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.
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.
An ongoing stream of EPAR 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. For this project, we seek to summarize the key public good characteristics of R&D investment for agriculture in general and for different subsets of crops, and hypothesize how these characteristics might be expected to affect public, private, or philanthropic funders’ investment decisions.
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 summarizes the literature on caloric and lipid deficiencies and their contribution to nutritional outcomes, and identifies key studies and pieces of literature related to this topic.
Cereals and pulses are important food and cash crops for farmers and rural households in Ethiopia. Despite the economic and food security importance of these crops, data and opinion suggest a yield gap: actual smallholder farm yields do not achieve estimated potential yields for wheat, sorghum, maize, lentils and peas. Furthermore, cereal prices in Ethiopia fall between import and export parity prices, limiting their international trading prospects. Although there are significant wheat imports, these reflect the influx of food aid, rather than competitive trade on the international market. The purpose of this brief is to estimate yield gaps in important Ethiopian crops in order to identify potential areas for productivity gains. We find that wheat, sorghum and maize all exhibit the potential for yield gains to increase domestic food availability. Additionally, all three crops experienced significant spikes in yield in the 2006 season. Further investigation into the climate conditions and policy in place that year may generate potential strategies to increase future yields. Analysis of Ethiopian lentil and pea yields suggest that productivity gains may be possible to increase food availability. Limited access to improved technologies appears to be the main constraint to pulse productivity in Ethiopia. Opportunities to increase lentil and pea yields appear to exist through increasing cultivation of improved varieties.
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.