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  • Author: David Evans, Maryam Akmal, Pamela Jakiela
  • Publication Date: 01-2020
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Many countries remain far from achieving gender equality in the classroom. Using data from 126 countries between 1960 and 2010, we document four facts. First, women are more educated today than fifty years ago in every country in the world. Second, they remain less educated than men in the vast majority of countries. Third, in many countries with low levels of education for both men and women in 1960, gender gaps widened as more boys went to school, then narrowed as girls enrolled; thus, gender gaps got worse before they got better. Fourth, gender gaps rarely persist in countries where boys are attaining high levels of education. Most countries with large, current gender gaps have low levels of male educational attainment. Many also perform poorly on other measures of development such as life expectancy and GDP per capita. Improving girls’ education is an important goal in its own right, but closing gender gaps in education will not be sufficient to close critical gaps in adult life outcomes.
  • Topic: Education, Gender Issues, Labor Issues, Inequality, Feminism, Equality
  • Political Geography: Global Focus
  • Author: Megan O'Donnell
  • Publication Date: 01-2020
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: Existing accountability mechanisms focused on global gender equality are largely retrospective in nature. Where mechanisms do probe at governments’ commitments to future progress, they often lack accompanying incentive structures (“carrots and sticks”) to encourage ambition. Countries re- port their progress implementing the Convention on the Elimination of All Forms of Discrimination against Women and the Beijing Platform for Action, participate in annual Commission on the Status of Women sessions, and touch on gender equality as part of voluntary national review reporting for the Sustainable Development Goals. Although these processes, among others, provide an opportu- nity for country reflection and for civil society engagement, they do not mandate that governments establish and adhere to forward-looking, specific commitments detailing how they aim to promote gender equality. The absence of future commitments makes it difficult for civil society actors to hold governments to account according to well-defined metrics. At the same time, governments and women’s rights advo- cates worldwide are increasingly discussing and adopting “feminist foreign policies” and “gender-re- sponsive budgeting.” There is a need to clearly define with robust and transparent metrics what these terms mean and how to hold countries who claim to be “feminist” and “gender-responsive” account- able for ambitious progress, while also encouraging other countries to increasingly prioritize gender equality.
  • Topic: Development, Gender Issues, Inequality, Feminism, Equality
  • Political Geography: Global Focus
  • Author: Dan Hoing
  • Publication Date: 02-2020
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: This working paper explores how donors can move towards greater Navigation by Judgment, highlighting the actions people inside and outside aid agencies can work to make change— encouraging more Navigation by Judgment on the margin, starting today. It focuses principally on accepting the need for a very different way of measuring success and holding projects and personnel accountable, and when and why that might be a very good idea.
  • Topic: Accountability, Transparency, Charity, Donors
  • Political Geography: Global Focus
  • Author: Kalipso Chalkidou, Martina Garau, Rachel Silverman, Adrian Towse
  • Publication Date: 02-2020
  • Content Type: Special Report
  • Institution: Center for Global Development
  • Abstract: Innovation—delivering new drugs, diagnostics, and devices—is a critical tool in the global fight against disease and premature death. Yet despite the potential for innovation to improve health around the world, the pharmaceutical industry’s investments in research and development (R&D) generally neglect diseases of the poor in favour of more lucrative high-income markets. Responding to this R&D gap, donor “push” investments have helped advance an innovation agenda to serve low- and middle-income countries. Though these investments have helped accelerate market entry of several important innovations, other donor-push products have fizzled upon market entry due to unaffordable or non-cost-effective pricing, disappointing efficacy, lack of political will, or lower-than-anticipated country demand. And with many large middle-income countries (MICs) poised to soon transition from donor aid, the sustainability of the current donor-led model is in question. Tuberculosis (TB), an infectious disease primarily affecting the poor and vulnerable, ranks among the top 10 global causes of death. Current TB treatment cycles are long and toxic, causing some patients to discontinue treatment, develop acquired drug resistance, and risk spreading a drug-resistant pathogen to others. Drug-resistant strains are more difficult to treat, traditionally requiring long-duration toxic regimens and high-cost hospitalization (though recent innovations offer a shorter, more tolerable, and more affordable treatment). Despite years of global investment in TB control, modelling suggests that global goals for TB cannot be achieved without major technological breakthroughs. One particularly desirable innovation would be a short-course universal drug regimen (UDR)—equally capable of treating drug-sensitive and drug-resistant strains, with a two-month or shorter treatment duration. Donors, particularly the Bill & Melinda Gates Foundation (BMGF), have funded substantial early-stage R&D to source new treatment compounds that could contribute to a UDR, but substantial additional investments in late-stage trials would be required to bring such a UDR to market.
  • Topic: Health Care Policy, Drugs, Medicine , Pharmaceuticals
  • Political Geography: Global Focus
  • Author: Dan Hoing
  • Publication Date: 02-2020
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: Management by way of top-down controls and targets sometimes gets in the way of aid donors’ aims, undermining project success. These unhelpful controls often stem from a need to account for performance; legislatures or executive boards induce agencies to exercise tight process controls and orient projects towards what is measurable and reportable. My 2018 book, Navigation by Judgment, presents quantitative empirics from a database of 14,000 projects and qualitative evidence from eight case studies in support of this claim. I wrote the book in part because I imagined it would be useful to show aid agencies and authorizers empirics that demonstrated the problem—that the first step to change was recognition. But after talking about my book at aid agencies and authorizers, I am confident that while my 2018 diagnosis was right, my theory of change was all wrong.
  • Topic: Leadership, Business , Accountability, Transparency, Management
  • Political Geography: Global Focus
  • Author: Gisela Robles Aguilar, Andy Sumner
  • Publication Date: 01-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Who are the world’s poor? This paper presents a new global profile of multidimensional poverty using three specifications of multidimensional poverty. The paper draws comparisons with the global monetary poverty profile and with the new World Bank measure of combined monetary and non-monetary poverty; discusses how global poverty differs by specification, the extent of multidimensionality, and presents a set of estimates of the disaggregated characteristics of global multidimensional poverty in 2015. We find the following: (i) at an aggregate level, the overall characteristics of global multidimensional poverty are similar to those of global monetary poverty at $1.90 per day; (ii) at a disaggregated level, we find that poverty in rural areas tends to be characterized by overlapping deprivations in education and access to decent infrastructure (water, sanitation, electricity, and housing) and counterintuitively, given the proximity, in principle, to better health care and economic opportunities, it is child mortality and malnutrition that is more frequently observed within urban poverty; and (iii) the extent of the multidimensionality of poverty differs substantially by region; moreover, some deprivations frequently overlap while others do not.
