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EPAR Technical Report #345
Review of Literature on Factors Affecting Private Sector Investment in Global Health R&D
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.

Technical Report, Technical Report Executive Summary
EPAR Technical Report #359
Review of Long-Term Impacts of Cash Transfer Programs
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.

Technical Report, Results Coding
EPAR Technical Report #329
Funding of Agricultural and Health R&D Public Goods
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.

Presentation Slides - ICABR 2017, Technical Report - ICABR 2017
EPAR Technical Report #338
Policy and Economic Considerations for the Provision of Global Public Goods: Biomedical Research and Development
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.

Poster Presentation
EPAR Research Brief #113
Analysis of World Bank Project Appraisal Documents Indicators for Water, Sanitation & Hygiene Projects
Publication Date: 12/20/2010
Type: Portfolio Review
Abstract

This brief analyzes the indicators used by the World Bank in its Project Appraisal Documents (PAD) to measure the outputs and outcomes of 44 Water, Sanitation and Hygiene projects in Africa and Asia from 2000-2010.  This report details the methods used to collect and organize the indicators, and provides a brief analysis of the type of indicators used and their evolution over time. A searchable spreadsheet of the indicators used in this analysis accompanies this summary. We find that some patterns emerge over time, though none are very drastic. The most common group of indicators used by the World Bank are “management” oriented indicators (28% of indicators). Management indicators are disproportionately used in African projects as compared to projects in Asia. Several projects in Africa incorporate indicators relating to legal/regulatory/policy outcomes, while projects in Asia do not. In recent years, the World Bank has used fewer indicators that measure service delivery, health, and education and awareness.

Portfolio Review, Results Coding
EPAR Research Brief #116
Sanitation Policy in India
Publication Date: 12/13/2010
Type: Literature Review
Abstract

Water supply and sanitation is the responsibility of sub-national state governments under the Indian Constitution. At present, the national government sets water supply and sanitation policy while states plan, design, and execute water supply schemes accordingly. Furthermore, while state governments are in charge of operation and maintenance, they may pass the responsibility to village or district levels. Given the highly decentralized provision of water and sanitation services, there is no autonomous regulatory agency for the water supply and sanitation sector in India at the state or national level. This report reviews literature on India’s urban sanitation policy. The methodology includes Google, Lexis-Nexis, and University of Washington Library searches, searches of two major Indian newspapers, and searches of websites and blogs sponsored by non-governmental organizations. Sources also include the India Sanitation Portal, a forum on sanitation in India used by governmental and nongovernmental organizations, and WASH Sanitation Updates, a sanitation news feed with considerable material on India. We find that urban sanitation policy, as embodied in the National Urban Sanitation Plan of 2008, remains focused on decentralized approaches. Our research reveals no evidence of a change in official policy, nor evidence suggesting that government sanitation programs conflict with official policy.

Literature Review