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32. Building back better after the COVID-19 pandemic
- Author:
- Miguel Jaramillo and Bruno Escobar
- Publication Date:
- 11-2021
- Content Type:
- Working Paper
- Institution:
- Group for the Analysis of Development (GRADE)
- Abstract:
- In this policy-oriented paper, we provide a pre- and post-pandemic socioeconomic analysis of Peru, along with a financially sustainable five-year Building Back Better recovery plan, which emphasizes the urgency of addressing some of the country’s structural weaknesses. We underscore the importance of public investment for this effort, but widen the focus to include current public expenditure, in order to take steps towards building a more universal social protection system. We show that this also contributes to reducing the gender imbalances in the labor market that the pandemic exposed and exacerbated. We provide a financial programming exercise that demonstrates that the plan is financially responsible under a reasonable fiscal rule. Four core ideas stand out from our analysis. Firstly, while public investment can be key to reigniting economic growth, it does not go very far in tackling structural weaknesses. Secondly, public spending in health can actually achieve this from two fronts: by beginning to build a universal access social protection system and by addressing gender imbalances in the labor market. Thirdly, focusing public discussion on social protection enables a broader approach to policy reform by including formal employment and productivity enhancing reforms, which are essential for the sustainability of a broad social protection system. Finally, we also show that the sector mix in public investment has an impact on employment results, both in terms of the volume of jobs generated and their gender composition.
- Topic:
- Health, Inequality, COVID-19, Socioeconomics, Public Spending, and Gender
- Political Geography:
- South America and Peru
33. Meeting the Global Health Challenge to Reduce Death and Disability from Alcohol, Tobacco, and Sugar-Sweetened Beverage Consumption with Corrective Taxes
- Author:
- Chris Lane and Vinayak Bhardwaj
- Publication Date:
- 11-2021
- Content Type:
- Working Paper
- Institution:
- Center for Global Development
- Abstract:
- Behind the daily trauma of COVID-19 lies a larger and longer-lasting global health challenge resulting from the consumption of tobacco, alcohol, and sugar-sweetened beverages. Using a sample of 25 large advanced and emerging market economies accounting for three-quarters of global GDP, we show that about 60 million productive life years were lost every year in 2000, 2010, and 2019 from death and disability attributable to alcohol, tobacco, and diets high in sugar-sweetened beverages. Using the cost-of-illness framework, the economic value of these lost productive years in 2019 is approximately $2.1 trillion in our country sample (in 2017 purchasing power parity dollars [PPP$]). We show that over a 20-year period, a higher tax effort is associated with larger reductions in economic costs. We also show that total corrective taxes for all the products under investigation fall far short of the indirect costs of consumption in all countries. We conclude that all advanced economies and emerging markets could reap substantial macroeconomic benefits from better health by raising corrective taxes on alcohol and tobacco and by introducing corrective taxes on sugar-sweetened beverages.
- Topic:
- Health, Disability, Tax Systems, Health Crisis, and Addiction
- Political Geography:
- Global Focus
34. Exploring How the US International Development Finance Corporation Can Support Health Sector Investments: Is the Glass Half Full or Half Empty?
- Author:
- Julia Kaufman, Janeen Madan Keller, and Rachel Silverman
- Publication Date:
- 07-2021
- Content Type:
- Working Paper
- Institution:
- Center for Global Development
- Abstract:
- Health sector investments present an opportunity for the US International Development Finance Corporation (DFC), under the Biden-Harris administration, to demonstrate meaningful global leadership and refocus on its development mandate, driving broader health benefits and contributing to global economic recovery. DFC’s early days have been defined by a mixed record, notably in the health sector. Still, in the context of the pandemic’s health and economic impacts, the agency is well positioned to help strengthen pandemic preparedness and expand equitable access to health products and innovation in low- and middle-income countries. Through investments to build private sector manufacturing and delivery capacity, DFC can help stem and reverse these losses and insure against future health crises. This policy paper explores how DFC can strategically invest in health while balancing sometimes competing policy imperatives related to health equity, commercial viability, and foreign policy interests. We first provide an overview of the development finance landscape in the health sector and select DFC health-focused investments to date. We then suggest three high-impact engagement opportunities in the health sector for DFC to consider, including building regional manufacturing hubs for health supplies; providing R&D incentives for biotechnology; and supporting robust supply chains for health-adjacent services and delivery models. Lastly, we outline key principles to guide future DFC health sector investments, such as compatibility with long-term universal health coverage goals, a learning agenda for development effectiveness, and health-specific considerations for additionality and co-financing.
