WORKING PAPER 18 - February 8, 2020
KEYWORDS: Ethiopia, health financing, aid, resource mobilization, Sub-Saharan Africa
In this paper, we discuss Ethiopia’s approach to health delivery, trends in health financing trends, focusing on the financing arrangements and expenditure management systems through which health funding is allocated from various internal and external sources. The paper reviews Ethiopia’s public financial management system to identify challenges and opportunities to improve domestic resource mobilization for health and resource allocation within the health sector. With the imminent transition away from external donor support that Ethiopia faces due to economic growth, the paper explores the sources of fiscal space for health in Ethiopia to sustain progress in the health sector through a deep dive of the sources of health financing through tax and non-tax revenues, additional borrowing, future aid prospects, and better fiscal discipline and expenditure efficiency.
WORKING PAPER 17 - January 28, 2020
KEYWORDS: middle income trap, economic growth, creative destruction
Since we coined the term in 2006, “the middle income trap” has been the subject of scores of investigations. The investigators have generally tried to answer one of two questions: Is there evidence to support the existence of the trap, and what can middle-income countries do to spring free of it? The evidence in support of its existence has been mixed, and the policy discussions have—to put it bluntly—been largely unhelpful. But our original proposition was that of the possibility of a trap, not its inevitability. We were more convinced of the absence of a functional theory of economic growth for middle-income economies. Solow-Swan models that stressed capital accumulation and exogenous technological change did well to explain growth in low-income countries, and Lucas-Romer models emphasizing learning and endogenous technical change identified the main drivers of growth in advanced economies and explained why capital and knowhow did not easily flow to poorer economies. Neither class of models has, to our knowledge, satisfactorily explained successful transitions from one type of growth to the other. In this paper, we propose that Schumpeterian models proposed by Aghion, Howitt and others that stress creative destruction and institutional change could provide the analytical foundations for understanding middle-income economies better. We present evidence that is consistent with the main predictions of this approach, and discuss its key policy implications, especially effective competition regimes, mechanisms to maintain social mobility, and adept management of economic crises.
WORKING PAPER 16 - January 13, 2020
KEYWORDS: Networks, Social Capital, Community Participation, Local Governance, India
Social networks and social capital have been a central discussion point for academicians and policy makers alike since last few decades. Intersecting literature on networks and applied areas stresses upon homophily effect operating through social categories of gender, caste and occupation play a crucial role in individual behaviour across health and related networks in the society. On the other hand, literature talks of social capital playing a vital role for the individual and collective society in various spheres of their lives. This empirical research triangulates the theories of social capital, social networks and community participation to study the role of networks in community participation in the context of local governance in rural society. We use indicators such as household network size as proxy to social capital, attendance and vocal participation as proxy to community participation while using the popular network concepts of peer-effect and homophily effect through logit models to assess the role of network-based social capital in community participation.
WORKING PAPER 15 - September 6, 2019
KEYWORDS: Global Public Goods, International Collective Action for Health, Global Action Plan, Aid for Health, World Health Organization, World Bank Group, Gavi, Vaccine Alliance, Global Fund to Fight AIDS, Tuberculosis, Malaria
Twelve multilateral health and development organizations have signed on to a joint Global Action Plan for Healthy Lives and Well-being for All (the Global Action Plan). The Global Action Plan includes a call for signatory organizations to align efforts to strengthen the provision of global public goods (GPGs) for health. In this paper, we examined multilateral support for GPGs for health, focusing on the four largest multilateral health organizations — Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Bank; and the World Health Organization. Our analysis aimed to understand how these organizations define GPGs for health and support such goods. Taking a cross-cutting view of the four organizations, it also aimed to lay out the steps these organizations could take to align their support for GPGs for health to deliver on the Global Action Plan.
To conduct this analysis, we conducted a desk-based review including relevant academic and grey literature, strategy and finance documents, and grants and projects databases. We also conducted 46 key informant interviews with senior leadership among these organizations as well as individuals from think tanks and academia who have expertise in GPGs for health and/or our multilateral agencies of focus.
Overall, we found that these four organizations lack an explicit GPGs for health strategy and they do not use a common definition of GPGs for health. All four are supporting GPGs for health in some form, through a variety of mechanisms, and it would be valuable to assess which of these are working the most effectively. A long-term, sustained financing mechanism for GPGs for health, and an overarching governance mechanism, will ultimately be needed.
WORKING PAPER 14 - December 16, 2019
KEYWORDS: BRI, imperialism, Chinese Tribute Order, soft power, imperialism of nation-states, debt, environment
I seek to grasp the genealogy of China’s Belt and Road (BRI) in relation both to the imperial Chinese world order and the historical sequence of forms of global domination, i.e., modern imperialism, the ‘imperialism of nation-states’ during the inter-war and Cold War period as well as the post-Cold War notion of ‘soft power’. While we may think of BRI as poised uncertainly between the logics of the older imperial Chinese order and the more recent logic impelled by capitalist nation-states, there are significant novelties in the new Chinese order, mostly in relation to debt, the environment and digital technology which constitute new realms of power not easily dominated by a hegemon.
