Ideas to Action:

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Cover of Struggling with Scale: Ebola’s Lessons for the Next Pandemic
May 9, 2019

Struggling with Scale: Ebola’s Lessons for the Next Pandemic (brief)

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.

Various bottles of pills
May 1, 2019

Aggregating Demand for Pharmaceuticals is Appealing, but Pooling Is Not a Panacea

As low- and middle-income 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.

Cover of Making Basel III Work Report
April 23, 2019

Making Basel III Work for Emerging Markets and Developing Economies

The report considers three different channels through which Basel III can affect financial stability and devel­opment in EMDEs: (1) effects on the volume, compo­sition, and stability of capital flows arising from the implementation of Basel III in advanced economies; (2) effects on financial stability and a level playing field from the adoption of the Basel framework by the home countries of affiliates of foreign banks operating in EMDEs; and (3) effects on financial stability, broad access to financial services, and deepening of local financial systems from the implementation of Basel III by EMDEs themselves.

Humanitarian workers in the DRC load supplies out of a truck
April 19, 2019

The Dos and Don’ts of USG Humanitarian Reorganization

The proposed FY 2020 budget 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.

 
Cover of Policy Paper 140
April 17, 2019

The Quality of UK Aid Spending, 2011–2018: An Analysis of Evaluations by the Independent Commission on Aid Impact

This paper analyses the grades awarded in the 65 primary reviews undertaken by the UK Independent Commission for Aid Impact (ICAI) over its first eight years of operation, from 2011 to 2018. It finds that ICAI has directly evaluated £28bn of UK aid over the period. Around four-fifths of spend assessed was graded as “satisfactory” (amber/green) or “strong” (green). The findings from ICAI reviews, and this report, should inform the UK Government’s aid allocations between departments at the forthcoming spending review. 

Cover of Working Paper 508
April 10, 2019

Pooled Procurement of Drugs in Low and Middle Income Countries - Working Paper 508

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. 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.

Cover of Working Paper 507
April 3, 2019

The Future of Global Health Procurement: Issues around Pricing Transparency - Working Paper 507

This paper focuses on the role that price transparency may play in the efficient and effective procurement of medicines by middle- and low-income countries. Will making prices publicly available make procurement more efficient and cost-effective medicines more accessible? We conclude that transparency of the procurement process significantly lowers costs by encouraging bidders. 

An 18-wheeler on a highway
March 26, 2019

The Machines Are Not So Easy to Ride: Another Take on Automation

Contrary to popular imagination, automation in the workplace is not some modern-day development composed chiefly of hardware, robotics, and human-cognition level embedded algorithms. Instead, it is an old phenomenon consisting primarily of business productivity software deployment in the forms of enterprise resource planning, customer resource management, and human capital management solutions. And however far back one goes, process control and risk management have always competed with increased flexibility for priority in the business case for these systems.

Bright Simons
Cover of Working Paper 505
March 21, 2019

The Limits (And Human Costs) of Population Policy: Fertility Decline and Sex Selection in China under Mao - Working Paper 505

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.

Close-up of hands using a phone to call a ride-sharing app
March 21, 2019

Why “Leapfrogging” in Frontier Markets Isn’t Working

There are two big questions about modern innovation: Why does it tend to confine itself to only a narrow “vanguard” of the economy in every part of the world? And why does it not provide as big a boost to productivity as expected, especially since the dotcom bust?

Bright Simons
March 20, 2019

New Gavi Modalities for a Changing World

In this note, we summarize the changing context and its relevance for Gavi, exploring the specific issues relevant to transitioning countries, never-eligible MICs, and countries dealing with complex emergencies or large-scale protracted displacement. We then offer four recommendations to increase Gavi’s relevance and effectiveness in a changing world.

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