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1271. Global Immunization and Gavi: Five Priorities for the Next Five Years

Author:
Amanda Glassman, Cordelia Kenney, and Janeen Madan Keller
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Child vaccination remains among the most cost-effective uses of public and aid monies.[1] In a highly contested funding environment where priorities must be set for the allocation of scarce concessional resources, investment in expanding the availability and coverage of cost-effective vaccination must come at the top of the list. Gavi’s mission—saving children’s lives and protecting people’s health by increasing equitable use of vaccines—remains highly relevant. Gavi and its partners have made enormous progress towards increasing equity in the introduction of vaccines; children living in the lowest-income countries now have access to the same set of vaccines as those living in high-income countries. Gavi and partners have also contributed to increased coverage; immunization rates are higher in Burundi and Rwanda, for example, than in many places in the United States and Europe. Yet the effects of under-immunization anywhere can have global implications everywhere, as recent outbreaks illustrate. New or dormant threats are also a new reality—newly vaccine-preventable diseases like Ebola or virulent flu strains can spread swiftly and lethally in an interconnected world.
Topic:
Health, Public Health, Vaccine, and Immunization
Political Geography:
Global Focus

1272. Digital Governance: Is Krishna a Glimpse of the Future?

Author:
Arshi Aadil, Alan Gelb, Anurodh Giri, and Kyle Navis
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The state of Andhra Pradesh is recognized as a leader in using technology to improve the delivery of public services, programs and subsidies. Many of its innovations were piloted in Krishna District, which has been visited by development agencies and delegations from many countries. This paper reports on research to better understand the functioning and effectiveness of its reforms to strengthen state capacity by digitalizing service delivery. Against the wider backdrop of the use of Aadhaar in India, it summarizes Andhra’s reforms, which go beyond those of most other jurisdictions in the measures taken to strengthen accountability, offer choice of service provider, and incorporate feedback loops using the vast amount of data generated by a real-time digital service system as well as beneficiary responses. It reports the results from surveys of beneficiaries who receive food rations through the Public Distribution System (PDS) and/or pensions, and on the response of landowners and tenant farmers to the digitization of land records, another important program. The results suggest strong support for the digitalization of these programs. The way in which the reforms have been implemented has indeed led to substantial improvements in delivery (as seen by beneficiaries) as well as, probably, significant fiscal savings. Is this case, then, a model for other Indian states and for other countries? Perhaps yes from a technology perspective; there are many lessons that apply to a wide range of programs and services and that others can usefully draw on. The picture is more complex from a political economy perspective, as suggested by some of the particular features of Andhra.
Topic:
Science and Technology, Governance, Reform, and Digitization
Political Geography:
Global Focus

1273. Transforming the Institutional Landscape in Sub-Saharan Africa: Considerations for Leveraging Africa’s Research Capacity to Achieve Socioeconomic Development

Author:
Alex Ezeh and Jessie Lu
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
In order to achieve sustainable development outcomes in sub-Saharan Africa (SSA), African institutions must be the leading experts on and primary providers of research solutions to local problems. Despite years of investment in capacity building, SSA lags behind every other region in terms of research outputs and government investments, and new models for building institutional capacity are needed. Through interviews with African institutional leaders and development partners working in SSA, this study finds that funding inefficiencies lead to key challenges within institutions’ governance and management structures, financial systems, talent management processes, leadership and institutional vision capacities, and peer support networks, all of which obstruct the ability of African institutions to become impactful and sustainable drivers of development outcomes in the region. We present for consideration three possible innovative models that can facilitate the emergence of strong Africa-based, Africa-led institutions: a multi-stakeholder funding platform, an integrator organization model, and a scale model.
Topic:
Development, Research, Sustainability, and Socioeconomics
Political Geography:
Africa and Sub-Saharan Africa

