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  • 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: Scott Morris, Gailyn Portelance
  • Publication Date: 01-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Under the World Bank’s 2018 capital agreement, borrowing countries are expected to gradually reduce their portfolios once a base income threshold—the Graduation Discussion Income (GDI)—is reached. However, the agreement also affirms the case for ongoing lending to these countries. One justification is tied to external value beyond the borrowing country’s borders (global public goods, or GPGs). Another is tied to building capacity within the borrowing country, which can mean a focus on sub-regions where poverty remains high and capacity weak. In this paper, we examine World Bank graduation policies and lending through the lens of China, which maintains a large portfolio of World Bank projects. China currently exceeds the GDI thresholds for IBRD borrowing at the national level, while income inequality within the country leaves many noncoastal provinces below the GDI per capita threshold. Aggregate and provincial-level analysis of World Bank lending in China shows that less than half of China’s portfolio comprises activities clearly linked to GPGs, while a slight majority of projects are based in provinces with per capita income below the GDI threshold. A substantial number of World Bank projects in China focus on climate change mitigation and transportation infrastructure construction, while a smaller number relate to capacity building. Overall, we find evidence that China’s borrowing is broadly consistent with the 2018 principles of institutional capacity strengthening and GPG-related engagement, although significant areas of bank engagement do not appear to fall within the parameters of these principles.
  • Topic: Poverty, Infrastructure, World Bank, Inequality
  • Political Geography: China, Asia
  • Author: Hannah Timmis, Mikaela Gavas
  • Publication Date: 01-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In 2017, the EU launched an ambitious programme of investment mobilisation in Africa and the Neighbourhood: the External Investment Plan (EIP). The EIP aims to increase the scale, impact, and coherence of EU-supported external investment by introducing various innovations to the European financial architecture, including a new guarantee mechanism and a unique “three-pillar” approach to investment support. The European Commission is proposing a significant expansion of the EIP under the EU’s new long-term budget, the Multiannual Financial Framework 2021–27, replacing the current plethora of investment tools and modalities with a single framework. This paper provides a comprehensive overview of the evolution of the EU’s complex external investment architecture. Based on interviews with stakeholders, it documents lessons learned during the EIP’s first year of implementation and proposes a series of options for the design and operationalisation of the new investment framework. To increase the additionality, development effectiveness, and efficiency of EU-supported external investment, it recommends that the European Commission improve the current architecture by providing greater policy steer to investors; increasing competition among institutions for investment support; clarifying linkages between the three pillars; setting clear guidance, fee structures, and standardised contractual terms; and strengthening management of investment tools.
  • Topic: Regional Cooperation, European Union, Finance, Investment
  • Political Geography: Europe
  • Author: Hannah Timmis, Mikaela Gavas
  • Publication Date: 01-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In 2017, the EU launched an ambitious programme of investment mobilisation in Africa and the Neighbourhood: the External Investment Plan (EIP). The EIP aims to increase the scale, impact, and coherence of EU-supported external investment by introducing various innovations to the European financial architecture, including a new guarantee mechanism and a unique “three-pillar” approach to investment support. The European Commission is proposing a significant expansion of the EIP under the EU’s new long-term budget, the Multiannual Financial Framework 2021–27, replacing the current plethora of investment tools and modalities with a single framework. This paper provides a comprehensive overview of the evolution of the EU’s complex external investment architecture. Based on interviews with stakeholders, it documents lessons learned during the EIP’s first year of implementation and proposes a series of options for the design and operationalisation of the new investment framework. To increase the additionality, development effectiveness, and efficiency of EU-supported external investment, it recommends that the European Commission improve the current architecture by providing greater policy steer to investors; increasing competition among institutions for investment support; clarifying linkages between the three pillars; setting clear guidance, fee structures, and standardised contractual terms; and strengthening management of investment tools.
  • Topic: Regional Cooperation, European Union, Finance, Investment
  • Political Geography: Europe
  • 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: Mikaela Gavas
  • Publication Date: 01-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Mikaela Gavas submitted written evidence to the United Kingdom's House of Lords EU External Affairs Sub-Committee on January 31, 2019. In her evidence Gavas answered questions about the future of UK-EU development cooperation after Brexit.
