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Janeen Madan Keller is a senior policy analyst and assistant director of global health at the Center for Global Development. Since joining CGD in June 2015, her research has covered a range of topics including global health financing and aid effectiveness, among others. Previously, she spent two years in Dakar, Senegal, where she worked with the UN World Food Program supporting nutrition and food security programs across West Africa. She has also worked with UNICEF in Mali and conducted research on health behavior change in Niger. Originally from Mumbai, India, she holds an MS in public health nutrition and food security from Tufts University and a BA with honors in political science and French from Vassar College.
Are genetically modified organisms (GMOs) likely to play a significant role in tackling malnutrition and reducing poverty in Africa? Our short answer is "it depends." In a new CGD policy paper and brief, we examine the evidence and conclude that currently available GMOs are of limited relevance for most developing countries, especially in Africa.
The debate over genetically modified organisms (GMOs) has been raging for twenty years and there is still more heat than light around the topic. While some developing countries have embraced the technology, much of Africa has followed the European Union’s precautionary approach. While not a panacea, GMOs could be part of a new green revolution in Africa if governments address the policy and institutional weaknesses that prevented Africa from participating in the first one, and if GM technology continues to develop.
The world will struggle to achieve the goals of ending extreme poverty and hunger by 2030 unless there is a sharp increase in agricultural productivity in Africa. Across sub-Saharan Africa, most people live in rural areas and rely on agriculture for their livelihoods; most of them are poor and many are hungry. Could genetically modified organisms (GMOs) help to address some of the causes contributing to Africa’s lagging agricultural productivity? Our answer is a qualified maybe.
Ethiopia is facing one of the worst droughts in decades, a painful reminder that food security challenges remain despite low food prices globally. Feed the Future—the Obama Administration’s global food security initiative—has been supporting Ethiopia and 18 other focus countries with projects that aim to boost farmer productivity and improve nutrition. How has the initiative performed in its first five years?
If Africa’s smallholder farmers are going to lift themselves out of poverty, they need access to formal financial services instead of the unstable, inflexible, informal arrangements that they currently rely on and that keep them poor. Ngozi Okonjo-Iweala and Janeen Madan review the ways in which digital technology is changing how financial services are delivered and made affordable. With the right investments and policies, farmers will be able to access credit, savings accounts, insurance, payment platforms, and other financial products that allow them to invest in their livelihoods without being exposed to exploitation or untenable risks.
The most essential feature of a social impact bond (SIB) is measuring impact. But what happens if the impact metric is questioned or unclear? A recent dispute over measuring the impact of a SIB for early childhood development in Utah yields two important practical lessons for this innovative financing tool. First, SIB implementers should be careful not to exaggerate the precision of their success indicators. Second, they need to be clear to everyone about which objectives they are pursuing.
Feed the Future has succeeded in bringing much needed attention to the pressing challenge of food security. But there is still plenty of room for improvement, particularly when it comes to encouraging country ownership and increasing transparency.
McDonald's has just gone global with its commitment to serve chicken free from antibiotics that are critically important to human health. Building on a similar phase-out in its US chicken supply in 2016, the company will ban critical antibiotic use from sourced chicken in a handful of high-income countries and Brazil in 2018, expanding to a longer list of “designated markets” by 2027. That's evidence of both the potential to reduce global antibiotic use in livestock and the vital role consumers can play in speeding progress.
Researchers highlight big issues with drug purchasing and generic drug markets
Eva Taylor Grant
Center for Global Development
WASHINGTON – Basic, everyday drugs can cost up to 20 to 30 times more in some poor countries than others, according to a new study released today by the Center for Global Development. The study examined billions of dollars of health spending on common, life-saving medicines in developing countries, mostly in Africa and Asia. To date, it is one of the largest-ever studies on global health procurement.
“Developing countries are often paying far more for everyday drugs than they should be. Why do some poor countries pay 20 to 30 times as much as others for common medicines to relieve pain or treat hypertension? In large part, because of flawed drug buying practices and broken generic medicines markets,” said Amanda Glassman, one of the authors of the study and the executive vice president at the Center for Global Development.
“A robust market for generic drugs is a core part of an affordable health system. But in way too many countries, generic drug markets are broken and patients are paying the price,” said Kalipso Chalkidou, the director of global health policy at the Center for Global Development and an author of the study. “You need enough competition to keep prices low and quality assurance that consumers trust, or essential medicines are going to be much more expensive than they should be.”
The study had three main findings:
In developing countries, prices for basic generic medicines can vary widely and far exceed wealthy-country prices. Some purchasers in low- and middle-income countries pay as much as 20 to 30 times more for basic generic medicines like omeprazole, used to treat heartburn, or acetaminophen (also known as paracetamol), a common pain reliever.
Low- and middle-income countries purchase more expensive branded generic drugs rather than unbranded quality-assured generics. In the US, most drugs are either on-patent medicines or unbranded generics, but in many developing countries more expensive brand-name generics are widely used, because people are concerned about unsafe or counterfeit drugs. In the poorest countries, unbranded generics are only 5 percent of the pharmaceutical market by volume—in comparison to the US where unbranded quality-assured generics are 85 percent of the market by volume.
There is little competition in the supply of essential medicines in low- and middle-income countries. The largest seller of products like contraceptives, cancer medicines, and antiparasitics can account for upwards of 85 percent of all sales in some countries.
“We’re talking about access to common medications for pain or high blood pressure, not the latest cutting-edge cancer drugs,” Glassman said.
“It’s not as exciting to talk about procurement as new health technologies or biotech breakthroughs,” she continued. “But drug purchasing is incredibly important, and if it’s done badly you end up with the poorest countries in the world paying some of the highest drug prices.”
You can read the full study at www.cgdev.org/better-health-procurement.