- Topic:
- Development, Health, Finance, and Investment
- Political Geography:
- North America and United States of America
35. Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak
- Author:
- Bilal Siddiqi, Maarten Voors, Johannes Haushofer, Oeindrila Dube, and Darin Christensen
- Publication Date:
- 03-2020
- Content Type:
- Working Paper
- Institution:
- Empirical Studies of Conflict Project (ESOC)
- Abstract:
- Developing countries are characterized by high rates of mortality and morbidity. A potential contributing factor is the low utilization of health systems, stemming from the low perceived quality of care delivered by health personnel. This factor may be especially critical during crises, when individuals choose whether to cooperate with response efforts and frontline health personnel. We experimentally examine efforts aimed at improving health worker performance in the context of the 2014–15 West African Ebola crisis. Roughly two years before the outbreak in Sierra Leone, we randomly assigned two accountability interventions to government-run health clinics — one focused on community monitoring and the other gave status awards to clinic staff. We find that over the medium run, prior to the Ebola crisis, both interventions led to improvements in utilization of clinics and patient satisfaction with the health system. In addition, child health outcomes improved substantially in the catchment areas of community monitoring clinics. During the crisis, the interventions also led to higher reported Ebola cases, as well as lower mortality from Ebola—particularly in areas with community monitoring clinics. We explore three potential mechanisms: the interventions (1) increased the likelihood that patients reported Ebola symptoms and sought care; (2) unintentionally increased Ebola incidence; or (3) improved surveillance efforts. We find evidence consistent with the first: by building trust and confidence in health workers, and improving the perceived quality of care provided by clinics prior to the outbreak, the interventions encouraged patients to report and receive treatment. Our results suggest that accountability interventions not only have the power to improve health systems during normal times, but can additionally make health systems resilient to crises that may emerge over the longer run.
- Topic:
- Health, Infectious Diseases, Health Care Policy, Mortality, Public Health, and Pandemic
- Political Geography:
- West Africa and Sierra Leone
36. Productivity and Adaptability: Why COVID-19 Has Not Overrun American Hospitals
- Author:
- Hanns Kuttner
- Publication Date:
- 11-2020
- Content Type:
- Working Paper
- Institution:
- Hudson Institute
- Abstract:
- Early in the COVID-19 epidemic, many gloomy images emerged of what might be ahead. In one, hospitals would be overrun by more COVID-19 patients than they could treat. Models developed at the Institute for Health Metrics and Evaluation (IHME) provided numbers that supported the image. For the most part, overrun hospitals did not happen. Things turned out better because America’s hospitals did better than the IHME model thought they could. Hospital productivity has proved to be greater than anticipated in the IHME model. Productivity determines how many patients hospitals can serve. Productivity reflects how many beds a hospital has and how many days each patient stays in a bed. The most common pattern in hospitals, patients who are discharged alive and do not require time in an intensive care unit (ICU), provide an example. Length of stay for that group has been a third shorter than assumed in the IHME model. The data required to tell the adaptability story in detail is not yet available. Only a qualitative assessment is possible at this point. Hospitals adapted in ways not anticipated in the IHME model. For example, they delayed elective surgical procedures, freeing up beds. The story will become more detailed as data about hospital admissions and the clinical course of COVID-19 patients becomes available.
