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112. Trade, Migration, and the Place Premium: Mexico and the United States
- Author:
- Raymond Robertson, Davide Gandolfi, and Timothy Halliday
- Publication Date:
- 03-2015
- Content Type:
- Working Paper
- Institution:
- Center for Global Development
- Abstract:
- Large wage differences between countries (“place premiums”) are well documented. Theory suggests that factor price convergence should follow increased migration, capital flows, and commercial integration. All three have characterized the relationship between the United States and Mexico over the last 25 years. This paper evaluates the degree of wage convergence between these countries during the period 1988 and 2011. We match survey and census data from Mexico and the United States to estimate the change in wage differentials for observationally identical workers over time. We find very little evidence of convergence. What evidence we do find is most likely due to factors unrelated to US-Mexico integration. While migration and trade liberalization may reduce the US-Mexico wage differential, these effects are small when compared to the overall wage gap.
- Topic:
- World Trade Organization
- Political Geography:
- United States and Mexico
113. Corruption and Averting AIDS Deaths
- Author:
- Willa Friedman
- Publication Date:
- 02-2015
- Content Type:
- Working Paper
- Institution:
- Center for Global Development
- Abstract:
- This paper looks at the impact of corruption on the effectiveness of antiretroviral drugs in preventing AIDS deaths and the potential channels that generate this relationship. This is based on a unique panel dataset of countries in sub-Saharan Africa, which combines information on all imported antiretroviral drugs (ARVs) from the World Health Organization's Global Price Reporting Mechanism with measures of corruption and estimates of the HIV prevalence and the number of AIDS deaths in each year and in each country. Countries with higher levels of corruption experience a significantly smaller drop in AIDS deaths as a result of the same quantity of ARVs imported. This is robust to different measures of corruption and to a measure of overall death rates as well as HIV-specific death rates as the outcome. A case-study analysis of the Kenyan experience illustrates one potential mechanism for the observed effect, demonstrating that disproportionately more clinics begin distributing ARVs in areas that are predominantly represented by the new leader's ethnic group.
- Topic:
- World Trade Organization
- Political Geography:
- Kenya and Africa
114. The Face of African Infrastructure: Service Availability and Citizens' Demands
- Author:
- Vijaya Ramachandran, Benjamin Leo, and Robert Morello
- Publication Date:
- 02-2015
- Content Type:
- Working Paper
- Institution:
- Center for Global Development
- Abstract:
- The need for infrastructure improvements is a top-tier economic, political, and social issue in nearly every African country. Although the academic and policy literature is extensive in terms of estimating the impact of infrastructure deficits on economic and social indicators, very few studies have examined citizen demands for infrastructure. In this paper, we draw upon survey data to move beyond topline estimates of national infrastructure access rates towards a more nuanced understanding of service availability and citizen demands at the regional, national, and sub-national level. We find a predictable pattern of infrastructure services across income levels—lower income countries have fewer services. The survey data also allows us to observe the sequencing of infrastructure services. On the demand side, survey respondents are most concerned with jobs and income-related issues, as well as with the availability of infrastructure: specifically transportation and sanitation. These priorities transcend demographic factors, including gender and location (urban/rural).
- Topic:
- Health
- Political Geography:
- Africa
115. Aligning Incentives, Accelerating Impact
- Author:
- Rachel Silverman, Mead Over, and Sebastian Bauhoff
- Publication Date:
- 12-2015
- Content Type:
- Special Report
- Institution:
- Center for Global Development
- Abstract:
- Founded in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is one of the world’s largest multilateral health funders, disbursing $3–$4 billion a year across 100-plus countries. Many of these countries rely on Global Fund monies to finance their respective disease responses—and for their citizens, the efficient and effective use of Global Fund monies can be the difference between life and death. Many researchers and policymakers have hypothesized that models tying grant payments to achieved and verified results—referred to in this report as next generation financing models—offer an opportunity for the Global Fund to push forward its strategic interests and accelerate the impact of its investments. Free from year-to-year disbursement pressure (like government agencies) and rigid allocation policies (like the World Bank’s International Development Association), the Global Fund is also uniquely equipped to push forward innovative financing models. But despite interest, the how of new grant designs remains a challenge. Realizing their potential requires technical know-how and careful, strategic decisionmaking that responds to specific country and epidemiological contexts—all with little evidence or experience to guide the way. This report thus addresses the how of next generation financing models—that is, the concrete steps needed to change the basis of payment from expenses to something else: outputs, outcomes, or impact. For example, when and why is changing the basis of payment a good idea? What are the right indicators and results to purchase from grantees? How much and how should grantees be remunerated for their achievements? How can the Global Fund verify that the basis of payment is sound—that the reported results are accurate and reliable and represent real progress against disease control goals? And what is needed to protect communities against coercion or other human rights abuses, ensuring that these new incentives do not drive unintended consequences?
- Topic:
- International Trade and Finance and Global Political Economy
- Political Geography:
- Global Focus
116. Power to the States: Making Fiscal Transfers Work for Better Health
- Author:
- Center for Global Development
- Publication Date:
- 12-2015
- Content Type:
- Special Report
- Institution:
- Center for Global Development
- Abstract:
- Most money and responsibility for health in large federal countries like India rests with subnational governments — states, provinces, districts, and municipalities. The policies and spending at the subnational level affect the pace, scale, and equity of health improvements in countries that account for much of the world’s disease burden: India, Indonesia, Nigeria, and Pakistan. Fiscal transfers between levels of government can — but do not always — play an important role in turning money into outcomes at the subnational level. Well designed, transfers can help put states on a level financial playing field by equalizing spending across states and adjusting allocations for the health risks of each state’s population. Transfers can increase accountability and create incentives for greater spending or effectiveness in service delivery. But transfers are rarely designed with attention to their desired outcomes. To get to better outcomes, international experience suggests that transfers need to be reexamined and reformed along three dimensions. First, central government’s allocation of national revenues to subnational governments should respond to needs and population size. Second, transfers should generate incentives to improve subnational governments’ spending quality and performance on outcomes. Third, independent systems to monitor, evaluate, and provide feedback data on subnational performance can generate greater accountability to the central government, parliaments, and legislatures as well as to citizens. These insights are seemingly simple and suggestive, but each country starts from its own unique history that requires careful technical analysis and political savvy to define reforms with genuine potential to improve health.
- Topic:
- International Political Economy, International Trade and Finance, and Financial Markets
- Political Geography:
- Global Focus
117. Better Hospitals, Better Health Systems, Better Health – A Proposal for a Global Hospital Collaborative for Emerging Economies
- Author:
- Center for Global Development
- Publication Date:
- 11-2015
- Content Type:
- Special Report
- Institution:
- Center for Global Development
- Abstract:
- Hospitals are central to building and maintaining healthy populations around the world. They serve as the first point of care for many, offer access to specialized care, act as loci for medical education and research, and influence standards for national health systems at large. Yet despite their centrality within health systems, hospitals have been sidelined to the periphery of the global health agenda as scarce financial resources, technical expertise, and political will instead focus on the expansion of accessible primary care. As a result, many hospitals in low- and middle-income countries have failed to evolve and modernize, both in operations and infrastructure, while the knowledge base on hospital effectiveness and efficiency remains small and inadequate. In turn, the standard of care and efficiency achieved by these hospitals has stagnated. The gap in treatment capacity and quality between wealthier and poorer countries—and between hospitals serving wealthier and poorer populations—is widening, just as emerging economies are poised to expand the range and depth of healthcare through universal health coverage.
- Topic:
- World Health Organization and Health Care Policy
- Political Geography:
- Global Focus