1274. Creating Opportunities for Rohingya Refugees and Hosts Through Forest Landscape Restoration

Author:
Heather Tallis, Cindy Huang, John Herbohn, Karen Holl, Sharif A. Mukul, and Kam Morshed
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Rohingya refugees began arriving in Bangladesh in August 2017, fleeing atrocities deemed serious crimes under international law by United Nations investigators. Over 740,000 new refugees have settled in two camps in Cox’s Bazar district of Chittagong: Kutupalong-Bulukhali and Naypara-Leda. The number of Rohingya in Cox’s Bazar now stands at around one million, comprising about 30 percent of the population. Kutupalong-Bulukhali is now the largest refugee camp in the world. The influx of Rohingya into Cox’s Bazar has exacerbated deforestation, underdevelopment, and climate vulnerability. Combined, these factors create an urgent need for new strategies and resources to address the increasing stress placed on the environment, and the consequences of this stress for refugee and host communities.
Topic:
Environment, Genocide, Refugees, Humanitarian Crisis, and Forest
Political Geography:
Myanmar

1275. Tackling the Triple Transition in Global Health Procurement

Author:
Rachel Silverman, Janeen Madan Keller, Amanda Glassman, and Kalipso Chalkidou
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive. Access to medicines, diagnostics, devices, and equipment is driven in large part by the efficiency of their procurement. Procurement is, therefore, central to the efforts of low- and middle-income countries to improve health, meet the Sustainable Development Goals, and achieve universal health coverage. Health product purchasing in low- and lower-middle-income countries already makes up a sizeable share of overall health spending; in fact, in just a subset of these countries, spending on health products totals an estimated $50 billion per year.[1] Procurement is not only essential to the missions of global health entities like the Global Fund, Gavi, UNICEF, UNFPA, and PEPFAR, but it also represents big money. In the case of the Global Fund, health product procurement accounts for $2 billion per year,[2] or almost half of its 2017 disbursements.[3] Yet despite its importance, procurement is an underappreciated health system function. Today’s procurement systems are hobbled by inefficiencies that leave some of the poorest countries paying some of the highest drug prices in the world.
Topic:
Health, Public Health, Transition, and Procurement
Political Geography:
Global Focus

1276. Fuel Subsidy Reform and Green Taxes: Can Digital Technologies Improve State Capacity and Effectiveness?

Author:
Alan Gelb and Anit Mukherjee
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Reforming inefficient and inequitable energy subsidies continues to be an important priority for policymakers as does instituting “green taxes” to reduce carbon emissions. Simply increasing energy prices will have adverse impact on poorer consumers, who may spend substantial budget shares on energy and energy-intensive products even though the rich typically appropriate more of the price subsidy. Equitable pricing reforms therefore need to be accompanied by programs to transfer compensation: depending on the situation, this can be targeted or universal. Successful reforms require measures to raise awareness-of the subsidies and the problems they cause, effective dissemination of the reform to the population, and rapid feedback loops to facilitate mid-course corrections. Digital technology, including for unique identification and payments, as well as general communications, can help build government capacity to undertake such reforms and respond to changes in fuel markets. The paper outlines the use of digital technology, drawing on four country cases. The technology is only a mechanism; it does not, in itself, create the political drive and constituency to push reform forward. However, it can be employed in a number of ways to increase the prospects for successful and sustainable reform.
Topic:
Climate Change, Energy Policy, Environment, Science and Technology, Reform, and Digitalization
Political Geography:
Africa, Middle East, India, and Latin America