  • Topic: Development, Regional Cooperation, European Union, Brexit
  • Political Geography: United Kingdom, Europe
  • Author: Michael Clemens
  • Publication Date: 01-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: ‘Guest workers’ earn higher wages overseas on temporary low-skill employment visas. This wage gap can be used to measure gaps in the productivity of workers due to where they are, not who they are. This paper estimates the effects of guest work on Indian applicants to a construction job in the United Arab Emirates, where an economic crisis allocated guest work opportunities as-good-as-randomly among several thousand families. Guest work raised the return to poor families' labor by a factor of four, with little evidence of systematic fraud.
  • Topic: Migration, Labor Issues, Migrant Workers, Guest Workers
  • Political Geography: India, Asia
  • 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: Cindy Huang, Kate Gough
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Bangladesh is providing a significant global public good by hosting nearly one million Rohingya refugees, including 700,000 who fled violence carried out with “genocidal intent” in 2017. Most refugees are living in camps in Cox’s Bazar District, where local resources and livelihoods are under strain. The situation has exacerbated development challenges and environmental degradation, such as inadequate public services and rapid deforestation. Safe, voluntary, and sustainable Rohingya repatriation to Myanmar is ultimately the best solution. However, the conditions for return do not exist, and Myanmar has not demonstrated meaningful progress in establishing them. Even if conditions did exist and voluntary repatriation began tomorrow, estimates show a large number of Rohingya will still be in Cox’s Bazar 10 years from now. The refugee situation is likely to be protracted. Medium-term planning is critical. The international community has an opportunity to recognize Bangladesh’s contributions through a robust responsibility-sharing process. In addition to humanitarian aid, this would include commitments that support development among host communities, as well as broader regional and national development strategies. There is precedent for development financing and beyond-aid solutions for refugees and host communities, such as in the Jordan, Lebanon, and Ethiopia Compacts. These agreements seek to meet the medium-term needs and generate inclusive growth for refugees and hosts, including through policy adjustments that enable self-reliance and reduce aid dependence. This brief explores the potential range of responsibility-sharing commitments in support of Bangladesh. It does not address the separate and equally important issues of securing justice and accountability for Myanmar’s alleged atrocities and establishing the necessary conditions in Myanmar for safe, voluntary, and sustainable repatriation—nor does it make recommendations on the humanitarian response, which remains essential. This brief focuses exclusively on the medium-term, development-oriented approach. It covers several categories of contribution and commitment types, including trade and investment, labor mobility, SEZ and infrastructure investment, private sector investment, resettlement, and development and climate finance. Each category includes illustrative examples, some of which are specific to one or a subset of UN Member States and others that are more broadly applicable. Geopolitical factors surrounding the Rohingya situation and potential responsibility-sharing commitments are also discussed. Building on this mapping, we will prepare a full report in 2019. The report will highlight a subset of anchor contributions that could build momentum for a responsibility-sharing process that delivers a “win-win-win” for refugees, host communities, and Bangladesh’s broader development objectives.
  • Topic: Human Rights, Refugees, Displacement, Humanitarian Crisis
  • Political Geography: Bangladesh, Asia
  • 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: Heather A. Knauer, Pamela Jakiela, Owen Ozier, Frances Aboud, Lia C.H. Fernald
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Worldwide, 250 million children under five (43 percent) are not meeting their developmental potential because they lack adequate nutrition and cognitive stimulation in early childhood. Several parent support programs have shown significant benefits for children’s development, but the programs are often expensive and resource intensive. The objective of this study was to test several variants of a potentially scalable, cost-effective intervention to increase cognitive stimulation by parents and improve emergent literacy skills in children. The intervention was a modified dialogic reading training program that used culturally and linguistically appropriate books adapted for a low-literacy population. We used a cluster randomized controlled trial with four intervention arms and one control arm in a sample of caregivers (n = 357) and their 24- to 83-month-old children (n = 510) in rural Kenya. The first treatment group received storybooks, while the other treatment arms received storybooks paired with varying quantities of modified dialogic reading training for parents. Main effects of each arm of the trial were examined, and tests of heterogeneity were conducted to examine differential effects among children of illiterate vs. literate caregivers. Parent training paired with the provision of culturally appropriate children’s books increased reading frequency and improved the quality of caregiver-child reading interactions among preschool-aged children. Treatments involving training improved storybook-specific expressive vocabulary. The children of illiterate caregivers benefited at least as much as the children of literate caregivers. For some outcomes, effects were comparable; for other outcomes, there were differentially larger effects for children of illiterate caregivers.
