Showing papers by "Center for Global Development published in 2013"

Participation: From Tyranny to Transformation: Exploring New Approaches to Participation in Development

Abstract: Participation is a popular approach to project implementation, policy-making and governance in both developing and developed countries. Recently, however, it has become fashionable to dismiss participation as more rhetoric than substance, and subject to manipulation by those intent on pursuing their own agendas under cover of community consent. This books seeks to rebut this simplistic conclusion. It describes and analyses new experiments in participation from a wide range of situations that show how, far from being a redundant and depoliticizing concept, participation can be linked to genuinely transformative processes and outcomes - provided that a political and not a technocratic approach is taken. It examines the recent convergence between participatory development and participatory governance, and the role of all the main actors - the state, civil society and donor agencies. It takes contemporary advances in development theory into account and proposes theoretical and practical ways forward.

Blunt Instruments: Avoiding Common Pitfalls in Identifying the Causes of Economic Growth

Abstract: Concern has intensified in recent years that many instrumental variables used in widely-cited growth regressions may be invalid, weak, or both. Attempts to remedy this general problem remain inadequate. We show how a range of published studies can offer more evidence that their results are not spurious. Key steps include: grounding growth regressions in more generalized theoretical models, deployment of new methods for estimating sensitivity to violations of exclusion restrictions, opening the “black box” of GMM with supportive evidence of instrument strength, and utilization of weak-instrument robust tests and estimators. (JEL C52, E23, F35, O41, O47) O ne of the great projects of economic research is to establish the causes of growth. Separating causes from correlates, however, is difficult. Many researchers have recently addressed this difficulty by deploying instrumental variables in cross-country datasets. This can help to identify causes of growth if the instruments do not materially affect growth through channels other than the variable of interest (the instruments are “valid”) and if the instruments correlate well with the variable of interest (the instruments are “strong”). Unfortunately, for reasons not always transparent in published studies, these instruments can be invalid, weak, or both. In this paper, we examine problems of instrument validity and strength in several growth papers recently published in general-interest and top field journals—not to single out those papers, but to concretely illustrate a general phenomenon that goes well beyond them. First, we discuss how an instrument that is plausibly valid when used in a single setting can be shown invalid by its use in additional settings. Second, we offer evidence that unacknowledged weak instruments may generate spurious findings in important applications, especially those using the popular Generalized Method

Tivozanib Versus Sorafenib As Initial Targeted Therapy for Patients With Metastatic Renal Cell Carcinoma: Results From a Phase III Trial

Abstract: Purpose Tivozanib is a potent and selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor 1 (VEGFR1), -2, and -3. This phase III trial compared tivozanib with sorafenib as initial targeted therapy in patients with metastatic renal cell carcinoma (RCC). Patients and Methods Patients with metastatic RCC, with a clear cell component, prior nephrectomy, measurable disease, and 0 or 1 prior therapies for metastatic RCC were randomly assigned to tivozanib or sorafenib. Prior VEGF-targeted therapy and mammalian target of rapamycin inhibitor were not permitted. The primary end point was progression-free survival (PFS) by independent review. Results A total of 517 patients were randomly assigned to tivozanib (n = 260) or sorafenib (n = 257). PFS was longer with tivozanib than with sorafenib in the overall population (median, 11.9 v 9.1 months; hazard ratio [HR], 0.797; 95% CI, 0.639 to 0.993; P = .042). One hundred fifty-six patients (61%) who progressed on sorafenib crossed over to rece...

Massively parallel tumor multigene sequencing to evaluate response to panitumumab in a randomized phase III study of metastatic colorectal cancer

