Research Topics

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 #339
Publication Date: 09/28/2017
Type: Data Analysis
Abstract

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. 

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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 Technical Report #337
Publication Date: 06/20/2016
Type: Data Analysis
Abstract

Relative to chronic hunger, seasonal hunger in rural and urban areas of Africa is poorly understood. No estimates are compiled, and limited evidence exists on prevalence, causes, and impacts. This paper contributes to the body of evidence by examining the extent and potential drivers of seasonal hunger using panel data from the Malawi Integrated Household Panel Survey (IHPS). Farmers are commonly thought to use various strategies to smooth consumption, including planting “off-season” crops, investing in post-harvest storage technologies, or generally diversifying farm portfolios including livestock products and/or wild crops. Similarly, when markets are available, farmers may diversify through off-farm income sources in order to purchase food in lean seasons. We investigate whether seasonal hunger – distinct from chronic hunger – exists in Malawi, drawing on two waves of panel data from the LSMS-ISA series. We examine the extent of seasonal hunger, factors associated with variation in seasonal hunger, and how recurring and longer-term seasonal hunger might be associated with various household welfare measures. We find that both urban and rural households report experiencing seasonal hunger in the pre-harvest months, with descriptive evidence suggesting male gender, age, and education of household head, livestock ownership, and storage of crops are associated with lower levels of seasonal hunger. In addition, we find that Malawian households with seasonal hunger harvest crops earlier than average – a short-term coping mechanism that can reduce the crop’s yield and nutritional value, possibly perpetuating hunger.

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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).