  • Topic: Poverty, World Bank, Inequality, Rural
  • Political Geography: Global Focus
  • Author: Pamela Jakiela, Owen Ozier
  • Publication Date: 01-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Languages use different systems for classifying nouns. Gender languages assign nouns to distinct sex-based categories, masculine and feminine. We construct a new data set, documenting the presence or absence of grammatical gender in more than 4,000 languages which together account for more than 99 percent of the world’s population. We find a robust negative cross-country relationship between prevalence of gender languages and women’s labor force participation and educational attainment. We replicate these associations in four countries in sub-Saharan Africa and in India, showing that educational attainment and female labor force participation are lower among those whose native languages use grammatical gender.
  • Topic: Gender Issues, Language, Masculinity , Femininity
  • Political Geography: Global Focus
  • Author: Michael Pisa, John Polcari
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: en years ago, only 6 percent of the population in low-income and lower-middle-income countries had access to the internet. Today, nearly one in every three people there does. The rapid expansion of internet access across the globe is a welcome development, but it raises new policy challenges. And while there is broad agreement in the development community on the importance of getting digital policy “right,” too little attention has been paid to how policymakers in the developing world can best engage with the companies who dominate the digital landscape. As governments reassess their relationship with these companies, an increasing number are enacting policies that raise barriers to the cross-border flow of data and put the largely global and open nature of the internet at risk. In this paper, we review how internet use has evolved in the developing world over the last decade, with a focus on initiatives by big tech companies to reach the “Next Billion Users.” We then examine how concerns about data privacy, disinformation, and market concentration have manifested in lower-income countries and how policymakers have begun to respond. We close by considering ways the development community can support policymakers seeking to maximize the benefits of an open internet while minimizing its risks.
  • Topic: Science and Technology, Governance, Inequality, Privacy, Internet, Emerging Technology
  • Political Geography: Global Focus
  • Author: Andrew Rogerson, Owen Barder
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: n 2019/2020 donor governments are anticipated to pledge up to $170 billion to various multilateral organisations as part of their replenishment cycles. In the past, these large replenishments have been approached piecemeal and characterised by path dependency, which arguably has led to underperformance of the multilateral system as a whole. This unusual bunching of replenishments of some of the largest organisations in 2019 provides an opportunity to think more coherently about multilateral funding and to address key systemic problems, such as overlapping mandates and under-funding of some parts of the system. In this paper we recognise that it is unlikely that donors will take a formal, system-wide approach to the replenishments, but instead provide three suggestions that could nudge donors toward better coordinating the effect of their decisions. These are (1) multilaterals should be invited to set out in advance, and in a common format, their “offer” on a number of key issues, (2) donors should increase the envelope for core multilateral funding by diverting money away from earmarked funds, and (3) donors should provide a confidential forecast of their likely replenishments to a trusted intermediary, so that the “business as usual” baseline scenario is known.
  • Topic: International Cooperation, Multilateral Relatons, Multilateralism
  • Political Geography: Global Focus
  • Author: Thiemo Fetzer, Stephan Kyburz
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Can institutionalized transfers of resource rents be a source of civil conflict? Are cohesive institutions better at managing conflicts over distribution? We exploit exogenous variation in revenue disbursements to local governments and use new data on local democratic institutions in Nigeria to answer these questions. There is a strong link between rents and conflict far away from the location of the resource. Conflict over distribution is highly organized, involving political militias, and concentrated in the extent to which local governments are non-cohesive. Democratically elected local governments significantly weaken the causal link between rents and political violence. Elections produce more cohesive institutions, and vastly limit the extent to which distributional conflict between groups breaks out following shocks to the rents. Throughout, we confirm these findings using individual level survey data.
  • Topic: Political Violence, Violence, Institutions, Human Resources
  • Political Geography: Global Focus
  • Author: Charles Kenny
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: There is a lot we don’t know about what automation will mean for jobs in the future, including its impact (if any) on gender inequality. This note reviews evidence and forecasts on that question and makes four main points: Past automation has been (broadly) positive for women’s average quality of life, economic empowerment, and equality. Forecasts of the gendered impact of automation and AI going forward based on the current distribution of employment suggest considerable uncertainty and a gender inequality of impact that is marginal compared to the potential impact overall. The bigger risk—and/or opportunity—is likely to be in the combined impact of automation, policy, and social norms in changing the type of work that is seen as male or female. Minimizing any potential aggravating impact of automation and AI on inequalities in economic power in the future can best be achieved by maximizing economic equality today.
  • Topic: Gender Issues, Labor Issues, Employment, Inequality, Feminism
  • Political Geography: Global Focus
  • Author: Michael Pisa, Denise McCurdy
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In many low- and lower-middle-income countries (LMICs) where disease burdens are highest, health supply chains function poorly, resulting in frequent stockouts and a high prevalence of substandard and even falsified medications. In response to these concerns, the global health initiatives have stepped up their efforts to improve supply chain management. At the same time, a growing number of rich country pharmaceutical companies are investing in digital technologies that help them “track and trace” the movement of medicines through the supply chain at the package-level. Drawing from interviews with over thirty experts, we find that traceability offers a realistic solution to some of the problems found in LMIC health supply chains but that implementing the approach is a huge logistical endeavor that requires a strong political commitment. We close by discussing how donors can support committed governments, by taking an evidence-based approach to determine what traceability methods work best.
  • Topic: International Cooperation, Health Crisis, Pharmaceuticals , Tracing
  • Political Geography: Global Focus
  • Publication Date: 03-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Transparency by design: Transparency should be the norm for all government contracts, particularly regarding information on what is being exchanged and for what price. Contracting systems should be designed to support proactive publication of contracts as open data. Public contracting should be designed for transparency and efficiency. Full contract publication should be the norm. Information needed to judge value for money should be disclosed. Exceptions in the public interest: Redactions on the basis of commercial sensitivity should only be justified where the public interest in withholding information is greater than the public interest in having that information published. The assessment should take into account both any commercial harm to the contractor and the broader benefits of transparency to markets and public trust. Where exceptions to publication are considered: Information should only be redacted for reasons of commercial sensitivity when the public interest in withholding information is greater than the public interest in disclosure. The public interest test should take into account the wider economic benefits of the sharing of commercial information, as well as the case for accountability and the public’s right to know. All redactions should be clearly marked with the reason for redaction. A clear and robust process: Governments should issue detailed guidance on commercial sensitivity principles and exemptions, put in place systems to support publication, ensure that redaction is time-limited, and use other oversight mechanisms to compensate for information withheld from publication. Governments should issue clear guidance to public entities, agencies, and firms on contract publication and when information may be exempted from publication for commercial sensitivity reasons. Where redaction is potentially allowed, there should be a clear process for determining what is redacted, why, for how long, and with what appeals process. There should be a system for ensuring that contracts and contract information are in fact disclosed in practice. Where exemption to disclosure of information is granted for commercial sensitivity reasons, this should be grounds for increased scrutiny through other oversight mechanisms.
