Publication: Improving Access to Medicines in Developing Countries : Application of New Institutional Economics to the Analysis of Manufacturing and Distribution Issues
Loading...
Published
2005-03
ISSN
Date
2013-05-30
Author(s)
Editor(s)
Abstract
This paper examines alternative frameworks for empirical analysis of supply side activities, namely, the manufacture and distribution of medicine, through the application of New Institutional Economics (NIE) concepts. Attention is focused particularly upon the potential utility of ideas from agency theory, transaction cost analysis and contemporary ideas from strategy theory. The major purpose of this paper is to use these theoretical frameworks to provide insight for policy makers, when faced with specific situations, whether in an international agency, or a private company, or in defining a national strategy. The analysis attempts to show the importance of distinctions between ideas of 'make' or 'buy', between 'national self sufficiency' and 'international purchasing' strategies, the limitations of contractual agreements under market governance and the crucial linkages between strategy formulation, strategy implementation and the necessary capabilities to achieve successful performance in practice. The current international situation on the investment, location and capacity of pharmaceutical manufacturing is reviewed and likely future scenarios suggested. Correspondingly current patterns of trade in medicines and their likely development within the context of the WTO and bilateral trade agreements are discussed. Against this background the promise and the pitfalls for new forms of public-private partnerships, which may offer attractive alternatives to conventional structures are evaluated. The implications of alternative future strategic options for national governments in setting the balance between health and industrial policies are examined and in particular the extent to which a national manufacturing capability should be developed or sustained. Similarly the scope for improving low cost distribution systems for medicines, based upon a mix of public and private sector channels, is assessed. We conclude with suggestions for further development of a transaction-based framework.
Link to Data Set
Citation
“Attridge, C. James; Preker, Alexander S.. 2005. Improving Access to Medicines in Developing Countries : Application of New Institutional Economics to the Analysis of Manufacturing and Distribution Issues. Health, Nutrition and Population (HNP)
discussion paper;. © World Bank. http://hdl.handle.net/10986/13668 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication Light Manufacturing in Tanzania : A Reform Agenda for Job Creation and Prosperity(Washington, DC: World Bank, 2013-09)The chapters in part one provides the overall context of light manufacturing in Tanzania. Chapter one presents the rationale for the study, the potential of the sector in creating jobs and prosperity for Africa, and the approach and methodology of the study. Chapter two reviews Tanzania's recent economic performance and prospects and concludes that, despite good macroeconomic performance, the country still needs to pursue structural transformation and diversification. Moreover, despite Tanzania's abundant natural endowments, manufacturing remains a viable source for job creation and prosperity. Chapter three examines the overall business environment among firms of all sizes in light industry in Tanzania. It first reviews the macroeconomic framework, focusing on wages, exchange rates, and interest rates before analyzing the microeconomic issues affecting firms such as export incentives, trade logistics, and access to electricity, land, and finance. Competition, an issue of paramount importance in improving Tanzania's competitiveness, is analyzed next, before a discussion of a potential shortcut for addressing some of the related macro and micro problems.Publication Growth Identification and Facilitation : The Role of the State in the Dynamics of Structural Change(2010-05-01)Active economic policies by developing countries governments to promote growth and industrialization have generally been viewed with suspicion by economists, and for good reasons: past experiences show that such policies have too often failed to achieve their stated objectives. But the historical record also indicates that in all successful economies, the state has always played an important role in facilitating structural change and helping the private sector sustain it across time. This paper proposes a new approach to help policymakers in developing countries identify those industries that may hold latent comparative advantage. It also recommends ways of removing binding constraints to facilitate private firms entry into those industries. The paper introduces an important distinction between two types of government interventions. First are policies that facilitate structural change by overcoming information and coordination and externality issues, which are intrinsic to industrial upgrading and diversification. Such interventions aim to provide information, compensate for externalities, and coordinate improvements in the "hard" and "soft" infrastructure that are needed for the private sector to grow in sync with the dynamic change in the economy s comparative advantage. Second are those policies aimed at protecting some selected firms and industries that defy the comparative advantage determined by the existing endowment structure either in new sectors