Abstract: Purpose: To investigate whether EGF receptor (EGFR) pathway mutations predicted response to monotherapy with panitumumab, an anti-EGFR monoclonal antibody, in a randomized phase III study of metastatic colorectal cancer. Experimental Design: Using massively parallel multigene sequencing, we analyzed 320 samples for 9 genes, with multigene sequence data from 288 (90%) samples. Results: Mutation rates were: KRAS (45%), NRAS (5%), BRAF (7%), PIK3CA (9%), PTEN (6%), TP53 (60%), EGFR (1%), AKT1 (<1%), and CTNNB1 (2%). In the randomized study and open-label extension, 22 of 138 (16%) wild-type KRAS (codons 12/13/61) patients versus 0 of 103 mutant KRAS (codons 12/13) patients had objective responses. Of 6 mutant KRAS (codon 61) patients, 1 with a Q61H mutation achieved partial response during the extension. Among wild-type KRAS (codons 12/13/61) patients, 0 of 9 patients with NRAS mutations, 0 of 13 with BRAF mutations, 2 of 10 with PIK3CA mutations, 1 of 9 with PTEN mutations, and 1 of 2 with CTNNB1 mutations responded to panitumumab. No patients responded to best supportive care alone. Panitumumab treatment was associated with longer progression-free survival (PFS) among wild-type KRAS (codons 12/13/61) patients [HR, 0.39; 95% confidence interval (CI), 0.28-0.56]. Among wild-type KRAS patients, a treatment effect for PFS favoring panitumumab occurred in patients with wild-type NRAS (HR, 0.39;95% CI, 0.27-0.56) and wild-type BRAF (HR, 0.37;95% CI, 0.24-0.55) but not mutant NRAS (HR, 1.94; 95% CI, 0.44-8.44). Conclusions: These results show the feasibility and potential clinical use of next-generation sequencing for evaluating predictive biomarkers.

Biofilm delays wound healing: A review of the evidence

Abstract: Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. This review summarizes the clinical experiences and in vivo evidence that implicate biofilm in delayed wound healing. The various mechanisms by which biofilm may impede healing are highlighted, including impaired epithelialization and granulation tissue formation, and reduced susceptibilities to antimicrobial agents and host defenses. Strategies to manage biofilm and encourage progression to wound healing are discussed; these include debridement and appropriate antimicrobial therapies which may be improved upon in the future with the emergence of anti-biofilm technologies.

Mirabegron for the treatment of overactive bladder: a prespecified pooled efficacy analysis and pooled safety analysis of three randomised, double‐blind, placebo‐controlled, phase III studies

Abstract: Introduction To examine pooled efficacy data from three, large phase III studies comparing mirabegron (50 and 100 mg) with placebo, and pooled safety data including additional mirabegron 25 mg and tolterodine extended release (ER) 4 mg results.

Impact of conditional cash transfers on maternal and newborn health.

Abstract: Maternal and newborn health (MNH) is a high priority for global health and is included among the Millennium Development Goals (MDGs). However, the slow decline in maternal and newborn mortality jeopardizes achievements of the targets of MDGs. According to UNICEF, 60 million women give birth outside of health facilities, and family planning needs are satisfied for only 50%. Further, skilled birth attendance and the use of antenatal care are most inequitably distributed in maternal and newborn health interventions in low- and middle-income countries. Conditional cash transfer (CCT) programmes have been shown to increase health service utilization among the poorest but little is written on the effects of such programmes on maternal and newborn health. We carried out a systematic review of studies on CCT that report maternal and newborn health outcomes, including studies from 8 countries. The CCT programmes have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers and reduced the incidence of low birthweight. The programmes have not had a significant impact on fertility while the impact on maternal and newborn mortality has not been well-documented thus far. Given these positive effects, we make the case for further investment in CCT programmes for maternal and newborn health, noting gaps in knowledge and providing recommendations for better design and evaluation of such programmes. We recommend more rigorous impact evaluations that document impact pathways and take factors, such as cost-effectiveness, into account.

Gender and Green Governance: The Political Economy of Women's Presence Within and Beyond Community Forestry

Abstract: PART 1: THE POTENTIAL OF PRESENCE 1 Presence and Representation 2 Gendered Interests and the Environment 3 From Absence to Negotiated Presence PART 2: THE IMPACT OF PRESENCE 4 Fieldsites and Field Profile 5 From Exclusion to Empowered Engagement 6 Rules and Rulemakers 7 Violations and Penalties 8 Conservation and Regeneration 9 Shortages Amidst Growing Plenty PART 3: BEYOND PRESENCE 10 Connecting with Civil Society: Weaving a Web of Strategic Alliances 11 Engaging with Government: Extending the Web

China's Development Finance to Africa: A Media-Based Approach to Data Collection

Abstract: How big is China’s aid to Africa? Does it complement or undermine the efforts of traditional donors? China releases little information, and outside estimates of the size and nature of Chinese aid vary widely. In an effort to overcome this problem, AidData, based at the College of William and Mary, has compiled a database of thousands of media reports on Chinese-backed projects in Africa from 2000 to 2011. The database includes information on 1,673 projects in 51 African countries and on $75 billion in commitments of official finance. This paper describes the new database methodology, key findings, and possible applications of the data, which is being made publicly available for the first time. The paper and database offer a new tool set for researchers, policymakers, journalists, and civil-society organizations working to understand China’s growing role in Africa. The paper also discusses the challenges of quantifying Chinese development activities, introduces AidData’s Media-Based Data Collection (MBDC) methodology, provides an overview of Chinese development finance in Africa as tracked by this new database, and discusses the potential and limitations of MBDC as a resource for tracking development finance.This working paper accompanies the release of AidData’s Chinese Official Finance to Africa Dataset, Version 1.0.