  • Topic: Children, Language, Rural, Parenting , Reading
  • Political Geography: Kenya
  • 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
  • Author: Maryam Akmal, Lant Pritchett
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The Sustainable Development Goals (SDGs) for education include the goal that “all youth...achieve literacy and numeracy” (Target 4.6). Achieving some absolute standard of learning for all children is a key element of global equity in education. Using the Annual Status of Education Report (ASER) data from India and Pakistan, and Uwezo data from Kenya, Tanzania, and Uganda that test all children of given ages, whether in school or not, on simple measures of learning in math, reading (local language), and English, we quantify the role of achieving equality between the richest 20% and the poorest 40% in terms of grade attainment and learning achievement toward accomplishing the global equity goal of universal numeracy and literacy for all children. First, excluding Kenya, equalizing grade attainment between children from rich and poor households would only close between 8% (India) and 25% (Pakistan) of the gap to universal numeracy, and between 8% (Uganda) and 28% (Pakistan) of the gap to universal literacy. Second, children from the poorest 40% of households tend to have lower performance in literacy and numeracy at each grade. If such children had the learning profiles of children from rich households, we would close between 16% (Pakistan and Uganda) and 34% (India) of the gap to universal numeracy, and between 13% (Uganda) and 44% (India) of the gap to universal literacy. This shows that the “hidden exclusion” (WDR, 2018) of lower learning at the same grade levels—a gap that emerges in the earliest grades—is a substantial and often larger part of the equity gap compared to the more widely documented gaps in enrollment and grade attainment. Third, even with complete equality in grade attainment and learning achievement, children from poor households would be far from the equity goal of universal numeracy and literacy, as even children from the richest 20% of households are far from universal mastery of basic reading and math by ages 12-13. Achieving universal literacy and numeracy to accomplish even a minimal standard of global absolute equity will require more than just closing the rich-poor learning gap, it will take progress in learning for all.
  • Topic: Development, Education, Sustainable Development Goals, Language
  • Political Geography: Pakistan, Kenya, Africa, Middle East, India, Asia, Tanzania
  • Author: Owen Barder, Hannah Timmis, Arthur Baker
  • Publication Date: 03-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: here has been a resurgence in calls to reconsider the cross-party consensus in the UK on foreign aid and development. The main political parties are all committed to spending 0.7 percent of gross national income on aid, to using the internationally agreed definition of aid, and to maintaining a separate government department to administer the majority of this aid, led by a Cabinet Minister. In their recent report, Global Britain: A Twenty-first Century Vision, Bob Seely MP and James Rogers lay challenge to these long-established pillars of UK development policy. In this note, we consider some of the questions they raise and suggest alternative answers.
  • Topic: Development, Government, Foreign Aid, Bureaucracy
  • Political Geography: Britain, Europe
  • 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: Kimberly Singer Babiarz, Paul Ma, Grant Miller, Shige Song
  • Publication Date: 03-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Most of China’s fertility decline predates the famous One Child Policy—and instead occurred under its predecessor, the Later, Longer, Fewer (LLF) policy. Studying LLF’s contribution to fertility and sex selection behavior, we find that it i) reduced China’s total fertility rate by 0.9 births per woman (explaining 28% of China’s modern fertility decline), ii) doubled the use of male-biased fertility stopping rules, and iii) promoted postnatal neglect (implying 210,000 previously unrecognized missing girls). Considering Chinese population policy to be extreme in global experience, our paper demonstrates the limits of population policy—and its potential human costs.
