Types of Research
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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.
This report reviews approaches to results measurement used by multilateral and bilateral donor organizations and highlights trends and gaps in how donors measure and report on their performance. Our review consists of assessing donor organizations in terms of their institutional design and levels of evaluation for results measurement, their organizational processes for measuring types of results including coordination and alignment with recipients, outputs and implementation, outcomes and impacts, and costs and effectiveness, and their processes for reporting and using results information. We collect evidence on 12 bilateral organizations and 10 multilateral organizations. The evidence review includes multi-country reviews of aid effectiveness, peer reviews by other donor organizations, donor evaluation plans and frameworks, and donor results and reporting documents. The report is based on an accompanying spreadsheet that contains the coded information from the 22 donor organizations. We find that donors report several types of results, but that there are challenges to measuring certain results at the aggregate donor level, due to challenges with funding and coordination for results measurement at the project, country, portfolio, and donor levels. Approaches to results measurement vary across donor organizations. We identify some trends and differences among groups of donors, notably between bilateral and multilateral donors, but overall there are no clear delineations in how donors approach results measurement.
We review the current body of literature exploring the theories behind holistic human development measurements and the tradeoffs of different methodologies for the construction of human development indices. Through a systematic review of published and grey literature in the fields of human, international, and economic development we identify 22 current indices that aggregate measures from multiple dimensions of human development. We then analyze these indices to identify tradeoffs related to their unique characteristics and construction methodologies, considering ease of calculation, coverage of different measures of human development, ease of interpretation, comparability, and novelty. The report is accompanied by an appendix of summary tables for each index with further details regarding background information, methodology, index components, and evaluation criteria addressed within the report.
Aid results information is often not comparable, since monitoring and evaluation frameworks, information gathering processes, and definitions of “results” differ across donors and governments. This report reviews approaches to results monitoring and evaluation used by governments in developing countries, and highlights trends and gaps in national monitoring and evaluation (M&E) systems. We collect evidence on 42 separate government M&E systems in 23 developing countries, including 17 general national M&E systems and 25 sector-specific national M&E systems, with 14 focused on HIV/AIDS, 8 on health, and 3 on agriculture. The evidence review includes external case studies and evaluations of M&E systems, government M&E assessments, M&E plans, strategic plans with an M&E component, and multi-country reviews of M&E, accountability, and aid effectiveness. We evaluate harmonization of government and development partner M&E systems, coordination and institutionalization of government M&E, challenges in data collection and monitoring, and analysis and use of results information. We also report on key characteristics of M&E systems in different sectors.
Aid donors are interested in the arguments for allocating aid via bilateral versus multilateral channels, and specifically in understanding which channel is more “effective” at supporting positive development and social outcomes. We contribute to the literature on this subject by summarizing recent OECD data on aid flows and reviewing the theoretical arguments from the aid literature on the different characteristics supporting effectiveness of bilateral versus multilateral aid. We then review the empirical literature, analyzing 40 papers that study the effectiveness of different aid channels on various outcomes. Many studies do not directly compare the effectiveness of aid channels, and the studies vary in how aid channels are defined, measured, and evaluated. Further, these studies do not directly test the hypothesized advantages of one channel of aid versus another; rather they test bilateral versus multilateral aid flows associations with development outcomes, assuming some causal mechanism is at work to explain differences in impact. We evaluate studies reporting the impacts of aid on GDP growth, governance, government investment spending, health, the HDI, poverty, and private investment, and find no consistent evidence that either bilateral or multilateral aid is more effective. The lack of conclusive evidence supporting either aid channel is likely related to differences in the methodologies of the studies included in this review, but may also be due to differences in how the theoretical arguments for the effectiveness of either channel apply in different circumstances.