Subterranean Struggles: New Dynamics of Mining, Oil, and Gas in Latin America

Abstract: Abbreviations Preface and Acknowledgments 1. Political Ecologies of the Subsoil Anthony Bebbington and Jeffrey Bury 2. New Geographies of Extractive Industries in Latin America Jeffrey Bury and Anthony Bebbington 3. Nature and Nation: Hydrocarbons, Governance, and the Territorial Logics of "Resource Nationalism" in Bolivia Thomas Perreault 4. Rocks, Rangers, and Resistance: Mining and Conservation Frontiers in the Cordillera Huayhuash, Peru Jeffrey Bury and Timothy Norris 5. Water for Gold: Confronting State and Corporate Mining Discourses in Azuay, Ecuador Jennifer Moore and Teresa Velasquez 6. Territorial Transformations in El Pangui, Ecuador: Understanding How Mining Conflict Affects Territorial Dynamics, Social Mobilization, and Daily Life Ximena S. Warnaars 7. Hydrocarbon Conflicts and Indigenous Peoples in the Peruvian Amazon: Mobilization and Negotiation along the Rio Corrientes Anthony Bebbington and Martin Scurrah 8. Synergistic Impacts of Gas and Mining Development in Bolivia's Chiquitania: The Significance of Analytical Scale Derrick Hindery 9. Natural Resources in the Subsoil and Social Conflicts on the Surface: Perspectives on Peru's Subsurface Political Ecology Julio C. Postigo, Mariana Montoya, and Kenneth R. Young 10. Anatomies of Conflict: Social Mobilization and New Political Ecologies of the Andes Anthony Bebbington, Denise Humphreys Bebbington, Leonith Hinojosa, Maria-Luisa Burneo, and Jeffrey Bury 11. Conclusions Anthony Bebbington, Jeffrey Bury, and Emily Gallagher Bibliography Contributors Index

Identification for Development: The Biometrics Revolution

Abstract: Formal identification is a prerequisite for development in the modern world. The inability to authenticate oneself when interacting with the state — or with private entities such as banks inhibits access to basic rights and services, including education, formal employment, financial services, voting, social transfers, and more. Unfortunately, underdocumentation is pervasive in the developing world. Civil registration systems are often absent or cover only a fraction of the population. In contrast, people in rich countries are almost all well identified from birth. This “identity gap” is increasingly recognized as not only a symptom of underdevelopment but as a factor that makes development more difficult and less inclusive.Many programs now aim to provide individuals in poor countries with more robust official identity, often in the context of the delivery of particular services. Many of these programs use digital biometric identification technology that distinguish physical or behavioral features, such as fingerprints or iris scans, to help “leapfrog” traditional paper-based identity systems. The technology cannot do everything, but recent advances enable it to be used far more accurately than previously, to provide identification (who are you?) and authentication (are you who you claim to be?). Technology costs are falling rapidly, and it is now possible to ensure unique identity in populations of at least several hundred million with little error.This paper surveys 160 cases where biometric identification has been used for economic, political, and social purposes in developing countries. About half of these cases have been supported by donors. Recognizing the need for more rigorous assessments and more open data on performance, the paper draws some conclusions about identification and development and the use of biometric technology. Some cases suggest large returns to its use, with potential gains in inclusion, efficiency, and governance. In others, costly technology has been ineffective or, combined with the formalization of identity, has increased the risk of exclusion.One primary conclusion is that identification should be considered as a component of development policy, rather than being seen as just a cost on a program-by-program basis. Within such a strategic framework, countries and donors can work to close the identification gap, and in the process improve both inclusion and the efficiency of many programs.