  • Topic: Population, Sexuality, Fertility
  • Political Geography: China, Asia
  • Author: Bright Simons
  • Publication Date: 03-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Just before the yuletide of 2018, I arrived in my native Ghana after one of my long spells away. I flipped out my phone, opened Uber, and tried to flag a ride from inside the shiny new terminal of Accra’s international airport. After a couple of false starts I gave up, walked out, and headed for the taxi stand. In the many days that followed, this ritual repeated itself with remarkable regularity. Sometimes I got the Uber, but on as many occasions, I couldn’t. The reasons for the frequent failure ranged from curious to bizarre. The “partner-drivers” would accept the request. Then they would begin to go around in circles. Sometimes they would start heading in the opposite direction. On a few occasions they would call and announce that they were “far away,” even though their registered location was visible to me on the app and their estimated time of arrival had factored into my decision to wait. It would take me a whole week to figure out that the problem wasn’t always that many Ghanaian Uber drivers couldn’t use GPS all that well, or that they were displeased with fares. There were other issues that I’d left out of my calculation, such as my payment preference, which was set to “bank card” instead of “cash.” The drivers want cash because it allows them to unofficially “borrow” from Uber and remit Uber’s money when it suits their cashflow. Though Uber offers two tiers of service, the difference in quality appeared negligible. Even on the upper tier, it was a constant struggle to find an Uber whose air conditioner hadn’t “just stopped working earlier today.” As something of a globetrotter used to seamless Uber services in European and American cities, I found the costs of onboarding onto Uber as my main means of mobility in Accra onerous. Why is a powerful corporation like Uber, reportedly valued by shrewd investment bankers at $120 billion, with $24 billion in capital raised, unable to maintain even a relative semblance of quality in its product in Ghana? And in other African cities I have visited? It may seem bleedingly obvious why heavily digitalised Facebook, Twitter, Microsoft, and Google manage to deliver fairly uniform standards of product quality regardless of where their customers are based, whilst Uber, because of its greater “embeddedness in local ecosystems” and lower digitalisation of its value chain, fails. But in that seemingly redundant observation enfolds many explanations for why the innovation-based leapfrogging narrative in frontier markets, especially in Africa, unravels at close quarters.
  • Topic: Development, Science and Technology, Governance, Digital Economy, Emerging Technology
  • Political Geography: Africa
  • Author: James C. Knowles
  • Publication Date: 03-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: This is the report of a midline evaluation of a randomized controlled trial to increase the utilization of saving and other financial services by women business owners in Indonesia. The trial was motivated by a recent law in Indonesia supporting the development of branchless banking services for a large unbanked rural population and by the results of several studies suggesting that it is possible to stimulate savings and improve a range of downstream outcomes with suitable interventions targeted to under-banked rural populations. The trial was conducted in 400 purposively selected rural and semi-urban villages in five districts of East Java province in which branchless banking services (including basic savings accounts accessible through mobile phones) were available. The randomized interventions supported by this trial include both supply-side treatments (higher agent incentives) and demand-side treatments (training and mentoring of female business owners). The data analyzed include both baseline and midline survey data on female and male business owners and branchless banking agents. Implementation of the trial was delayed due to difficulties in recruiting suitable agents in all 400 trial villages. Numerous supply-side problems, both technical and logistical, were also reported in the monitoring data. However, the midline results indicate that the interventions were successfully delivered, resulting in significant positive effects on key intermediate outcomes, including knowledge and use of mobile banking services and initial take up of a mobile basic savings account. Downstream effects indicate that the supply- and demand-side interventions, particularly in combination, increased women business owners’ savings, empowerment, self-confidence, and economic welfare.
  • Topic: Women, Finance, Rural, Financial Services
  • Political Geography: Indonesia, Indo-Pacific
  • 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: Jeremy Konyndyk
  • Publication Date: 04-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The FY 2020 budget request released by the White House last month contained a sweeping proposal to rationalize and streamline US government humanitarian assistance programs overseas. The proposal would merge the three humanitarian budget accounts (International Disaster Assistance, Migration and Refugee Assistance, and Food For Peace Title II); strip programming responsibilities from the State Department’s refugee bureau and consolidate them entirely in a new humanitarian bureau at USAID; and establish a vaguely described “dual hat” senior leader role to oversee humanitarian activities at both USAID and the State Department. The proposed changes would be the most significant overhaul of USG humanitarian structures in decades. The proposal in its current form is unlikely to get much traction in Congress, where it is seen on both sides of the aisle as dramatically weakening US leadership on refugees. In light of other moves by the administration—like slashing refugee resettlement numbers and treating asylum seekers roughly—that is a legitimate and vital concern. There is ample reason to approach the proposal with caution, particularly the idea of stripping away the refugee bureau’s resources.