  • Topic: Government, Transparency, Public Service, Contracts
  • Political Geography: Global Focus
  • Author: Bright Simons
  • Publication Date: 03-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In 1981, a former sheep farmer took a one-week crash course in computing, had an epiphany, and teamed up with a car tyres millionaire to form DJ AI. DJ AI announced a new artificial intelligence platform for sale at $600 that could build computer programs for customers. They named their game-changer “The Last One.” All users had to do was follow a set of screen menus, plug, and play, and bingo, they could do away with all those pesky system administrators and programmers. $6 million was spent marketing this powerful piece of magic on both sides of the Atlantic, sometimes to comic effect. Such dreams of software building software, literally cutting out the middleman, have recurred regularly since the 1960s in peaks and troughs, but we are still waiting. From the late 90s onwards, however, new data-driven approaches to automation, particularly so-called deep learning, and the involvement of many of the world’s smartest and most loaded companies, have begun to convince many level-headed analysts that this time it is going to be different. The technologies, we are told, can learn, and so it is about time we paid critical attention to the pace at which they are already and could even further turn upside down the world of work as we know it. Some of the most elegant attempts to evaluate and categorise the impact of these new capabilities on employment and income inequality can be found in papers by David Autor and his co-authors on labour market polarisation and the effect of computerisation on the market demand for skills. More than a decade after these papers were written, their core ideas and the schemas they proposed continue to inspire the framing of the issues in influential circles, making them the most cited in their writers’ corpus. The Economist is right to describe Autor’s seminal work as enormously influential. The elegance and rigorous use of data in these two persuasive treatises are not, however, enough to prevent one major convenient generalisation from weakening their key arguments. The generalisation in question emanates from the conflation of several different patterns of computerisation with “automation,” the replacement of human actors in the chain of work, which is then used as a proxy for technology diffusion and infusion into various modes of work, following in a tradition that also encompasses Goldin and Katz’s equally elegant formulation of the automation question as one of a contention between returns to skills versus returns to algorithms. Having taken “automation” as the predominant form in which modern technology manifests itself in the workplace, Autor and his collaborators then proceed to construct a spectrum of possibilities for technology’s infusion: complement, substitute, or bypass (CSB). In the CSB paradigm, modern technology in the workplace tends to complement super-skilled, high-earning, workers, in complex, adaptive, operations, thereby boosting their productivity and bargaining power; substitute for the contribution of most medium-skilled workers in many routine tasks, thus depressing their wage potential; and bypass low-skilled workers, such as drivers, waiters, and janitors, thus rendering their fate somewhat indeterminate even if their numbers grow. It is not difficult to see why Autor et al.’s extensive use of crosswalking across census-based industrial classification schemes and the Dictionary of Occupational Titles should encourage this neat stratification. Once something is coded, it acquires a hardness that confers rigour and opacity.
  • Topic: Science and Technology, Automation, Emerging Technology
  • Political Geography: Global Focus
  • Author: Kalipso Chalkidou, Adrian Towse
  • Publication Date: 04-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: spending on pharmaceuticals and other healthcare commodities is high and makes up a large proportion of healthcare spending in rich and poorer markets alike. A popular response to the problem of escalating drugs budgets has been transparency of drug pricing within and across borders. In a rare alignment of policy priorities, the Trump administration, the US Senate, and the World Health Organisation are calling for more transparency of the prices paid for prescription drugs as a means of tackling the ever-growing pharmaceuticals bill. Recently Italy’s health minister joined in, calling for a World Health Assembly resolution which would mandate WHO to “provide governments with a forum for sharing information on drug prices, revenues, research and development costs, public sector investments and research and development subsidies, marketing costs and other related information.” But is price transparency really the answer to healthcare systems’ fiscal sustainability challenges as they strive to expand access to new technologies or even merely sustain provision within strained public budgets? Well, it depends!
  • Topic: Transparency, Medicine , Pharmaceuticals , Price
  • Political Geography: Global Focus
  • Author: Kalipso Chalkidou, Adrian Towse, Richard Sullivan
  • Publication Date: 04-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Criticising cancer medicine pricing as too high is what football fans know as an "open goal"—a target that is hard to miss. Yet somehow the World Health Organization (WHO) Technical Report on Cancer Pricing manages to do just that with a paper to the WHO Executive Board calling for price and cost transparency. The assumption goes that transparency will reduce the prices and costs of cancer medicines, a mantra that has united the Trump administration, the US Congress, and the Italian health minister with many NGOs who have called for “greater cost and price transparency”—a sentiment echoed by KEI, which states that “international action is required to improve transparency in reporting the costs of R&D and production, including public sources of funding.”
  • Topic: World Health Organization, Health Care Policy, Medicine , Cancer, Price
  • Political Geography: Global Focus
  • Author: Pierre Dubois, Yassine Lefouili, Stephane Straub
  • Publication Date: 04-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: We use data from seven low and middle income countries with diverse drug procurement systems to assess the effect of centralized procurement on drug prices and provide a theoretical mechanism that explains this effect. Our empirical analysis is based on exhaustive data on drug sales quantities and expenditures over several years for forty important molecules. We find that centralized procurement of drugs by the public sector allows much lower prices but that the induced price reduction is smaller when the supply side is more concentrated.
  • Topic: Drugs, Medicine , Centralization, Price
  • Political Geography: Global Focus
  • Author: Emma Boswell Dean
  • Publication Date: 04-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: With the goal of driving down drug costs, governments across the globe have instituted various forms of pharmaceutical price control policies. Understanding the impacts of such policies is particularly important in low- and middle-income countries, where lack of insurance coverage means that prices can serve as a barrier to access for patients. In this paper, we examine the theoretical and empirical effects of one implementation of pharmaceutical price controls, in which the Indian government placed price ceilings on a set of essential medicines. We find that the legislation resulted in broadly declining prices amongst both directly impacted products and competing products. However, the legislation also led to decreased sales of price-controlled and closely related products, preventing trade that would have otherwise occurred. The sales of small, local generics manufacturers were most impacted by the legislation, seeing a 14.5 percent decrease in market share and a 5.3 percent decrease in sales. These products tend to be inexpensive, but we use novel data to show that they are also of lower average quality. We provide evidence that the legislation impacted consumer types differentially. The benefits of the legislation were largest for quality-sensitive consumers, while the downsides largely affected poor and rural consumers, two groups already suffering from low access to medicines.