- Topic:
- Health, Science and Technology, Health Care Policy, COVID-19, and Pharmaceuticals
- Political Geography:
- North America and United States of America
37. Combating China’s COVID-19 Propaganda Offensive to Undermine the United States on the Global Stage
- Author:
- John Lee
- Publication Date:
- 03-2020
- Content Type:
- Working Paper
- Institution:
- Hudson Institute
- Abstract:
- Throughout the United States, it is becoming increasingly clear that the Chinese Communist Party (CCP) is exploiting COVID-19 in an effort to reshape the global order and enhance China’s international leadership at the expense of the US. A range of prominent commentators further assert that the Trump administration bears much of the blame for this turn of events. This argument tends to rest on twin assumptions:1 China is winning the battle of narratives when it comes to comparative national competence and its decisiveness in responding to its COVID-19 outbreak. The Trump administration is damaging America’s standing by getting off to a bad start in its response to the pandemic, exposing the underlying weaknesses of American institutions and preparedness for such a crisis. These arguments correctly acknowledge that the global pandemic is occurring within a context of US-China strategic, political, and economic competition and/or rivalry. This is the point of warnings to the administration that there is more at stake than containing and managing the virus, even if that is the immediate priority.
- Topic:
- International Relations, Foreign Policy, Economics, Health, National Security, and COVID-19
- Political Geography:
- China and East Asia
38. The Effects of Financial Inclusion on Development Outcomes: New Insights from ASEAN and East Asian Countries
- Author:
- Rajabrata Banerjee, Ronald Donato, and Admasu Afsaw Maruta
- Publication Date:
- 09-2020
- Content Type:
- Working Paper
- Institution:
- Economic Research Institute for ASEAN and East Asia (ERIA)
- Abstract:
- This study empirically examines the effects of financial inclusion on economic development, – economic growth, education, health, and income inequality – in 20 Asian countries in the period 2004-2015. The financial inclusion index at an aggregate level is constructed using a hybrid methodology (reported in the previous paper) and we empirically examine its relationship with particular development outcomes. We then disaggregate the index into the three dimensions of financial inclusions – access, usage, and quality – and further into the top two indicators from each dimension based on principal component analysis scores (reported in the previous paper), to examine whether specific dimensions or indicators are more strongly associated with particular development outcomes than with others. Our results show that aggregate financial inclusion has a strong positive effect on all development outcomes and this effect improves for countries with lower political risk. At the dimension level, while usage is the only dimension impacting on economic growth, and access is the only dimension impacting on health outcomes, both usage and access influence education and income inequality. Moreover, the top ranked indicators in each dimension exert a far greater positive influence on development outcomes than the second highest ranked indicators. Our findings show that adopting a single blanket policy may not be appropriate to realise the full potential of financial inclusion in a less developed country. Policy prescriptions should therefore target specific dimension and indicators of financial inclusion to maximise the positive effect on development outcomes.
- Topic:
- Development, Health, Finance, and Fiscal Policy
- Political Geography:
- Asia
39. Health Technology Assessment for the US Healthcare System
- Author:
- Aspen Institute and USC Schaeffer Center For Health Policy & Economics
- Publication Date:
- 03-2020
- Content Type:
- Working Paper
- Institution:
- Aspen Institute
- Abstract:
- The USC Schaeffer Center for Health Policy & Economics and the Aspen Institute’s Health, Medicine & Society Program have together established an advisory panel to consider how the U.S. can better link the price of health technologies to the benefits they provide to patients while ensuring a sustainable healthcare ecosystem that supports innovation.
- Topic:
- Health, Science and Technology, Health Care Policy, and Emerging Technology
- Political Geography:
- North America and United States of America
40. Addressing Antimicrobial Resistance
- Author:
- Aspen Health Strategy Group
- Publication Date:
- 04-2020
- Content Type:
- Working Paper
- Institution:
- Aspen Institute
- Abstract:
- In June 2019, the Aspen Health Strategy Group met for three days to explore the topic of antimicrobial resistance. We are pleased to present the final report from our work, based upon the group’s rich discussion. In the tradition of the thought-provoking conversations and dialogue on how to address critical societal issues — the hallmark of the Aspen Institute — the report includes five big ideas to address antimicrobial resistance.
- Topic:
- Health, Public Health, Resistance, and Medicine
- Political Geography:
- Global Focus