and for commodity and subsistence crops in particular, as well as R&D for health in general and for neglected diseases in particular, with a focus on Sub-Saharan Africa and South Asia. Finally, we present rationales for which funders are predicted to fund which R&D types based on these funder and R&D characteristics. We then compile available statistics on funding for agricultural and health R&D from private, public and philanthropic sources, and compare trends in funding from these sources against expectations. We find private agricultural R&D spending focuses on commodity crops (as expected). However contrary to expectations we find public and philanthropic spending also goes largely towards these same crops rather than staples not targeted by private funds. For health R&D private funders similarly concentrate on diseases with higher potential financial returns. However unlike in agricultural R&D, in health R&D we observe some specialization across funders – especially for neglected diseases R&D - consistent with funders’ expected relative advantages.
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.
This brief presents an overview of EPAR’s previous research on nutrition and food security and outlines summaries and key findings from 15 technical reports and research briefs. Key findings are drawn from our own original analyses as well as from other sources, which are cited in the individual reports. We also include appendices briefly summarizing EPAR’s research on health and climate change, topics somewhat related to nutrition and food security, and EPAR’s confidential work on nutrition and food security.
Household survey data are a key source of information for policy-makers at all levels. In developing countries, household data are commonly used to target interventions and evaluate progress towards development goals. The World Bank’s Living Standards Measurement Study - Integrated Surveys on Agriculture (LSMS-ISA) are a particularly rich source of nationally-representative panel data for six Sub-Saharan African countries: Ethiopia, Malawi, Niger, Nigeria, Tanzania, and Uganda. To help understand how these data are used, EPAR reviewed the existing literature referencing the LSMS-ISA and identified 415 publications, working papers, reports, and presentations with primary research based on LSMS-ISA data. We find that use of the LSMS-ISA has been increasing each year since the first survey waves were made available in 2009, with several universities, multilateral organizations, government offices, and research groups across the globe using the data to answer questions on agricultural productivity, farm management, poverty and welfare, nutrition, and several other topics.
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).
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