  • Topic: Medicine , Pharmaceuticals , Price, Price Control
  • Political Geography: Global Focus
  • Author: Thorsten Beck, Liliana Rojas-Suarez
  • Publication Date: 04-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: A sound financial regulatory framework is critical for minimizing the risk imposed by financial system fra­gility. In the world’s emerging markets and developing economies (EMDEs), such regulation is also essential to support economic development and poverty reduc­tion. Meanwhile, it is increasingly recognized that global financial stability is a global public good: recent decades have seen the development of new inter­national financial regulatory standards, to serve as benchmarks for gauging regulation across countries, facilitate cooperation among financial supervisors from different countries, and create a level playing field for financial institutions wherever they operate. For the worldwide banking industry, the international regulatory standards promulgated by the Basel Com­mittee on Banking Supervision (BCBS) stand out for their wide-ranging scope and detail. Even though the latest Basel recommendations, adopted in late 2017 and known as Basel III, are, like their predecessors, calibrated primarily for advanced countries, many EMDEs are in the process of adopting and adapting them, and many others are considering it. They do so because they see it as in their long-term interest, but at the same time the new standards pose for them new risks and challenges. This report assesses the implica­tions of Basel III for EMDEs and provides recommen­dations for both international and local policymakers to make Basel III work for these economies.
  • Topic: Development, Economics, Emerging Markets, Markets
  • Political Geography: Global Focus
  • Author: Cassandra Nemzoff, Kalipso Chalkidou, Mead Over
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: As low- and middle-income countries reduce their reliance on donor aid, they are increasingly obliged to assume some degree of financial responsibility for donor projects. This challenge will be particularly complex in the procurement of health commodities. In recent decades, recipient countries have benefitted from donor-aggregated demand and pooling mechanisms, negotiated prices, purchasing, and delivery of commodities. However, as countries shift away from donor support, their challenge will be finding a way to aggregate demand in order to achieve the benefits that the pooled purchasing arrangements of vertical health programs now provide. As a first step in tackling this challenge, much can be learned from a diverse group of pooled procurement initiatives that have developed over the past 40 years in high-, middle-, and low-income countries. This note reviews the rationale and functions of these initiatives, notes their potential benefits and barriers, and draws lessons regarding how best to incorporate pooled pharmaceutical purchasing models into the design and implementation of health financing reforms in countries in transition. We first provide a brief background on the procurement challenges faced by countries in transition. In section 2, we provide an overview of different types of pooling initiatives, highlighting the key features of each. Leveraging our research and key interviews, we outline the real and potential benefits of pooling in section 3, and the most pressing barriers that organizations or countries will face as they seek ways to aggregate demand in section 4. In section 5 we discuss some of the issues that countries and development partners should address when considering pooled procurement initiatives and make two recommendations: (1) countries and development partners should conduct further research on the merits of pooled procurement, and (2) they should develop a straw model of a pooled procurement governance structure that could be tested using a series of pilots.
  • Topic: Budget, Public Health, Medicine , Pharmaceuticals
  • Political Geography: Global Focus
  • Author: Jeremy Konyndyk
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The next pandemic is a matter of when, not if. Preparing for this inevitability requires that policymakers understand not just the science of limiting disease transmission or engineering a drug, but also the practical challenges of expanding a response strategy to a regional or global level. Achieving success at such scales is largely an issue of operational, strategic, and policy choices—areas of pandemic preparedness that remain underexplored.
  • Topic: International Cooperation, Ebola, Public Health, Pandemic
  • Political Geography: Global Focus
  • Author: Cindy Huang, Jimmy Graham
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: There are over 68.5 million forcibly displaced people in the world, including about 40 million Internally Displaced Persons (IDPs) who have moved because of conflict, including political, communal, and criminal violence.[i] There are millions more IDPs who have been displaced by other drivers, including disasters, economic instability, and development projects such as infrastructure construction. These IDPs, 99 percent of whom are in low- and middle-income countries (LMICs), face severe economic challenges as a result of displacement.[1] To help them overcome these challenges, policymakers should focus on helping IDPs achieve greater self-reliance. The best approach to doing so will depend in large part upon the context—particularly the extent to which IDP populations are based in urban or rural areas. Our analysis shows that about half of IDPs in LMICs are in urban areas, that the composition varies significantly across countries, and that there is a substantial lack of IDP location data.
  • Topic: Displacement, Urban, Rural, Internal Displacement , Economic Integration
  • Political Geography: Global Focus
  • Author: Cindy Huang, Jimmy Graham
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: As of December 2017, there were over 68.5 million forcibly displaced people in the world, including about 40 million Internally Displaced Persons (IDPs) displaced by conflict.[1] Millions more were displaced internally by other drivers, including disasters, economic instability, and development projects such as infrastructure construction.[2] IDPs face severe economic challenges as a result of their displacement, with harmful impacts on consumption, health, education, security, housing, labor conditions, and social outcomes.[3] They face these challenges for long periods of time: IDPs often spend many years or even decades displaced.[4] And for displaced women and girls—who face unique challenges ranging from legal restrictions on owning property to larger wage reductions following displacement—the economic challenges can be even greater.[5] Furthermore, IDPs tend to be disproportionately located in low- and middle-income countries (LMICs): over 99 percent of the world’s IDPs displaced by conflict are in LMICs. Within these countries, populations in more marginalized areas are often more severely affected by displacement.[6] Thus, those who are displaced tend to face greater economic difficulties to begin with and displacement only compounds these difficulties.
  • Topic: Displacement, Urban, Internal Displacement , Economic Integration
  • Political Geography: Global Focus
  • Author: Michael Pisa
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: As the organization responsible for setting international standards on anti-money laundering and countering the financing of terrorism (AML/CFT), the Financial Action Task Force (FATF) has encouraged countries to design measures that protect the integrity of the financial system and support financial inclusion. But it has also received criticism that poor implementation of its standards can undermine financial access. One of the FATF’s main tools for compelling effective use of its standards is the mutual evaluation process, which relies on peer reviews to assess countries’ level of compliance with the FATF Recommendations. We explore whether these reviews have been conducted in a way that helps or hinders national efforts to promote financial inclusion by reviewing the 33 developing country mutual evaluations that took place between 2015-2018. Overall, these findings suggest that assessment teams have conducted mutual evaluations in a way that supports efforts to promote financial inclusion and the flexible use of simplified measures. There is, however, inconsistency in how assessors treat risks emanating from financial exclusion, which suggests the need for a more systematic approach to evaluating these risks.
  • Topic: Development, Terrorism, Finance, Financial Integrity
  • Political Geography: Global Focus
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Internationally set goals and guidelines directly influ­ence the setting of health care priorities at the national level, affecting how limited resources are generated and allocated across health care needs. The influence of global priority setting, such as through the formu­lation of overarching goals or normative guidelines for specific disease areas, is particularly significant in low- and middle-income countries that rely heavily on overseas development assistance. Because no sys­tematic approach exists for dealing with resource con­straints, however, which vary across countries, goals and guidance are often inappropriate for some country contexts; their implementation can, therefore, reduce the efficiency and equity of health care spending. The Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines, co-convened by the Center for Global Development, Thanzi la Onse, and the HIV Modelling Consortium, has brought together disease specialists, policymakers, economists, and modelers from national governments, international organizations, and academic institutions across the globe to address these issues, to take stock of current approaches, and make recommendations for better practice. The Working Group deliberated on the roles and purposes of goals and guidelines and consid­ered how economic evidence might be formally incor­porated into policy recommendations and health care decision making. The target audiences for this report are international health institutions, large stakehold­ers in disease programs across the world, and national governments.
