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111. Achieving an AIDS Transition: Preventing Infections to Sustain Treatment

Author:
Mead Over
Publication Date:
11-2011
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
An unprecedented surge in donor support for HIV/AIDS treatment over the last decade has lengthened and improved the lives of millions of people living with HIV/AIDS. But because the rate of new infections outpaces the rate of AIDS-related deaths, the number of people living with AIDS—and therefore the number of people needing treatment—is growing faster than the funding needed to treat them. In 2009, about 1.8 million people died from AIDS-related illnesses while about 2.6 million were newly infected with HIV, increasing the total number of people living with HIV/AIDS by more than three-quarters of a million.
Topic:
Development, Health, and Foreign Aid

112. Safer, Faster, Cheaper: Improving Clinical Trials and Regulatory Pathways to Fight Neglected Diseases

Author:
Amanda Glassman and Thomas Bollyky
Publication Date:
10-2011
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
More than a billion people suffer from neglected diseases, and millions die each year. Effective remedies have been few because of low investment, but with a surge in funding in the past decade, dozens of candidate drugs and vaccines are now in the pipeline. Before these products can reach the people who need them, they must be tested in large-scale clinical trials that are expensive, time-consuming, and risky. These trials must be conducted with highly vulnerable patients in resource-and infrastructure-poor countries where the neglected disease burden exists. There is not enough funding to support the costs and regulatory oversight of these clinical trials. A two-pronged approach to improve the quality and lower the cost of clinical trials in the developing world is needed.
Topic:
Development, Health, Poverty, and Infrastructure

113. The High Return to Private Schooling in a Low-Income Country

Author:
Tessa Bold, Mwangi Kimenyi, Germano Mwabu, and Justin Sandefur
Publication Date:
12-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Existing studies from the United States, Latin America, and Asia provide scant evidence that private schools dramatically improve academic performance relative to public schools. Using data from Kenya—a poor country with weak public institutions—we find a large effect of private schooling on test scores, equivalent to one full standard deviation. This finding is robust to endogenous sorting of more able pupils into private schools. The magnitude of the effect dwarfs the impact of any rigorously tested intervention to raise performance within public schools. Furthermore, nearly two thirds of private schools operate at lower cost than the median government school.
Topic:
Development, Education, Government, and Poverty
Political Geography:
Kenya, United States, Asia, and Latin America

114. More Money or More Development: What Have the MDGs Achieved?

Author:
Charles Kenny and Andy Sumner
Publication Date:
12-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
What have the MDGs achieved? And what might their achievements mean for any second generation of MDGs or MDGs 2.0? We argue that the MDGs may have played a role in increasing aid and that development policies beyond aid quantity have seen some limited improvement in rich countries (the evidence on policy change in poor countries is weaker). Further, there is some evidence of faster-than-expected progress improving quality of life in developing countries since the Millennium Declaration, but the contribution of the MDGs themselves in speeding that progress is—of course—difficult to demonstrate even assuming the MDGs induced policy changes after 2002. The paper concludes with reflections on what the experience of MDGs in terms of global goal setting has taught us and how things might be done differently if there were to be a new set of MDGs after 2015. Any MDGs 2.0 need targets that are set realistically and directly link aid flows to social policy change and to results.
Topic:
Development, Economics, Humanitarian Aid, Poverty, and Foreign Aid

115. Overselling Broadband: A Critique of the Recommendation of the Broadband Commission for Digital Development

Author:
Charles Kenny
Publication Date:
12-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The Broadband Commission for Digital Development is an ITU (UN International Telecommunications Union) and UNESCO–backed body set up to advocate for greater broadband access worldwide. The commission's Declaration of Broadband Inclusion for All and other reports call for governments to support ubiquitous fixed broadband access as a vital tool for economic growth and to reach the Millennium Development Goals. Examining the evidence, however, shows that the benefits of broadband are being oversold. Several points stand out: (i) the evidence for a large positive economic impact of broadband is limited; (ii) the impact of broadband rollout on achieving the MDGs would be marginal; (iii) there is little evidence ubiquitous broadband is needed for 'national competitiveness' or to benefit from opportunities like business process outsourcing; (iv) the costs of fixed universal broadband rollout dwarf available resources in developing countries; (and so) (v) the case for government subsidy of fixed broadband rollout is very weak. There are, however, some worthwhile policy reforms that could speed broadband rollout without demanding significant government expenditure.
Topic:
Development, Globalization, Science and Technology, and Communications
Political Geography:
United Nations