  • Topic: Foreign Aid, Budget, Refugees, Humanitarian Crisis
  • Political Geography: United States, North America
  • 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: Sarah Rose
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The US Department of Defense (DOD) is not a development agency, but it does manage millions of dollars of development assistance. In the early 2000s, DOD took on a significantly expanded development role, prompting a number of concerns and creating a lingering perception of intensive US military involvement in development activities. In fact, lessons learned from this era drove a reconceptualization of the Pentagon’s role in development. Today, the military controls only a tiny portion of US development funds, most of which go toward health (mainly PEPFAR) and disaster relief activities. This paper provides a brief landscape analysis of DOD’s recent development aid-funded efforts, breaking down its engagement into six key thematic areas. It concludes with five considerations related to DOD’s role in development assistance: (1) DOD has comparative advantages that make it an important actor in US development policy; (2) civilian-military coordination is hard but critical for development policy coherence; (3) adequate resourcing of civilian agencies is critical for effective civilian-military division of labor; (4) increasing the flexibility of civilian agencies’ staffing, programming, and funding could complement the military’s rapid response capabilities; and (5) incomplete transparency and limited focus on results reduces accountability around DOD’s aid investments.
  • Topic: Defense Policy, Development, Military Strategy, Bureaucracy, Civil-Military Relations
  • Political Geography: United States, North America
  • 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: Kalipso Chalkidou, Nishant Jain, Françoise Cluzeau, Amanda Glassman
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Hailed as one of the largest publicly funded health insurance programs in the world, India’s “Modicare” has, since its launch a little more than six months ago, made universal healthcare coverage an election theme for the first time in the country’s history.[1] In this note, we describe the program, with an emphasis on its better-known secondary and tertiary care component, and offer policy recommendations to strengthen the scheme post-election to enhance its contribution to India’s vision for universal health coverage (UHC). In a country of almost 1.4 billion people that is home to one-third of global maternal deaths, where public spending for health accounts for roughly 1 percent of GDP and where 60 million people fall into poverty every year because of healthcare bills, fixing healthcare is a daunting task that will determine the world’s performance against the Sustainable Development Goals over the coming decade.
  • Topic: Health, Health Care Policy, Public Health, Health Insurance
  • Political Geography: India, Asia
  • Author: Scott Morris
  • Publication Date: 05-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The Kunming-Vientiane (K-V) railway, part of the Kunming-Singapore multi-country rail network (or “Pan-Asia Railway”), is an anchor investment of the Chinese government’s Belt and Road initiative (BRI). This case study will assess the rail project along four dimensions: economic implications; procurement arrangements; labor; and environmental and social safeguards. In each of these areas, evidence from the railway project suggests that Chinese policy and practice could be better aligned with the practices of other sources of multilateral and bilateral development finance. Where the project’s standards are broadly aligned, at least in principle, there is nonetheless reason to believe that China’s approach carries heightened risks given the overall scale of financing. These risks hold for China’s global program of official finance, which has made the country the largest source of official credit in the world. In this regard, BRI policymakers should consider a more rigorous set of “best practices” that align Chinese official finance with leading multilateral standards, even if these practices don’t currently characterize many other bilateral lenders. Such an approach would be consistent with the multilateral vision for BRI espoused by Chinese officials and reflected in the framework of the annual Belt and Road Forum for International Cooperation. This study considers what a stronger set of standards would look like in the context of the four areas of focus.