  • Topic: Development, Health, Health Care Policy, Public Health
  • Political Geography: Global Focus
  • Author: Dan Hoing, Lant Pritchett
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Accountability is rightly at the center of the conversation regarding how to improve governance systems, particularly health and education systems. But efforts to address accountability deficits often focus primarily on improving what can be counted and verified—what we term “accounting-based accountability.” We argue that introducing greater accounting-based accountability will only very rarely be the appropriate solution for addressing accountability problems. We illustrate this by exploring the role of Accountability ICT in (not) improving education system performance. Strengthening “real” accountability is not the same as improving data systems for observation and verification, and often attempts at the latter undermine the former. The development discourse’s frequent semantic misunderstanding of the term “accountability” has pernicious real-world consequences with real effects on system reform efforts and ultimately global welfare.
  • Topic: Education, Governance, Accountability, Welfare
  • Political Geography: Global Focus
  • Author: Felice Apter, Amanda Glassman, Janeen Madam Keller
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Next week, Women Deliver—the world’s largest conference on gender equality and the health, rights, and wellbeing of women and girls—will kick off. At just around 200 days before the calendar turns to 2020, this conference is an opportunity for the family planning (FP) community—including the FP2020 Core Partners (the Bill & Melinda Gates Foundation, DFID, UNFPA, and USAID) and Reference Group—to review lessons from the past eight years and look forward beyond 2020, the landmark that has long dominated FP discussions. The key question: In a rapidly changing context, how can the FP community sustain gains and realize the benefits of high-quality FP access in low- and middle-income countries, including lower maternal mortality, better newborn and child health, and increased women’s empowerment?[1] This note highlights three issues for the global FP movement post-2020, building on CGD’s engagement in this space, including our working group on alignment in family planning.[2] We review the underlying critical assumptions in FP2020’s initial design along with their strengths and weaknesses, and place future approaches squarely within the context of today’s evolving landscape—one that looks very different than the year 2012, when FP2020 was launched.
  • Topic: Gender Issues, Feminism, Family Planning, Sex Education
  • Political Geography: Global Focus
  • Author: Janeen Madam Keller, William Savedoff
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The availability and affordability of health products—medicines, diagnostics, devices, and equipment—are critical to achieving universal health coverage and improving health outcomes. Yet low- and middle-income countries face multiple challenges in procuring health products related to institutional inefficiencies, market failure, and fragmented demand. At the same time, the world is evolving rapidly in ways that will affect health procurement, from changes in countries’ eligibility for foreign assistance to advances in information technologies. Looking forward, efforts to improve global health procurement must proactively address the sweeping changes on the horizon. Drawing on a range of political, economic, and social trends, this paper envisions how the global landscape might change between now and 2030, with a focus on the implications for global health, particularly the procurement of health products. The paper develops three possible but distinct futures—worlds characterized as atomistic, privately led, or multilateral.It concludes by describing the policy options and locus of action to improve global health procurement in light of these scenarios, emphasizing three areas of work: financing and modes of collaboration, procurement procedures and tools, and procurement capacity.
  • Topic: Health, Health Care Policy, Public Health, Health Crisis
  • Political Geography: Global Focus
  • Author: Marco Cangiano, Alan Gelb, Ruth Goodwin-Groen
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The ability of digital payments to deliver better outcomes for governments, businesses, and individuals—including driving financial inclusion—has been one of the success stories of the digital age. Payments are central to how governments transfer and receive financial resources; however, the way such payments are made—and how they could be made more effectively—is often not mainstreamed in public financial management (PFM) despite the fact that many of the direct benefits from effective digitalization of payments are identitical to those traditionally expected from strong PFM systems.The digitalization of payments does not provide a silver bullet for solving PFM problems; therefore it needs to be approached in an integrated way, with strong leadership from central agencies, including the Ministry of Finance, to exploit the synergies between the many different types of payments facilitated by digital technology. The paper explores the linkages between the digitalization of payments and PFM, including through four case studies.
  • Topic: Finance, Digitalization, Financial Management
  • Political Geography: Global Focus
  • Author: Lauren Post, Cindy Huang, Sarah Charles
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In its 18th replenishment of the International Development Association (IDA18, covering 2017–2020), the World Bank made a game-changing decision to create a US$2 billion financing window to support low-income countries hosting large numbers of refugees.[1] This financing is significant for two key reasons. First, in its scale and scope, the Refugee Sub-Window (RSW) is responsive to both the programmatic and policy needs of protracted refugee crises. Second, in supporting both refugees and their host communities, the RSW aligns refugee responses with host countries’ national development plans.
  • Topic: Development, World Bank, Refugees, Humanitarian Crisis
  • Political Geography: Global Focus
  • Author: Rachel Silverman, Amanda Glassman, Kalipso Chalkidou, Janeen Madan Keller
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive.
  • Topic: Health, Public Health, Pandemic, Procurement, Medicine
  • Political Geography: Global Focus
  • Author: Roxanne Oroxom, Amanda Glassman
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: With a vision of “creating equal access to new and underused vaccines,” Gavi set several coverage-specific targets for 2020 as part of its Phase IV strategy, including the immunization of an additional 300 million children, increased pentavalent 3 and measles-containing vaccine (MCV) 1 coverage, and greater equity in coverage across wealth quintiles.[1] The strategy also called for broadening protection through improved routine coverage and the introduction of new vaccines.[2]
  • Topic: Health, Children, Public Health, Vaccine
  • Political Geography: Global Focus
  • Author: Amanda Glassman, Cordelia Kenney, Janeen Madan Keller
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Child vaccination remains among the most cost-effective uses of public and aid monies.[1] In a highly contested funding environment where priorities must be set for the allocation of scarce concessional resources, investment in expanding the availability and coverage of cost-effective vaccination must come at the top of the list. Gavi’s mission—saving children’s lives and protecting people’s health by increasing equitable use of vaccines—remains highly relevant. Gavi and its partners have made enormous progress towards increasing equity in the introduction of vaccines; children living in the lowest-income countries now have access to the same set of vaccines as those living in high-income countries. Gavi and partners have also contributed to increased coverage; immunization rates are higher in Burundi and Rwanda, for example, than in many places in the United States and Europe. Yet the effects of under-immunization anywhere can have global implications everywhere, as recent outbreaks illustrate. New or dormant threats are also a new reality—newly vaccine-preventable diseases like Ebola or virulent flu strains can spread swiftly and lethally in an interconnected world.
