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You searched for: Content Type Working Paper Remove constraint Content Type: Working Paper Publishing Institution Center for Global Development Remove constraint Publishing Institution: Center for Global Development Topic Health Remove constraint Topic: Health
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  • Author: Rachel Glennerster, Heidi Williams, Georg Weizsacker, Ruth Levine, Jean Lee, Michael R. Kremer, Ernst R. Berndt
  • Publication Date: 08-2006
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The G8 is considering committing to purchase vaccines against diseases concentrated in low-income countries (if and when desirable vaccines are developed) as a way to spur research and development on vaccines for these diseases. Under such an “advance market commitment,” one or more sponsors would commit to a minimum price to be paid per person immunized for an eligible product, up to a certain number of individuals immunized. For additional purchases, the price would eventually drop to close to marginal cost. If no suitable product were developed, no payments would be made. We estimate the offer size which would make revenues similar to the revenues realized from investments in typical existing commercial pharmaceutical products, as well as the degree to which various model contracts and assumptions would affect the cost-effectiveness of such a commitment. We make adjustments for lower marketing costs under an advance market commitment and the risk that a developer may have to share the market with subsequent developers. We also show how this second risk could be reduced, and money saved, by introducing a superiority clause to a commitment. Under conservative assumptions, we document that a commitment comparable in value to sales earned by the average of a sample of recently launched commercial products (adjusted for lower marketing costs) would be a highly cost-effective way to address HIV/AIDS, malaria, and tuberculosis. Sensitivity analyses suggest most characteristics of a hypothetical vaccine would have little effect on the cost-effectiveness, but that the duration of protection conferred by a vaccine strongly affects potential cost-effectiveness. Readers can conduct their own sensitivity analyses employing a web-based spreadsheet tool.
  • Topic: Development, Economics, Health, Markets
  • Author: Gunilla Petterson, Michael A. Clemens
  • Publication Date: 08-2006
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The migration of doctors and nurses from Africa to developed countries has raised fears of an African medical brain drain. But empirical research on the causes and effects of the phenomenon has been hampered by a lack of systematic data on the extent of African health workers' international movements. We use destination-country census data to estimate the number of African-born doctors and professional nurses working abroad in a developed country circa 2000, and compare this to the stocks of these workers in each country of origin. Approximately 65,000 African-born physicians and 70,000 African-born professional nurses were working overseas in a developed country in the year 2000. This represents about one fifth of African-born physicians in the world, and about one tenth of African-born professional nurses. The fraction of health professionals abroad varies enormously across African countries, from 1% to over 70% according to the occupation and country. These numbers are the first standardized, systematic, occupation-specific measure of skilled professionals working in developed countries and born in a large number of developing countries.
  • Topic: Development, Health, Migration
  • Political Geography: Africa
  • Author: Owen Barder
  • Publication Date: 07-2006
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: It is sometimes claimed that an increase in aid might cause Dutch Disease—that is, an appreciation of the real exchange rate which can slow the growth of a country's exports— and that aid increases might thereby harm a country's long-term growth prospects. This essay argues that it is unlikely that a long-term, sustained and predictable increase in aid would, through the impact on the real exchange rate, do more harm than good, for three reasons. First, there is not necessarily an adverse impact on exports from Dutch Disease, and any impact on economic growth may be small. Second, aid spent in part on improving the supply side—investments in infrastructure, education, government institutions and health—result in productivity benefits for the whole economy, which can offset any loss of competitiveness from the Dutch Disease effect. Third, the welfare of a nation's citizens depends on their consumption and investment, not just output. Even on pessimistic assumptions, the additional consumption and investment which the aid finances is larger than any likely adverse impact on output. However, the macroeconomic effects of aid can cause substantial harm if the aid is not sustained until its benefits are realized. The costs of a temporary loss of competitiveness might well exceed the benefits of the short-term increase in aid. To avoid doing harm, aid should be sustained and predictable, and used in part to promote economic growth. This maximizes the chances that the long-term productivity and growth benefits will offset the adverse effects—which may be small if they exist at all—that big aid surges may pose as a result of Dutch Disease.
  • Topic: Economics, Health, Humanitarian Aid
  • Political Geography: Europe
  • Author: Owen Barder, Ethan Yeh
  • Publication Date: 02-2006
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: How can the international community save more children's lives faster and more effectively in the 21st century? This Working Paper analyzes the extent to which “frontloading” and predictable vaccine funding, as proposed by the International Finance Facility for Immunization (IFFIm), is more effective in impacting vaccine coverage than spending vaccine funds equally throughout the lives of projects. The IFFIm is an initiative of the Global Alliance for Vaccines and Immunization (GAVI), and supported by the governments of the United Kingdom, France, Sweden, Italy, Spain and Norway. An initial IFFIm investment of $4 billion is expected to prevent 5 million child deaths by 2015, and more than 5 million future adult deaths. Using a stylized model, the authors quantify the positive and negative effects of predictable vaccine funds and frontloading, and finds IFFIm's approach can increase the impact of vaccine coverage by 22%. This is because stable and long-term financing allows vaccine manufacturers and countries to plan for long periods of time, knowing that resources will be available. Front-loading helps to reduce the spread of disease and to immunize large groups of people faster.
  • Topic: Economics, Health, Human Welfare, International Cooperation
  • Political Geography: United Kingdom, Norway, France, Spain, Italy, Sweden
  • Author: Maureen Lewis
  • Publication Date: 01-2006
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: What factors affect health care delivery in the developing world? Anecdotal evidence of lives cut tragically short and the loss of productivity due to avoidable diseases is an area of salient concern in global health and international development. This working paper looks at factual evidence to describe the main challenges facing health care delivery in developing countries, including absenteeism, corruption, informal payments, and mismanagement. The author concludes that good governance is important in ensuring effective health care delivery, and that returns to investments in health are low where governance issues are not addressed.
  • Topic: Corruption, Government, Health, Third World
  • Author: Vijaya Ramachandran, Manju Kedia Shah, Ginger Turner
  • Publication Date: 01-2006
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: This paper analyzes the determinants of firms' decision to provide HIV/AIDS prevention activities. Using data from 860 firms and 4,955 workers in Uganda, Tanzania, and Kenya, it shows that larger firms, and firms with higher skilled workers tend to invest more in AIDS prevention. Firms where more than 50 percent of workers are unionized are also more likely to do more prevention activity. Finally, these characteristics are also significant in determining whether or not a firm carries out pre-employment health checks of its workers. The results shed light on the likelihood of private sector intervention and the gaps that will require public sector assistance.
  • Topic: Health, Human Welfare, Humanitarian Aid, Non-Governmental Organization
  • Political Geography: Uganda, Kenya, Tanzania
  • Author: Maureen Lewis
  • Publication Date: 01-2006
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: What factors affect health care delivery in the developing world? Anecdotal evidence of lives cut tragically short and the loss of productivity due to avoidable diseases is an area of salient concern in global health and international development. This working paper looks at factual evidence to describe the main challenges facing health care delivery in developing countries, including absenteeism, corruption, informal payments, and mismanagement. The author concludes that good governance is important in ensuring effective health care delivery, and that returns to investments in health are low where governance issues are not addressed.
  • Topic: Corruption, Development, Health, Human Welfare