Scaling Up What Works: Experimental Evidence on External Validity in Kenyan Education

Abstract: The recent wave of randomized trials in development economics has provoked criticisms regarding external validity. We investigate two concerns — heterogeneity across beneficiaries and implementers — in a randomized trial of contract teachers in Kenyan schools. The intervention, previously shown to raise test scores in NGO-led trials in Western Kenya and parts of India, was replicated across all Kenyan provinces by an NGO and the government. Strong effects of short-term contracts produced in controlled experimental settings are lost in weak public institutions: NGO implementation produces a positive effect on test scores across diverse contexts, while government implementation yields zero effect. The data suggests that the stark contrast in success between the government and NGO arm can be traced back to implementation constraints and political economy forces put in motion as the program went to scale.

Social Assistance in Developing Countries

Abstract: The rapid spread of large-scale and innovative social transfers in the developing world has made a key contribution to the significant reduction in global poverty over the last decade. Explaining how flagship anti-poverty programmes emerged, this book provides the first comprehensive account of the global growth of social assistance transfers in developing countries. Armando Barrientos begins by focusing on the ethical and conceptual foundations of social assistance, and he discusses the justifications for assisting those in poverty. He provides a primer on poverty analysis, and introduces readers to the theory of optimal transfers. He then shifts the focus to practice, and introduces a classification of social assistance programmes to help readers understand the diversity in approaches and design in developing countries. The book concludes with an analysis of the financing and politics of the emerging institutions and of their potential to address global poverty.

Reducing Urban Poverty in the Global South

Abstract: 1. Why this Book? 2. Approaches to Poverty Reduction in Towns and Cities of the Global South 3. The Work of Local, National and International Agencies 4. Citizen led Povery Reduction 5. Understanding Pro-poor Politics and Pro-poor Transformation 6. A Future that Low-income Dwellers want - and can Help Secure

The Renminbi Bloc is Here: Asia Down, Rest of the World to Go?

Abstract: A country’s rise to economic dominance tends to be accompanied by its currency becoming a reference point, with other currencies tracking it implicitly or explicitly. For a sample comprising emerging-market economies, we show that in the last three years, the renminbi (RMB) has increasingly become a reference currency, which we define as one that exhibits a high degree of co-movement with other currencies. In East Asia, there is already a RMB bloc, because the RMB has become the dominant reference currency, eclipsing the US dollar, which is a historic development. In this region, 7 currencies out of 10 co-move more closely with the RMB than with the dollar, with the average value of the co-movement coefficient relative to the RMB being about 60 percent greater than that for the dollar. We find that co-movements with a reference currency, especially for the RMB, are associated with trade integration. We draw some lessons for the prospects for the RMB bloc to move beyond Asia based on a comparison of the RMB’s situation today and that of the Japanese yen in the early 1990s. If trade were the sole driver, a more global RMB bloc could emerge by the mid-2030s, but complementary reforms of the financial and external sectors could considerably expedite the process.

The Hyperglobalization of Trade and Its Future

Abstract: Th is paper describes seven salient features of trade integration in the 21st century: Trade integration has been more rapid than ever (hyperglobalization); it is dematerialized, with the growing importance of services trade; it is democratic, because openness has been embraced widely; it is criss-crossing because similar goods and investment fl ows now go from South to North as well as the reverse; it has witnessed the emergence of a mega-trader (China), the fi rst since Imperial Britain; it has involved the proliferation of regional and preferential trade agreements and is on the cusp of mega-regionalism as the world's largest traders pursue such agreements with each other; and it is impeded by the continued existence of high barriers to trade in services. Going forward, the trading system will have to tackle three fundamental challenges: In developed countries, the domestic support for globalization needs to be sustained in the face of economic weakness and the reduced ability to maintain social insurance mechanisms. Second, China has become the world’s largest trader and a major benefi ciary of the current rules of the game. It will be called upon to shoulder more of the responsibilities of maintaining an open system. Th e third challenge will be to prevent the rise of mega-regionalism from leading to discrimination and becoming a source of trade confl icts. We suggest a way forward—including new areas of cooperation such as taxes—to maintain the open multilateral trading system and ensure that it benefi ts all countries.

Social Assistance in Developing Countries

Abstract: The rapid spread of large-scale and innovative social transfers in the developing world has made a key contribution to the significant reduction in global poverty over the last decade. Explaining how flagship anti-poverty programmes emerged, this book provides the first comprehensive account of the global growth of social assistance transfers in developing countries. Armando Barrientos begins by focusing on the ethical and conceptual foundations of social assistance, and he discusses the justifications for assisting those in poverty. He provides a primer on poverty analysis, and introduces readers to the theory of optimal transfers. He then shifts the focus to practice, and introduces a classification of social assistance programmes to help readers understand the diversity in approaches and design in developing countries. The book concludes with an analysis of the financing and politics of the emerging institutions and of their potential to address global poverty.