  • Topic: Health, Public Health, Vaccine, Immunization
  • Political Geography: Global Focus
  • Author: Arshi Aadil, Alan Gelb, Anurodh Giri, Kyle Navis
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The state of Andhra Pradesh is recognized as a leader in using technology to improve the delivery of public services, programs and subsidies. Many of its innovations were piloted in Krishna District, which has been visited by development agencies and delegations from many countries. This paper reports on research to better understand the functioning and effectiveness of its reforms to strengthen state capacity by digitalizing service delivery. Against the wider backdrop of the use of Aadhaar in India, it summarizes Andhra’s reforms, which go beyond those of most other jurisdictions in the measures taken to strengthen accountability, offer choice of service provider, and incorporate feedback loops using the vast amount of data generated by a real-time digital service system as well as beneficiary responses. It reports the results from surveys of beneficiaries who receive food rations through the Public Distribution System (PDS) and/or pensions, and on the response of landowners and tenant farmers to the digitization of land records, another important program. The results suggest strong support for the digitalization of these programs. The way in which the reforms have been implemented has indeed led to substantial improvements in delivery (as seen by beneficiaries) as well as, probably, significant fiscal savings. Is this case, then, a model for other Indian states and for other countries? Perhaps yes from a technology perspective; there are many lessons that apply to a wide range of programs and services and that others can usefully draw on. The picture is more complex from a political economy perspective, as suggested by some of the particular features of Andhra.
  • Topic: Science and Technology, Governance, Reform, Digitization
  • Political Geography: Global Focus
  • Author: Rachel Silverman, Janeen Madan Keller, Amanda Glassman, Kalipso Chalkidou
  • Publication Date: 07-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive. Access to medicines, diagnostics, devices, and equipment is driven in large part by the efficiency of their procurement. Procurement is, therefore, central to the efforts of low- and middle-income countries to improve health, meet the Sustainable Development Goals, and achieve universal health coverage. Health product purchasing in low- and lower-middle-income countries already makes up a sizeable share of overall health spending; in fact, in just a subset of these countries, spending on health products totals an estimated $50 billion per year.[1] Procurement is not only essential to the missions of global health entities like the Global Fund, Gavi, UNICEF, UNFPA, and PEPFAR, but it also represents big money. In the case of the Global Fund, health product procurement accounts for $2 billion per year,[2] or almost half of its 2017 disbursements.[3] Yet despite its importance, procurement is an underappreciated health system function. Today’s procurement systems are hobbled by inefficiencies that leave some of the poorest countries paying some of the highest drug prices in the world.
  • Topic: Health, Public Health, Transition, Procurement
  • Political Geography: Global Focus
  • Author: David Evans, Fei Yuan
  • Publication Date: 07-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Despite dramatic global gains in access to education, 130 million girls of school age remain out of school. Among those who do enter, too many do not gain the essential skills to succeed after they complete their schooling. Previous efforts to synthesize evidence on how to improve educational outcomes for girls have tended to focus on interventions that are principally targeted to girls, such as girls’ latrines or girls’ scholarships. But if general, non-targeted interventions—those that benefit both girls and boys—significantly improve girls’ education, then focusing only on girl-targeted interventions may miss some of the best investments for improving educational opportunities for girls in absolute terms. This review brings together evidence from 270 educational interventions from 177 studies in 54 low- and middle-income countries and identifies their impacts on girls, regardless of whether the interventions specifically target girls. The review finds that to improve access and learning, general interventions deliver gains for girls that are comparable to girl-targeted interventions. At the same time, many more general interventions have been tested, providing a broader menu of options for policy makers. General interventions have similar impacts for girls as for boys. Many of the most effective interventions to improve access for girls are household-based (such as cash transfer programs), and many of the most effective interventions to improve learning for girls involve improving the pedagogy of teachers. Girl-targeted interventions may make the most sense when addressing constraints that are unique to girls.
  • Topic: Education, Children, Women, Feminism
  • Political Geography: Global Focus
  • Author: Nancy Lee, Asad Sami
  • Publication Date: 07-2019
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: Interest in mobilizing private finance for SDG investments is surging in a world of stagnating aid, limited fiscal space, and rising LIC debt. But is more reliance on private finance realistic for LICs? This paper explores the performance since the global financial crisis of one source of private finance for LICs: cross-border private capital inflows. Much of the evidence is encouraging, and some of it flies in the face of conventional wisdom. For LICs, private capital inflows are an important and growing source of finance. For the median LIC, private capital inflows are now as large as ODA as a share of GDP. And the FDI component—most of LIC inflows—has been stable and resilient throughout the post-crisis period. Importantly, inflows are not all captured by resource-rich LICs. In 2017, more than half of capital inflows to LICs went to non-resource-rich LICs. Increasingly, policies, not just resource endowments, shape LIC destinations for foreign capital. The relation between median capital inflows/GDP and median regulatory quality is significantly positive for non-resource-rich LICs. And sources of FDI are diversifying. In 2016, China’s stock of FDI in Africa was almost as large as that of the traditional investors: the US, UK, and France. But there is also not-so-good news. Median private capital inflow/GDP ratios are not positively correlated with median private domestic investment/GDP in LICs. Nor is there a significant relationship with median public investment/GDP. The apparent lack of complementarity between foreign and domestic investment may point to problems related to investment enclaves and/or the role of the state in LIC economies. As in other countries, non-FDI inflows to LICs are volatile and sensitive to global commodity prices and interest rates. We find no relation between median country per capita income levels and private inflows/GDP, highlighting the need for caution in IDA graduation policies.
  • Topic: Development, Capital Flows, Interest Rates, Private Sector, Capital
  • Political Geography: Global Focus
  • Author: Owen Barder, Euan Ritchie, Andrew Rogerson
  • Publication Date: 07-2019
  • Content Type: Case Study
  • Institution: Center for Global Development
  • Abstract: We revisit the policy dilemmas thrown up by so-called Multi-bi funding (earmarked bilateral aid routed via multilateral channels), based on a case study of World Bank trust funds, given their industry-leading overall size and relative transparency. We update patterns of sources and uses of Multi-bi using the 2019 Trust Funds Directory and use this to derive a new Index of Responsible Multi-bi Donorship. We consider complementary donor motivations for Multi-bi, highlighting their perceived need to shift the focus of a multilateral institution faster than they believe possible through its core systems. We examine potential negative effects of Multi-bi on the distortion of funding choices available to client countries, and above all on the risk of “hollowing out” of the multilateral itself, as the locus of power and accountability shifts from the wider collective toward a narrower set of contracting relationships. We find that current trust fund reform efforts can at best partly address these dynamics, while the growing trend toward creation of sub-windows within the main core funding instrument could potentially make things worse. Instead, we offer a pragmatic two-track solution that could significantly reduce tensions between funder needs and institutional integrity. This involves (a) developing an improved battery of output indicators mapped to donor core contributions, to enhance visibility and results reporting and (b) routing new Multi-bi proposals increasingly through core governance processes, focusing initially on greater transparency and on demonstrating their additionality to donors’ core funding.
