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 #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 #338
Publication Date: 05/19/2017
Type: Literature Review
Abstract

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.

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 #325
Publication Date: 01/30/2016
Type: Literature Review
Abstract

This brief reviews the various definitions of global public goods (GPGs) and regional public goods (RPGs) found in the literature and provides examples of each in six frequently discussed sectors: environment, health, knowledge, security, governance, and infrastructure. We identify multiple alternative definitions that have gained some traction in the literature, but GPGs are generally agreed to exhibit publicness in consumption, distribution of benefits, and decision-making. Because policy choices determine what is and what is not a GPG, there cannot be a fixed list of such goods; some always have the property of global publicness, while others have over time changed from being local or national to being global in terms of benefits and costs. GPGs are thus redefined as goods that are in the global public domain. GPG and RPG financing mechanisms include payments by users and beneficiaries, taxes, fees, and levies, private funding by non-profit corporations, profit-making firms, and philanthropic individuals and organizations, national and international public resources, and partnerships between several sources of financing. We conclude with an analysis of trends in GPG and RPG financing through Official Development Assistance (ODA) using time series data from the OECD’s Creditor Reporting System and other sources. We find that 14% of ODA in 2014 was allocated to sub-sectors labelled by Reiner et al. as GPGs, while 15% of ODA was allocated to RPGs, and that GPG and RPG spending has steadily increased from 2002-2014.

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 Research Brief #285
Publication Date: 06/19/2014
Type: Literature Review
Abstract

This brief draws on recent reports by the OECD, the World Bank, the Overseas Development Institute (ODI), the Climate Policy Initiative (CPI) and others to provide an overview of climate finance in developing countries. The brief is divided into three sections: (i) sources of global climate finance; (ii) country-level flows of climate finance; and (iii) applications of climate finance in developing countries. The brief is designed to give a concise overview of financial flows directed at climate change mitigation and adaptation globally and in developing countries, with an introduction to climate finance accounting such that climate financial flow volumes can be compared to aid volumes in other sectors. Total global climate finance flows were approximately USD $364 billion in 2011 (Buchner et al., 2012) and $359 billion in 2012. However the vast majority of these flows - 76%, or $275 billion - was finance generated and spent within a country’s own borders (domestic finance) (Buchner et al., 2013). The “Fast-Start Finance” period from 2010-2012 saw $35 billion in new aid mobilized for climate finance in developing countries. Developed countries have recently committed to mobilize an additional $100 billion per year by 2020.

EPAR Research Brief #228
Publication Date: 04/18/2014
Type: Literature Review
Abstract

Cassava (Manihot esculenta Crantz) is a widely-grown staple food in the tropical and subtropical regions of Africa, Asia, and Latin America. In this brief we examine the environmental constraints to, and impacts of, smallholder cassava production systems in Sub-Saharan Africa (SSA) and South Asia (SA), noting where the analysis applies to only one of these regions. We highlight crop-environment interactions at three stages of the cassava value chain: pre-production (e.g., land clearing), production (e.g., soil, water, and input use), and post-production (e.g., crop storage). At each stage we emphasize environmental constraints on production (poor soil quality, water scarcity, crop pests, etc.) and also environmental impacts of crop production (e.g., soil erosion, water depletion and pesticide contamination). We then highlight good practices for overcoming environmental constraints and minimizing environmental impacts in smallholder cassava production systems. Evidence on environmental issues in smallholder cassava production is relatively thin, and unevenly distributed across regions. The literature on cassava in South Asian smallholder systems is limited, reflecting a crop of secondary importance (though it is widely found elsewhere in Asia such as South East Asia), in comparison to cassava in much of SSA. The majority of the research summarized in this brief is from SSA. The last row of Table 1 summarizes good practices currently identified in the literature. However, the appropriate strategy in a given situation will vary widely based on contextual factors, such as local environmental conditions, market access, cultural preferences, production practices and the policy environment.