1277. Maximizing the Shared Benefits of Legal Migration Pathways: Lessons from Germany’s Skills Partnerships

Author:
Michael Clemens, Helen Dempster, and Kate Gough
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The world is experiencing significant demographic shifts. By 2100, Europe’s working-age population will have declined, and sub-Saharan Africa’s working-age population will have greatly increased. Many of these new labor market entrants will seek opportunities in Europe, plugging skill gaps and contributing to economies in their countries of destination. Germany is one country piloting and implementing projects that can help alleviate such demographic pressures and maximize the potential mutual benefits of legal labor migration. We discuss these projects, and highlight differences in their potential impact on development in the country of origin. We recommend that European governments build on, adapt, and pilot-test one of Germany’s approaches, also known as the Global Skill Partnership model: training potential migrants in their countries of origin before migration, along with non-migrants. Ideally, governments should pursue such pilot-tests with those countries that exhibit rising future migration pressure to Europe, particularly in sub-Saharan Africa. Neither the conclusion nor the results of this analysis reflect the opinion of the Federal Ministry of Economic Cooperation and Development (BMZ) or Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ).
Topic:
Migration, Labor Issues, Immigration, and Border Control
Political Geography:
Africa, Europe, Germany, and Sub-Saharan Africa

1278. What We Learn about Girls’ Education from Interventions that Do Not Focus on Girls

Author:
David Evans and Fei Yuan
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Despite dramatic global gains in access to education, 130 million girls of school age remain out of school. Among those who do enter, too many do not gain the essential skills to succeed after they complete their schooling. Previous efforts to synthesize evidence on how to improve educational outcomes for girls have tended to focus on interventions that are principally targeted to girls, such as girls’ latrines or girls’ scholarships. But if general, non-targeted interventions—those that benefit both girls and boys—significantly improve girls’ education, then focusing only on girl-targeted interventions may miss some of the best investments for improving educational opportunities for girls in absolute terms. This review brings together evidence from 270 educational interventions from 177 studies in 54 low- and middle-income countries and identifies their impacts on girls, regardless of whether the interventions specifically target girls. The review finds that to improve access and learning, general interventions deliver gains for girls that are comparable to girl-targeted interventions. At the same time, many more general interventions have been tested, providing a broader menu of options for policy makers. General interventions have similar impacts for girls as for boys. Many of the most effective interventions to improve access for girls are household-based (such as cash transfer programs), and many of the most effective interventions to improve learning for girls involve improving the pedagogy of teachers. Girl-targeted interventions may make the most sense when addressing constraints that are unique to girls.
Topic:
Education, Children, Women, and Feminism
Political Geography:
Global Focus

1279. Supply and Demand in a Time of Changing Geopolitics and a Changing Climate

Author:
Aspen Institute
Publication Date:
01-2019
Content Type:
Working Paper
Institution:
Aspen Institute
Abstract:
The Forum on Global Energy, Economy & Security is an annual conversation to discuss global energy markets, crude oil, petroleum products and natural gas supply and demand, midstream, shale development, geopolitics, energy security, and environmental topics. The forum features Aspen’s time-honored moderated roundtable discussion format which, while each session is introduced by brief presentations, stresses dialogue between participants rather than conference-style speaker presentations with question and answer only. The forum is enhanced by an informal atmosphere and a not-for-attribution rule that encourages new thinking, dissenting opinions, and frank discussion.
Topic:
Climate Change, Energy Policy, Environment, Natural Resources, and Renewable Energy
Political Geography:
Global Focus

1280. NextGen Network Key Takeaways: Prague, Czech Republic

Author:
Aspen Institute
Publication Date:
03-2019
Content Type:
Working Paper
Institution:
Aspen Institute
Abstract:
Aspen Central Europe hosted the Network in Prague in January 2019, with participants from Hungary, Poland, Slovakia, and the Czech Republic. Participants emphasized that there should be a focus on mapping where exactly AI can support existing professions, create new ones, but most importantly streamline the education system towards current trends and lifelong learning. It is essential to speed up the adoption of AI in Europe, as well as connect it with major challenges in society, such as tackling climate change or innovating healthcare, where, for example, AI can be explained by its promoters as a way of delivering better services rather than merely introducing a new technology.
Topic:
Climate Change, Science and Technology, Health Care Policy, and Artificial Intelligence
Political Geography:
Europe, Czech Republic, and Central Europe