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?
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.
Gavi’s Role in Market Shaping and Procurement: Progress, Challenges, and Recommendations for an Evolving Approach
In this note, we diagnose key challenges that will strain Gavi’s model during the 2021–2025 period and beyond. We then offer recommendations for an evolving approach, which closely align with Gavi’s goal to maximize the impact of countries’ current and future domestic investments.
Gavi’s Approach to Health Systems Strengthening: Reforms for Enhanced Effectiveness and Relevance in the 2021–2025 Strategy
In this note, we highlight the results of Gavi HSS evaluations, how Gavi has responded to identified challenges and limitations in the HSS proposal and implementation process, and what options are available to enhance the effectiveness of HSS support for Gavi’s core mandate. We also discuss the importance of 4G (Gavi, the Global Fund, the Global Financing Facility, and the World Bank Group) collaboration.
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. In this note, we explore these coverage challenges in greater detail and offer recommendations for how Gavi can address them in its 5.0 strategy.
This overview note lays out five challenges and summarizes some of our ideas to address them; backing up each is a standalone note that provides greater detail and options for action. An accompanying note looks at the full set of issues through a country lens.
In this note, we explore some of the challenges facing Gavi-eligible countries. We then propose procedural improvements or adaptations to Gavi’s operations to better support the needs of country governments and other partners.
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.