116. Oil to Cash: Fighting the Resource Curse through Cash Transfers

Author:
Todd Moss
Publication Date:
01-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Many of the world's poorest and most fragile states are joining the ranks of oil and gas producers. These countries face critical policy questions about managing and spending new revenue in a way that is beneficial to their people. At the same time, a growing number of developing countries have initiated cash transfers as a response to poverty, and these programs are showing some impressive results. In this paper, I propose putting these two trends together: countries seeking to manage new resource wealth should consider distributing income directly to citizens as cash transfers. Beyond serving as a powerful and proven policy intervention, cash transfers may also mitigate the corrosive effect natural resource revenue often has on governance.
Topic:
Development, Energy Policy, Oil, Poverty, and Natural Resources

117. Where Have All the Donors Gone? Scarce Donor Funding for Non-Communicable Diseases

Author:
Rachel Nugent and Andrea B. Feigl
Publication Date:
01-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Health conditions in developing countries are becoming more like those in developed countries, with non-communicable diseases (NCDs) predominating and infectious diseases declining. The increased awareness of changing health needs, however, has not translated into significant shifts in resources or policy-level attention from international donors or governments in affected countries. Driven by changes in lifestyle related to nutrition, physical activity, and smoking, the surging burden of NCDs in poor countries portends painful choices, particularly for countries with weak health systems that are struggling to manage persistent infectious disease burdens and to protect the poor from excessive out-of-pocket expenses.
Topic:
Development, Health, Poverty, Third World, and Foreign Aid

118. Quantifying Vulnerability to Climate Change: Implications for Adaptation Assistance

Author:
David Wheeler
Publication Date:
01-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
This paper attempts a comprehensive accounting of climate change vulnerability for 233 states, ranging in size from China to Tokelau. Using the most recent evidence, it develops risk indicators for three critical problems: increasing weather-related disasters, sea-level rise, and loss of agricultural productivity. The paper embeds these indicators in a methodology for cost-effective allocation of adaptation assistance. The methodology can be applied easily and consistently to all 233 states and all three problems, or to any subset that may be of interest to particular donors. Institutional perspectives and priorities differ; the paper develops resource allocation formulas for three cases: (1) potential climate impacts alone, as measured by the three indicators; (2) case 1 adjusted for differential country vulnerability, which is affected by economic development and governance; and (3) case 2 adjusted for donor concerns related to project economics: intercountry differences in project unit costs and probabilities of project success. The paper is accompanied by an Excel database with complete data for all 233 countries. It provides two illustrative applications of the database and methodology: assistance for adaptation to sea level rise by the 20 island states that are both small and poor and general assistance to all low-income countries for adaptation to extreme weather changes, sea-level rise, and agricultural productivity loss.
Topic:
Climate Change, Development, Poverty, and Foreign Aid
Political Geography:
China

119. TrAid+ Channeling Development Assistance to Results

Author:
Alex Ergo and Ingo Puhl
Publication Date:
03-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Development assistance is meant to improve the lives of poor people in developing countries, but the effectiveness of aid in meeting this goal is uncertain. Demonstrating failure—or success—is difficult because traditional donor financing mechanisms track inputs, not results. This is compounded by poor coordination between actors and a lack of transparency, accountability, and country ownership. Development assistance that is ineffective or has unknown outcomes wastes resources, erodes the constituency for aid, and most importantly fails to improve the lives of poor people as much as it could. TrAid+ is a new mechanism that aims to address these problems by creating a market for certified development outputs—outputs for which both the delivery and the quality have been verified. By ensuring that these outputs, such as safe deliveries or gas connections, meet certain standards, trAid+ acts as a third-party stamp of approval that donors, tax payers, recipient-country governments, service providers, and beneficiaries can trust to know that their aid is being used effectively and is contributing to the development objectives of the recipient country. And trAid+ makes all information accessible online, making it easier for funders to link with projects that are working and projects that are working to link with anyone interested in purchasing certified development outputs. TrAid+ can be tailored to any sector where outputs can be clearly defined and measured, whether health, education, infrastructure, or agriculture. This paper describes the trAid+ concept in detail and proposes practical steps to establish the trAid+ platform.
Topic:
Development, Humanitarian Aid, Poverty, and Foreign Aid

120. IDA at 65: Heading Toward Retirement or a Fragile Lease on Life?

Author:
Todd Moss and Benjamin Leo
Publication Date:
03-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Even under conservative assumptions, IDA will likely face a wave of country graduations by 2025. We project that it will lose more than half of its client countries and that the total population living in IDA-eligible countries will plunge by two-thirds. The remaining IDA-eligible countries will be significantly smaller in size and overwhelmingly African, and a majority are currently considered fragile or post-conflict. This drastically altered client base will have significant implications for IDA's operational and financial models. We conclude with three possible options for IDA and recommend that World Bank shareholders and management begin frank discussions on its future sooner rather than later.
Topic:
Demographics, Development, Health, World Bank, and Health Care Policy
Political Geography:
Africa