The US Department of Defense (DOD) is not a development agency, but it does manage millions of dollars of development assistance.
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.
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.
With the goal of driving down drug costs, governments across the globe have instituted various forms of pharmaceutical price control policies. 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.
A CGD Task Force assessed the implications of Basel III for EMDEs and provided recommendations for both international and local policymakers to make Basel III work for these economies. This brief summarizes the key findings and recommendations.
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.
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.
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.
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 Technical Report on Cancer Pricing manages to do just that with a paper to the WHO Executive Board calling for price and cost transparency.
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.
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!
Midline Effects of a Randomized Controlled Trial to Increase the Utilization of Financial Services by Women Business Owners in Rural Indonesia - Working Paper 506
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.
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.
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.
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?
Every year, governments worldwide sign contracts worth trillions of dollars. They buy textbooks and fighter planes, hire consultants, commission firms to run railways and build bridges, take out loans and give guarantees, grant mining concessions, and issue licenses to use the public airwaves. Each time, legal documents specify who will pay how much to whom for what.
There 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.
Learning Equity Requires More than Equality: Learning Goals and Achievement Gaps between the Rich and the Poor in Five Developing Countries - Working Paper 504
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.