Efficacy and safety of ipragliflozin in patients with type 2 diabetes inadequately controlled on metformin: a dose-finding study.

Abstract: Aims Ipragliflozin is a novel, selective inhibitor of sodium glucose co-transporter 2 (SGLT2 inhibitor) in clinical development for type 2 diabetes mellitus (T2DM) treatment. This study assessed the efficacy and safety of different doses of ipragliflozin. Methods In a 12-week, multicentre, double-blind, randomized, placebo-controlled, dose-finding study patients with inadequate glycaemic control on metformin monotherapy (≥1500 mg/day) were randomized to one of four ipragliflozin treatment groups (12.5, 50, 150 or 300 mg once daily) or placebo. Primary efficacy outcome was mean change from baseline in haemoglobin A1c (HbA1c) compared to placebo at week 12. Adverse events (AEs), vital signs and laboratory safety measurements were assessed. Results Ipragliflozin dose dependently decreased HbA1c from baseline to week 12 compared to placebo (−0.22, −0.34, −0.40 and −0.48% for ipragliflozin 12.5, 50, 150 and 300 mg, respectively). Decreases in body weight and blood pressure were observed for all ipragliflozin groups. AEs occurred in 39.7–51.4% of the ipragliflozin groups and 39.4% of placebo patients. Urinary tract infections (1.4–6.9 vs. 6.1%), genital infections (0–4.3 vs. 1.5%) and hypoglycaemia (0–5.9 vs. 3.0%) were similar in the ipragliflozin and placebo groups, respectively, without dose dependency. There were no clinically relevant effects on other safety measurements. Conclusions Ipragliflozin treatment improved glycaemic control when added to metformin therapy and may be associated with weight loss and reductions in blood pressure compared to placebo. No safety or tolerability concerns were identified at any of the tested doses supporting the further development of ipragliflozin at ≥50 mg doses in T2DM patients.

Inclusive Innovation: Definition, Conceptualisation and Future Research Priorities

Abstract: There is increasing policy, practice and academic interest in ?inclusive innovation? In simple terms, this is the means by which new goods and services are developed for and/or by those who have been excluded from the development mainstream; particularly the billions living on lowest incomes However, there are many competing perspectives on inclusive innovation, which this paper resolves into an integrated ?ladder? model of different levels of inclusive innovationResearch has so far lagged practice and there is need for a more concerted effort at knowledge-building for inclusive innovation Based on a three-country interview study with 37 policy-makers, strategists, private sector and NGO sector representatives ? and founded on a review of existing literature on inclusive innovation ? this paper reports findings about research priorities in inclusive innovation Respondents identified a set of eleven priority research topics, which are categorised as stakeholder-, systemic- or process-orientedThese priorities provide evidence-based guidance for future research on inclusive innovation

Efficacy of Qutenza® (capsaicin) 8% patch for neuropathic pain: A meta-analysis of the Qutenza Clinical Trials Database

Abstract: Qutenza® is a capsaicin patch used to treat peripheral neuropathic pain, including postherpetic neuralgia (PHN) and human immunodeficiency virus-associated neuropathy (HIV-AN). The Qutenza Clinical Trials Database has been assembled to more fully characterize the effects of Qutenza. We conducted a within-subject meta-analysis of Qutenza studies to further define the medication's efficacy profile across studies. The meta-analysis combined individual patient data from randomized, controlled studies of Qutenza in peripheral neuropathic pain (1458 subjects treated with approved doses of Qutenza or control patches; 1120 with PHN and 338 with HIV-AN). These 7 studies had similar designs and were performed with the high-dose 8% capsaicin Qutenza patch and a 0.04% low-dose control patch. The difference between treatment groups for the primary efficacy end point of percentage change from baseline to weeks 2 to 12 on pain intensity score was calculated. Response was defined as a ≥ 30% decrease in mean pain intensity score during weeks 2 to 12. The overall between-group difference in percentage change from baseline in pain intensity was 8.0% (95% confidence interval 4.6, 11.5; P<.001), which statistically significantly favored Qutenza over low-dose control. Qutenza superiority was demonstrated for both PHN and HIV-AN patients for the primary end point and the end point proportion of 30% pain reduction response, and for PHN patients for the end point of proportion of 50% pain reduction response. These results confirm that Qutenza is effective for the treatment of both PHN and HIV-AN compared to low-dose control patch.