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1. Economic Dimensions of Personalized and Precision Medicine in Asia: Evidence from Breast Cancer Treatment in Taiwan

Author:
Jui-fen Rachel Lu and Karen Eggleston
Publication Date:
04-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
High costs of precision medicine raise concerns about exacerbating income-related disparities in healthcare utilization and health outcomes. One approach to expanding coverage in Asia has been to cover the precision therapy but require the pharmaceutical firm to cover the costs of the companion diagnostic test. Taiwan’s National Health Insurance (NHI) adopted this approach for lung cancer, colorectal cancer and leukemia, but not for the first target therapy covered by NHI, trastuzumab for the treatment of HER2-positive breast cancer. Analyzing a unique dataset linking medical claims, cancer registry data and proxies for income between 2004 and 2015, we find that lower-income patients are more likely to be diagnosed with later stages of breast cancer, and this pattern renders NHI coverage of anti-HER2 therapy pro-poor even before full coverage of the diagnostic tests. Moreover, the expansion of NHI coverage—including the FISH diagnostic test and trastuzumab for early-stage breast cancer—strengthened the pro-poor distribution of genetic testing and target treatment, albeit only marginally. The extent of pharmaceutical company coverage of testing and its impact on patient access are topics of our ongoing research, contrasting breast cancer with colorectal cancer.
Topic:
Health, Health Care Policy, Economic Inequality, and Medicine
Political Geography:
Taiwan and Asia

2. Towards a More Equal Indonesia: How the government can take action to close the gap between the richest and the rest

Author:
Luke Gibson
Publication Date:
02-2017
Content Type:
Commentary and Analysis
Institution:
Oxfam Publishing
Abstract:
The gap between the richest and the rest in Indonesia has grown faster in the past two decades than in any other country in South-East Asia. The four richest men in Indonesia now have more wealth than the poorest 100 million people. Inequality is slowing down poverty reduction, dampening economic growth and threatening social cohesion. President Jokowi has made fighting inequality his administration's top priority for 2017. This report shows how he could achieve this by enforcing a living wage for all workers, increasing spending on public services, and making big corporations and rich individuals pay their fair share of tax.
Topic:
Inequality, Economic Inequality, Social Cohesion, and Elites
Political Geography:
Indonesia, Asia, and Southeast Asia

3. Empowering Grassroots Women Through Transformational Partnerships in Agricultural Value Chains

Author:
Mark Vincent Aranas
Publication Date:
09-2017
Content Type:
Working Paper
Institution:
Oxfam Publishing
Abstract:
The Gender Transformative and Responsible Agribusiness Investments in South East Asia (GRAISEA) programme works to promote women’s economic empowerment in agricultural value chains. The agricultural sector is heavily reliant on women workers, but these women do not have equal access to resources – only 12 percent of the three million landowners in Asia are women, for example. Together with the Institute for Social Enterprise for Asia and its partners, GRAISEA documented the stories of women who have been empowered by partnerships in the Philippines and Thailand. This case study tells their stories and presents a set of benchmarks for how transformational partnerships can be implemented in agricultural value chains.
Topic:
Agriculture, Gender Issues, Economic Inequality, Fishing, and Empowerment
Political Geography:
Asia and South East Asia

4. For Richer or Poorer: The capture of growth and politics in emerging economies

Author:
Alice Krozer
Publication Date:
09-2015
Content Type:
Working Paper
Institution:
Oxfam Publishing
Abstract:
The emerging economies Brazil, China, India, Indonesia, Mexico, Russia, South Africa and Turkey - in short, the BRICSAMIT - have come to be considered the economic powerhouses of recent decades. Not only have these countries managed to reduce poverty; most have embarked on a steep economic growth path and play an increasingly influential role on the global scene. But today, all eight BRICSAMIT countries occupy the top ranks as some of the most unequal countries in the world. The price these countries - and millions of their citizens - pay for this is high. Excessive inequality hampers development prospects: negatively impacting growth potential, threatening poverty reduction, leading to mass migration flows and 'brain drain', and reducing opportunities for young people. This report, which was commissioned by civil society networks across the BRICSAMIT countries, aims to increase the urgency to tackle the structural causes of inequality by shedding light on the nature and scope of the issue in the BRICSAMIT, and the economic, political and social consequences these countries are now facing as a result.
Topic:
International Cooperation, Migration, Poverty, and Economic Inequality
Political Geography:
Africa, Russia, China, Europe, Indonesia, Turkey, Asia, South Africa, Brazil, South America, and Mexico

5. The Asian Financial Crisis, Uphill Flow of Capital, and Global Imbalances: Evidence from A Micro Study

Author:
Brahima Coulibaly and Jonathan Millar
Publication Date:
08-2008
Content Type:
Working Paper
Institution:
Board of Governors of the Federal Reserve System
Abstract:
This study assesses the role of the Asian Önancial crisis of the late 1990s in the emergence and persistence of the large current account surpluses across non-China emerging Asia, which have been a signiÖcant counterpart to the U.S. current account deÖcit. Using panel data encompassing nearly 3,750 Örms, we trace the current account surpluses to a marked and broad-based decline in corporate expenditures on Öxed investment in the aftermath of the crisis that cuts across a wide spectrum of countries, industries, and Örms. The lower corporate spending in turn depressed aggregate investment rates, widened the saving-investment gap, and allowed the region to turn into a net exporter of capital. We then consider the factors behind this reduction in postcrisis corporate investment. While weaker Örm-level fundamentals in the postcrisis period seem to explain part of the drop in investment rates, ongoing re-structuring owing to large debts accumulated and excess investment undertaken in the run-up to the crisis has been the main source of restraint postcrisis corporate investment. The results suggest that even after a decade, the e§ect of the Önancial crisis is still a§ecting corporate investment decisions in emerging Asia, and that as the restructuring completes its course, investment rates will likely rise to contribute to a gradual reduction in the regionís current account surpluses.
Topic:
Emerging Markets, Financial Crisis, Economic Inequality, and Investment
Political Geography:
Asia

6. Globalisation and Labour Markets Policy Issues Arising from the Emergence of China and India

Author:
David T. Coe
Publication Date:
11-2007
Content Type:
Working Paper
Institution:
The Organisation for Economic Co-operation and Development
Abstract:
Globalisation is having important effects on labour markets in OECD countries. The global supply of labour has increased enormously with the emergence of China and India. At the same time technological advances have contributed to heightened income inequality and changed the nature of globalisation itself, most vividly demonstrated by the rapid growth of offshoring of business services that were previously nontradable. It is argued in this paper that these developments are best characterized as an intensification and broadening of the process of globalisation rather than a fundamental change in the nature of globalisation. They will, nevertheless, have long-lasting effects on OECD labour markets, increasing the urgency of implementing the labour market policies set out in the Restated OECD Job Strategy. The paper concludes that the most important implication of the emergence of China and India in the context of widespread perceptions of increasing economic inequality may be to reduce support for globalisation in OECD countries.
Topic:
Globalization, Labor Issues, Economic Inequality, and Labor Market
Political Geography:
China, India, and Asia