  • Topic: Infrastructure, Belt and Road Initiative (BRI), Transportation, Railways
  • Political Geography: China, Asia
  • 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: Liesl Schnabel, Cindy Huang
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In August 2017, widespread violence carried out with “genocidal intent” in Myanmar forced 745,000 Rohingya to flee to Bangladesh and settle in camps in Cox’s Bazar.[1] Fifty-two percent of the refugee population there are women and girls.[2] Those of reproductive age are in dire need of emergency and longer-term sexual and reproductive health and rights (SRHR)[3] services. Many have additional needs related to sexual trauma experienced in Myanmar and/or in Bangladesh.[4],[5] For many, these needs are not being fully met due to implementation and access barriers.
  • Topic: Gender Issues, Health, Women, Reproductive Rights, Sexual Health
  • Political Geography: Asia, Myanmar
  • 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: Artur Kovalchuk, Charles Kenny, Mallika Snyder
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: This paper examines the impact of Ukraine’s ambitious procurement reform on outcomes amongst a set of procurements that used competitive tendering. The ProZorro system placed all of the country’s government procurement online, introduced an auction approach as the default procurement method, and extended transparency. The reform was introduced with a dramatic increase in the proportion of government procurement that was conducted competitively. This paper examines the impact of ProZorro and reform on contracts that were procured competitively both prior to and after the introduction of the new system. It finds some evidence of impact of the new system on increasing the number of bidders, cost savings, and reduced contracting times.
  • Topic: Governance, Reform, Procurement, Contracts
  • Political Geography: Europe, Ukraine, Eastern Europe
  • Author: Kimberly Ann Elliott
  • Publication Date: 06-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: American policymakers have failed to adequately respond to concerns about globalization’s effects and the resulting backlash has taken an ugly turn in recent years. While globalization is only one of many factors contributing to economic dislocation, sluggish wage growth and inequality in the United States, foreigners, and developing countries in particular, are frequently the target of those who are frustrated at being left behind. Yet few realize that US trade policy effectively discriminates against poorer countries. In addition, provisions in trade agreements that tilt the playing field in favor of business interests over those of American consumers and workers also often undermine development priorities in partner countries. American policymakers should rethink the substance and process of trade policy and negotiations to spread the benefits more broadly, at home and abroad.
  • Topic: Globalization, International Trade and Finance, Inequality, Domestic Policy
  • Political Geography: United States, North America
  • 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: Alex Ezeh, Jessie Lu
  • Publication Date: 07-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In order to achieve sustainable development outcomes in sub-Saharan Africa (SSA), African institutions must be the leading experts on and primary providers of research solutions to local problems. Despite years of investment in capacity building, SSA lags behind every other region in terms of research outputs and government investments, and new models for building institutional capacity are needed. Through interviews with African institutional leaders and development partners working in SSA, this study finds that funding inefficiencies lead to key challenges within institutions’ governance and management structures, financial systems, talent management processes, leadership and institutional vision capacities, and peer support networks, all of which obstruct the ability of African institutions to become impactful and sustainable drivers of development outcomes in the region. We present for consideration three possible innovative models that can facilitate the emergence of strong Africa-based, Africa-led institutions: a multi-stakeholder funding platform, an integrator organization model, and a scale model.
  • Topic: Development, Research, Sustainability, Socioeconomics
  • Political Geography: Africa, Sub-Saharan Africa
  • Author: Heather Tallis, Cindy Huang, John Herbohn, Karen Holl, Sharif A. Mukul, Kam Morshed
  • Publication Date: 07-2019
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Rohingya refugees began arriving in Bangladesh in August 2017, fleeing atrocities deemed serious crimes under international law by United Nations investigators. Over 740,000 new refugees have settled in two camps in Cox’s Bazar district of Chittagong: Kutupalong-Bulukhali and Naypara-Leda. The number of Rohingya in Cox’s Bazar now stands at around one million, comprising about 30 percent of the population. Kutupalong-Bulukhali is now the largest refugee camp in the world. The influx of Rohingya into Cox’s Bazar has exacerbated deforestation, underdevelopment, and climate vulnerability. Combined, these factors create an urgent need for new strategies and resources to address the increasing stress placed on the environment, and the consequences of this stress for refugee and host communities.
  • Topic: Environment, Genocide, Refugees, Humanitarian Crisis, Forest
  • Political Geography: Myanmar