Research Topics

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EPAR Technical Report #346
Publication Date: 04/23/2018
Type: Literature Review
Abstract

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.

EPAR Technical Report #345
Publication Date: 12/01/2017
Type: Literature Review
Abstract

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.

EPAR Technical Report #359
Publication Date: 11/13/2017
Type: Literature Review
Abstract

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.

EPAR Technical Report #329
Publication Date: 05/31/2017
Type: Literature Review
Abstract

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.

EPAR Research Brief #332
Publication Date: 02/26/2016
Type: Literature Review
Abstract

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.

EPAR Research Brief #316
Publication Date: 12/13/2015
Type: Literature Review
Abstract

The literature on poverty’s causes and cures in developing countries posits a variety of contributing factors. Most researchers acknowledge that a sustained exit from poverty is complex and no single causal pathway from poverty to non-poverty exists. In this review, we present a summary framework for categorizing the various theorized pathways out of poverty, and evaluate the empirical evidence for which interventions and resulting outcomes are most frequently and most strongly associated with poverty alleviation. We conducted a literature review on pathways out of poverty for low-income households in developing countries and identified and categorized general strategies and outcomes demonstrated to be empirically associated with poverty alleviation. We organized the general strategies into four asset groups that could be targeted to alleviate poverty: human, natural, built / financial, and social / political. Much of the literature presents positive results on poverty alleviation, but it is difficult to compare across studies because many of the studies were conducted in different countries and at different scales, and use a variety of outcome measures.

EPAR Technical Report #293
Publication Date: 03/31/2015
Type: Literature Review
Abstract

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).

EPAR Technical Report #94
Publication Date: 08/17/2010
Type: Literature Review
Abstract

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.

EPAR Technical Report #60
Publication Date: 03/05/2010
Type: Literature Review
Abstract

In recent years, product supply chains for agricultural goods have become increasingly globalized. As a result, greater numbers of smallholder farmers in South Asia (SA) and Sub-Saharan Africa (SSA) participate in global supply chains, many of them through contract farming (CF). CF is an arrangement between a farmer and a processing or marketing firm for the production and supply of agricultural products, often at predetermined prices. This literature review finds empirical evidence that demonstrates that the economic and social benefits of CF for smallholder farmers are mixed. A number of studies suggest that CF may improve farmer productivity, reduce production risk and transaction costs, and increase farmer incomes. However, critics caution that CF may undermine farmers’ relative bargaining power and increase health, environmental, and financial risk through exposure to monopsonistic markets, weak contract environments, and unfamiliar agricultural technologies. There is consensus across the literature that CF has the best outcomes for farmers when farmers have more bargaining power to negotiate the terms of the contract. In reviewing the literature on CF, we find a number of challenges to comparing studies and evaluating outcomes across contracts. This literature review summarizes empirical findings and analyses regarding contract models and best practices to increase farmers’ bargaining power and decrease contract default.

EPAR Research Brief #32
Publication Date: 06/30/2009
Type: Literature Review
Abstract

Though not indigenous to Sub-Saharan Africa (SSA), cassava plays, to varying degrees, five major roles in African development: famine-reserve crop, rural food staple, cash crop for urban consumption, livestock feed, and industrial raw material. Cassava production in SSA was historically a significant staple crop for smallholder farmers and continues to be the second most important food crop in Africa (after maize) in terms of calories consumed. Subsistence crops such as cassava are often considered women’s crops with the standard explanation that women are responsible for feeding the family and thus prefer to grow crops for the household. This brief reviews the role that women play in cassava production, and considers ways to better address gender issues from planting through post-harvest production. We find that the potential gains to cassava production made possible through improved technology will not be fully realized without the participation of women farmers and without women farmers having access to credit, markets, and extension services. Additionally, evidence from SSA suggests that labor for harvesting and processing, rather than labor for weeding, has become the key labor constraint for cassava, and addressing this concern may be more important than further yield increases for raising production levels.