  • Topic: Development, Economics, Finance, Banks, Donors, Funding
  • Political Geography: Global Focus
  • Author: Jeremy Konyndyk
  • Publication Date: 08-2019
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: The world’s humanitarian aid architecture is growing outdated. Relief programs are most effective when they are integrated, locally owned, and demand driven. But humanitarian action in the 21st century remains constrained by a 20th-century aid model: siloed, supply driven, and centered on the individual mandates and sectors of major international aid agencies. This makes aid both less effective and less responsive than it could be. In a world where displacement is at the highest levels in generations, climate disasters are increasing, and humanitarian funding is beginning to level off, this disconnect is no longer tenable. But fixing it is not a simple matter—multiple rounds of humanitarian reform over the past 15 years have made progress but fallen short of fundamental change. Earlier this summer in Geneva, CGD convened two high-level private roundtables, one with leaders from humanitarian donor institutions and another with senior executives from major humanitarian aid agencies (both multilaterals and NGOs), to discuss how to make humanitarian aid more cohesive and user-centered. The meetings were part of a multiyear research initiative exploring how modernizing the humanitarian business model and humanitarian governance are integral to improving field-level humanitarian impact. CGD teed up the conversation with three emerging ideas from our research (you can see the presentation slides here). These ideas—the subjects of several forthcoming papers CGD is developing —explore ways of better aligning aid delivery around enhanced impact toward affected people’s priorities
  • Topic: Development, Humanitarian Aid, International Cooperation, Reform, Humanitarian Intervention
  • Political Geography: Global Focus
  • Author: Scott Morris
  • Publication Date: 08-2019
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: This note proposes a new Research Ventures Fund (RVF) at the World Bank to better prioritize R&D investments in support of development progress. The RVF would employ financing mechanisms that are consistent with research needs: significant scale and scope, patience, and tolerance for failure. Existing development-oriented research consortia like CGIAR would provide a promising start for RVF funding allocations. Donors to the IDA-19 replenishment should take the first step in securing funding for the new fund in 2019.
  • Topic: Development, International Cooperation, Science and Technology, World Bank, Finance, Research, Banking
  • Political Geography: Global Focus
  • Author: Jeremy Konyndyk, Rose Worden
  • Publication Date: 09-2019
  • Content Type: Research Paper
  • Institution: Center for Global Development
  • Abstract: The notion that humanitarian response should center on the people it serves, rather than the aid agencies serving them, has been repeatedly codified in humanitarian commitments as far back as the early 1990s. Yet the mainstream humanitarian system has struggled to translate these commitments into practice: corresponding reform efforts have failed to systemically broaden accountability to and participation of aid recipients in response efforts. Major constraints have included misaligned incentive structures between donors and aid agencies, power imbalances between aid providers and aid recipients, and operational and political complexities arising at field level. To produce real systemic change, the aid system must move beyond technical and rhetorical approaches to accountability and begin reshaping the power and incentive structures that influence aid decision-making. This paper proposes a set of mutually reinforcing recommendations centered around three imperatives: enshrining the influence of aid recipients at all levels of aid decision-making; developing independent channels for soliciting the priorities and perspectives of crisis-affected people; and institutionalizing a set of enabling changes to humanitarian operational and personnel practices.
  • Topic: Development, Humanitarian Aid, Institutionalism, Humanitarian Crisis
  • Political Geography: Global Focus
  • Author: Kalipso Chalkidou, Anupama Dathan, Francis Ruiz
  • Publication Date: 09-2019
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: Global health interventions, like many public policies, are rife with uncertainty. Will a program, such as a malaria prevention strategy that looks strong on paper, work as intended? Will a new technology, such as a specific drug or device that appears effective in clinical trial settings, work in practice and provide good value-for-money? In the case of programs made up of a complex interaction of multiple interventions, implementers often create a theory of change and then meticulously track whether it is being followed every step of the way, from each input translating into the prespecified activity, and the activities yielding the right outputs and the expected outcomes. When observational data is available that permits quantitative analysis (evaluation), it may also be possible to estimate causal impact in a given setting by applying experimental methods (such as a randomized controlled trial) or quasi-experimental techniques (such as difference-in-difference analysis). Such program evaluations generally consider outputs (e.g. the number of bed nets distributed) and relatively short-term outcomes (e.g. malaria infections following bed net distribution). Many eval- uations also collect data years after the program to identify longer-term impacts. Cost-effectiveness calculations are sometimes conducted after ascertaining the cost and impact of the program, but such analyses aren’t necessarily considered when determining whether to implement a certain program or technology—especially when politics and other concerns get in the way. Discrete clinical interventions and technologies (which are defined as including clinical interven- tions, drugs, diagnostics and even public health programs) are usually the subject of health technolo- gy assessment (HTA) to inform coverage decisions in many contexts. The underpinning evidence base for HTA typically involves a synthesis of randomized trial data, designed to reduce bias in estimating causal inference and relative effectiveness. Trial data is then combined with information from other sources and study designs to develop models of the technology’s long-term health and cost impact in a given context. A key feature of both programs and technologies is uncertainty.
  • Topic: Health, International Cooperation, Science and Technology, Humanitarian Intervention, Pharmaceuticals
  • Political Geography: Global Focus
  • Author: Charles Kenny
  • Publication Date: 09-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Development finance institutions have positioned themselves as key agencies to help the world meet the Sustainable Development Goals. It is doubtful that they can deliver. This paper outlines the challenges facing DFIs in achieving (anywhere near) such an expansion in their impact, particularly in infrastructure and particularly in the poorest countries. It notes that private investment in SDG priority areas is low in the poorest countries, and the record of private investment in rolling out services is mixed. These issues are linked in part to significant supply side constraints based on country characteristics. DFIs do better than the market as a whole at investing in challenging infrastructure–but not by much. And while the scale of their ‘leverage’ in terms of attracting dollars that would otherwise not have been invested is hard to determine, in the poorest markets in infrastructure it is certainly low. Finally, DFIs and donors more broadly have long tried to improve deal flow with limited success, suggesting there are few deals on the margin of occurring which only require small extra incentives to materialize.
  • Topic: Development, Finance, Institutions, Sustainability
  • Political Geography: Global Focus
  • Author: Anna Popova, David Evans, Mary E. Breeding, Violeta Arancibia
  • Publication Date: 09-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Many teachers in low- and middle-income countries lack the skills to teach effectively, and professional development (PD) programs are the principal tool that governments use to upgrade those skills. At the same time, few PD programs are evaluated, and those that are evaluated show highly varying results. In this paper, we propose a set of indicators—the In-Service Teacher Training Survey Instrument—to standardize reporting on teacher PD programs. Applying the instrument to 33 rigorously evaluated PD programs, we find that programs that link participation to career incentives, have a specific subject focus, incorporate lesson enactment in the training, and include initial face-to-face training tend to show higher student learning gains. In qualitative interviews, program implementers also report follow-up visits as among the most effective characteristics of their professional development programs. We then use the instrument to present novel data on a sample of 139 government-funded, at-scale professional development programs across 14 countries. The attributes of most at-scale teacher professional development programs differ sharply from those of programs that evidence suggests are effective, with fewer incentives to participate in PD, fewer opportunities to practice new skills, and less follow-up once teachers return to their classrooms.
