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Economic development, institutional analysis, health systems, corruption, evaluation
Bill Savedoff was a senior fellow at the Center for Global Development where he works on issues of aid effectiveness and health policy. His current research focuses on the use of performance payments in aid programs and problems posed by corruption. At the Center, Savedoff played a leading role in the Evaluation Gap Initiative and co-authored Cash on Delivery Aid with Nancy Birdsall. Before joining the Center, Savedoff prepared, coordinated, and advised development projects in Latin America, Africa and Asia for the Inter-American Development Bank and the World Health Organization. As a Senior Partner at Social Insight, Savedoff worked for clients including the National Institutes of Health, Transparency International, and the World Bank. He has published books and articles on labor markets, health, education, water, and housing including “What Should a Country Spend on Health?,” Governing Mandatory Health Insurance, and Diagnosis Corruption.
Health technologies can reduce healthcare spending. On average, they don’t. Prominent examples—like the way polio vaccines eliminated the need for iron lungs—seem to drive a common faith in healthcare technology as a tool to “cure” costly health systems. But it actually works the other way around—health systems (policies, institutions, and markets) and human responses to them determine whether these tools will (or won’t) increase spending.
When the UN adopted the Sustainable Development Goals (SDGs) in 2015, they were met with a mix of hope, dismay, and derision. Until we see how people respond to these goals, judgments about their specificity, complexity, and usefulness are educated guesses. At a workshop last month, I got a glimpse of two ways the SDGs may be making a difference—focusing political attention and reorganizing aid relationships.
Last November, the IMF released a workable guide to issues that come up when a country decides to raise tobacco taxes. This is a big step. As far as I know, this is the first public statement from the IMF on tobacco taxes since 1999. Yet while it recognizes the health effects of reducing tobacco consumption, the technical note never addresses how you would make sure that tobacco taxes reduce smoking.
When people hear that a foreign aid program is paying for results, they can think about it in two very different ways. Some people think that paying for results is a way to control recipients, making them more strictly accountable to the people or organizations that are paying them. Others think that paying for results is a way to give recipients more autonomy and encourage them to be accountable to their beneficiaries (in the case of service providers) or their constituents (in the case of governments). It turns out that both perspectives are right—depending on just how the program that pays for results is designed.
In 2016 on the CGD Podcast, we have discussed some of development's biggest questions: How do we pay for development? How do we measure the sustainable development goals (SDGs)? What should we do about refugees and migrants? And is there life yet in the notion of globalism? The links to all the full podcasts featured and the work they reference are below, but in this edition, we bring you highlights of some of those conversations.
In 2006, CGD published a working group report that addressed the insufficient number of rigorous impact evaluations of social programs in low- and middle-income countries. Last week —marking 10 years since the report’s release—CGD and J-PAL co-hosted the event, “Improving Development Policy through Impact Evaluation,” which echoed three key messages of the 2006 report: 1) conduct more and better evaluations; 2) connect evaluators and policymakers; and 3) recognize that impact evaluations are an important global public good that requires more unconstrained funding.
Aid agencies are investing more in energy projects than ever before, but will they succeed? Not if they ignore the key obstacle to progress: governments that choose the status quo over serious reforms.
Are pay-for-performance aid programs such as Cash on Delivery Aid more vulnerable to corruption than traditional input-focused programs? My guests this week, senior fellows William Savedoff and Charles Kenny, argue in a new new working paper and brief that the opposite is true.
This paper briefly assesses the Health Systems Funding Platform and finds that its progress differs little from prior initiatives, although it does present an opportunity to make global health aid more effective.
In recent years, the interdisciplinary nature of global health has blurred the lines between medicine and social science. As medical journals publish non-experimental research articles on social policies or macro-level interventions, controversies have arisen when social scientists have criticized the rigor and quality of medical journal articles.
Corruption is an obstacle to social and economic progress in developing countries yet we still know very little about the effectiveness of anti-corruption efforts and their impact on development impact. This essay looks at 25 years of efforts by foreign aid agencies to combat corruption and proposes a new strategy which could leverage existing approaches by directly incorporating information on development results.
When we make presentations on COD AIDat development agencies, we are frequently told: “Oh, we’re already doing that.” The more we investigate, however, the fewer cases we find where agencies are really disbursing funds against independently verified outcomes in a hands-off fashion. We’re tempted to say “close but no cigar.”
With the US Congress considering cuts to foreign assistance and aid budgets in other donor countries coming under increased pressure, evidence about what works in global development is more important than ever. Evidence should inform decisions on where to allocate scarce resources—but to do so, evaluations must be of good quality.