WORKING PAPER 13 - September 6, 2019
KEYWORDS: Lebensraum, Mahan, Ratzel, realism, Semple, Reinsch, Treitschke, Turner, Weltpolitik, world power, world politics
Beginning in the 1890s as US political elites began to think of the US as a “world power” or “great power” — a status that was considered distinct from a merely continental or hemispheric one. There is evidence for this in the writings of academic intellectuals such as the political scientist Paul Reinsch, the geographer Ellen Churchill Semple, and the historian and publicist Alfred Mahan, as well in the political rhetoric employed by politicians such as Henry Cabot Lodge and Theodore Roosevelt. This semantic and ideological shift in the self-image of the United States has its parallel in similar processes at work in Germany in the 1890s. At that time, German imperialism, long focused on the continent, began to develop a navally-oriented Weltpolitik around which intellectuals elaborated a discourse on the requirements of national greatness and “world empire.” This essay argues that the roots of the American foreign policy realism of the 1930s and 40s can be traced to this transatlantic moment.
WORKING PAPER 12 - September 6, 2019
KEYWORDS: realism, New International Economic Order (NIEO), utopianism, Global North, Global South
Not so long ago, an alternative to American hegemony and progressive isolationism was elaborated by non-aligned segments of the international left. In the search for potentially usable models from the past, this paper will shed light on the New International Economic Order (NIEO). Promulgated as a United Nations resolution in 1974, and drafted by leaders in the Global South, the NIEO was one of the most widely discussed transnational governance reforms of the twentieth century. This paper will argue that the NIEO was an exercise in utopian realism that fundamentally depended on foregrounding the global security dilemma and defending the legitimacy and lasting utility nation-state. As a result of these commitments, the NIEO's proponents unwittingly self-limited their chances for long-term success on the international stage.
WORKING PAPER 11 - September 12, 2019
KEYWORDS: Aron, Kennan, Morgenthau, neoconservatism, political realism
What are the politics of political realism? This paper tries to answer the question by showing the political differences that emerged between the doyens of IR realism theory—Raymond Aron, Hans Morgenthau and George Kennan—during the 1970s. It argues that the Vietnam War and differing perceptions of American military power in the 1970s led these elder statesmen of IR realism theory into myriad political directions. Perhaps the best way to understand the nature of IR realist thought, then, is to focus not just on the theories that inspire political realism, but its diverse political applications, which, in the case of Aron, Morgenthau and Kennan, led to wide-ranging ways of thinking about what the role of the US in the world should be. If we make this move, we would see that Aron, the supposed embodiment of liberal moderation, became by the 1970s the most reactionary or militarist of the elder generation of IR realists.
WORKING PAPER 10 - September 6, 2019
KEYWORDS: Morgenthau, International Relations Theory, realism, World Government
Prominent mid-century classical realists (e.g., E.H. Carr, John Herz, Hans J. Morgenthau) married identifiably realist ideas about international relations to left-liberal (and progressive) political sympathies, in some cases advocating a fundamental reorganization of the interstate system along globalist institutional lines. Although the history of international ideas clearly suggests the possibility of a progressive realist synthesis, legitimate questions can still be raised about its overall theoretical coherence.
WORKING PAPER 09 - July 22, 2019
KEYWORDS: Africa, debt, public debt, government
Since 2014, almost all African countries have experienced an increase in public debt and a change in its nature. The ratio of public debt to GDP has doubled, and sovereign debt is changing from concessional credit provided by official agencies to market-based loans from private institutions. This paper attempts to answer three questions that are being asked with increasing urgency to avoid another debt crisis. First, has the quality of institutions and policies of African countries, critical to sustaining higher levels of debt, improved since the debt relief of the early 2000s? Second, will debt markets get to know emerging Africa well enough before the next crisis? Third, have the resolutions of recent defaults in Africa been orderly so that debtor governments are not herded into traps set by foreign creditors? Our calculations suggest that the answer to all three questions is ‘no’. To avoid another debt crisis, the paper recommends preventive measures that involve full transparency in debt accounting, greater realism in growth forecasts, and diligence in matching the region’s seemingly limitless public investment needs with weak public sector capacity to manage infrastructure investments. More specifically, we recommend that as a rule African governments treat increases in commodity prices as temporary — not permanent — shocks; that in deciding how to finance public investment, governments compare the marginal cost of funds from taxation with market terms of borrowing; and that governments avoid financing long-term infrastructure projects with short-term money from abroad.