  • Topic: Development, Education, Labor Issues, Academia, Teaching
  • Political Geography: Global Focus
  • Publication Date: 10-2019
  • Content Type: Research Paper
  • Institution: Center for Global Development
  • Abstract: There is a significant and ongoing ramp-up in support for explicitly subsidized official development finance to the private sector around the world, but its role remains poorly defined. Lessons from the aid effectiveness literature as a whole and principles on effective use of aid suggest the need for approaches that do not merely finance the marginal private investment. Regarding experience of government intervention in markets, subsidies are only one of many options to incentivize the private sector, and bespoke subsidies provided by outside actors are rarely likely to be the most efficient form. This paper discusses where outside subsidy of the private sector may make sense and develops principles for the use of aid in subsidies based on that analysis. Subsidies should be allocated on the basis of necessity in meeting public policy goals; the norm for subsidy allocations should be competitive approaches or open offers; non-competitive subsidies should only support market making; subsidy levels should be capped; and subsidy levels should be transparent. Much of the content of these “new” principles is already implied or specified by the existing Multilateral Development Bank Principles to Support Sustainable Private Sector Operations, but they suggest that development finance institutions should not use their standard business model when using subsidies.
  • Topic: Development, Privatization, Foreign Aid, Private Sector, Subsidies
  • Political Geography: Global Focus
  • Author: William Savedoff
  • Publication Date: 10-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The aid literature and high-level accords like the Paris Declaration argue that “country ownership” is critical to the effectiveness of aid. In response, donors and recipients renamed themselves “development partners,” obscuring the tendency for country ownership benefits (i.e. more successful and sustainable programs) to come at the expense of satisfying the funding countries’ priorities. This paper illustrates the tradeoff between country ownership and funders’ priorities with a formal model in which aid is governed by a contract to produce a jointly desired outcome. The model generalizes the Principal-Agent approaches for studying aid which treat countries as having multiple objectives. The new model illustrates how a recipient country’s rational resource allocation choices vary with different aid contracts, whether based on lump sum payments, input-based payments, conditional payments, matching grants or outcome payments. It reveals two critical aspects of the country ownership debate. First, even when funders and recipients agree on project goals, funders can only achieve their priorities through distorting domestic allocative choices. Second, funders are likely to fully embrace country ownership only in cases where they believe alternative uses of domestic funds have integrity (as defined by the funder). The model also shows that when funders put higher priority on achieving their goals than accommodating recipient allocation preferences, they should prefer conditional payments, matching grants, or outcome payments. Among these, the donor’s preferences would depend on the relative observability of expenditures to outcomes. If instead funders embrace country ownership and seek to maximize the country’s welfare, lump sum grants are better. In terms of Paris Declaration goals of sustainability, the aid contracts which are least aligned with recipient country priorities will not be sustained after aid ends unless domestic preferences are altered by a process of hysteresis.
  • Topic: Development, Diplomacy, International Cooperation, Foreign Aid
  • Political Geography: Global Focus
  • Author: Kimberly Ann Elliott
  • Publication Date: 11-2019
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: For nearly 50 years, the world’s “least developed countries” have received extra financial support and preferential trade treatment to help them grow and develop. In the first three decades after the Unit- ed Nations (UN) created the LDC category in 1971, only one country—diamond-rich Botswana—out- grew that status. Since then, four more countries have graduated, and the pace is set to accelerate over the coming decade. Moreover, the countries approaching graduation in the next decade will pose different adjustment challenges than those that preceded them. When a country successfully graduates, it loses access to the special finance and trade programs that come with LDC status. In the case of trade, that can mean the graduating country’s exporters sudden- ly face the higher tariffs that their more advanced competitors face, so-called most-favored nation (MFN) tariffs. Even if these countries remain eligible for the Generalized System of Preferences (GSP) that is available to developing countries, those programs are typically much less generous than the duty-free, quota-free market access that most advanced economies provide for LDCs.1 Moreover, out- side the European Union (EU), few countries provide transition measures for graduating LDCs (see Annex A). Nor does there appear to be much planning to prepare for the coming wave of graduations. The United Kingdom has already committed to provide barrier-free market access for LDCs, similar to the EU’s Everything But Arms (EBA) program.2 But British policymakers have a unique opportunity to improve on that model as part of post-Brexit trade and development planning, including to ad- dress the coming wave of graduations. And if the UK remains in the customs union, it can work with EU policymakers to improve the graduation process as part of the review of the GSP regulation that expires in 2023.
  • Topic: Development, International Cooperation, European Union, Trade, Transition
  • Political Geography: Europe, Global Focus
  • Author: Ruth Lopert
  • Publication Date: 11-2019
  • Content Type: Policy Brief
  • Institution: Center for Global Development
  • Abstract: Around the world, development economists and researchers are exploring proposals to tax excise goods, and several have produced models demonstrating that such taxes can generate substantial revenues. This note attempts to list the organizations and research initiatives currently addressing taxation of tobacco, alcohol, and sugar-sweetened beverages—the “bads”—to help navigate the landscape of existing research and identify gaps and opportunities for further work.
  • Topic: Development, Economics, Tax Systems, Revenue Management
  • Political Geography: Global Focus
  • Author: Scott Morris, Jessie Lu
  • Publication Date: 11-2019
  • Content Type: Research Paper
  • Institution: Center for Global Development
  • Abstract: Donor support for agriculture development is not keeping pace with developing country demand or the need for finance implied by Sustainable Development Goal 2. In order to increase the overall volume of resources available for these needs, IFAD is pursuing a reform agenda that considers providing loans on harder terms to its client countries. This study assesses whether this hardening of lending terms will affect country demand for projects. Using the World Bank experience as a proxy, this paper examines whether graduation from the International Development Association to the International Bank for Reconstruction and Development affects the sector portfolios of countries and the types of investment demands within agriculture through both statistical and qualitative country case study analysis. We find that as countries graduate, there is a relative shift away from “soft” sector investments and a different mix of investments within the agricultural sector. We argue that IFAD’s consideration of harder lending terms should also include consideration of how to respond to a different mix of country demand within the agricultural sector. Specifically, the fund should consider some scaling up of projects, increased emphasis on capital investments, and a greater emphasis on policy engagement with client countries.
  • Topic: Agriculture, Development, Investment, Sustainability, Banking
  • Political Geography: Global Focus