that are too advanced or in old sectors that have lost comparative advantage.Publication Green Industrial Policies : When and How(World Bank, Washington, DC, 2013-10)Green industrial policies can be defined as industrial policies with an environmental goal -- or more precisely, as sector-targeted policies that affect the economic production structure with the aim of generating environmental benefits. This paper provides a framework to assess their desirability depending on the effectiveness and political acceptability of price instruments. The main messages are the following. (i) Greening growth processes to the extent and with the speed needed cannot be done without industrial policies, even if prices can be adjusted to reflect environmental objectives. (ii) "Sunrise" green industrial policies are needed because they support the development of critical new technologies and sectors, bring down costs, and allow for reduced emissions in the short term even in the absence of carbon pricing. (iii) "Sunset" green industrial policies and trade policies may be needed in conjunction with safety nets to make carbon pricing politically or socially acceptable. They can help mitigate the impact of a carbon price on competitiveness and unemployment and smooth the transition by helping industries adjust to the new conditions. (iv) Green or not, industrial policy requires carefully navigating the twin dangers of market and governance failure. The viability of supported technologies and sectors is difficult to assess through a market-test given their dependence on continued environmental policies or pricing -- such as a carbon price. Particular attention must be paid to avoid potential unintended negative effects, such as rebound effects (especially if prices are inappropriate), misallocation of capital, or capture and rent-seeking behaviors.Publication Strengthening Bolivian Competitiveness : Export Diversification and Inclusive Growth(World Bank, 2009-06-01)Bolivia's trade liberalization, launched in the mid-1980s, has resulted in a relatively open trade regime; but the results have been mixed. Bolivia's export to Gross Domestic Product (GDP) ratio and export entrepreneurship index rating are among the highest in the Latin American and Caribbean (LAC) region and the country has achieved great success in making soya the major export crop in less than 10 years. At the same time, the country's share in world trade has stagnated and exports are increasingly dominated by gas and minerals. Reinvigorating the nontraditional export sector is important for the government of Bolivia as it implements its national development plan. As a resource-rich country, the Bolivian government's emphasis on export diversification is well-placed but the optimal nontraditional export strategy should build on successes in the traditional sector. This study investigates: (a) the role trade should play in Bolivia's development strategy considering the country's natural resource endowment; (b) the lessons of Bolivia's integration to the world economy; (c) the linkages between Bolivia's past trade and economy and a forward-looking analysis of the impact of different scenarios on growth, employment, trade flows, and poverty; (d) constraints to higher export competitiveness and weaknesses related to transport and logistics; and (e) the characteristics of exporting firms and the constraints affecting them. The main findings of the analysis are that preferential access to world markets is necessary but not sufficient for success in nontraditional exports; rather, success depends largely on increasing the competitiveness of exporting firms. Second, a neutral incentive regime is essential to the growth of nontraditional exports. Third, efficient backbone services are vital for reducing exporters' costs. Finally, the government should be proactive in addressing institutional impediments to cross-border trade. The study presents prioritized policy implications of the analysis related to: (i) trade policy and preferential access to markets; (ii) the incentives regime; (iii) backbone services; (iv) increasing the effectiveness of institutions to promote cross-border trade; and (v) setting the foundations for exports diversification.Publication A State Trading Enterprise for Grains in Russia? Issues and Options(Washington, DC, 2009-10)The impact of state trading enterprises (STEs) on domestic and international grain markets has been studied extensively over the years, generating a considerable body of theoretical and empirical evidence. The aim of this note is to draw on this body of evidence to analyze possible options for Russia's future state involvement in grain trade. The note covers the following three parts: i) outline of the potential economic impacts of STEs in grain trade from an economic perspective; ii) review of some of the global experience with STEs that are involved in grain exports; and iii) evaluation of options for state involvement in grain trade in Russia. The coverage in this note is limited to grains and to the impacts of STEs in countries that are net exporters of grain. Of the major grains, the note focuses on wheat which is by far the most important Russian export grain. Importing STEs are much more numerous than exporting STEs worldwide. However, unlike Ukraine, which has jumped between net export and net import situations for wheat as recently as 2003/04, it appears that Russia has become a consistent exporter since the beginning of this decade, even in years with relatively poor crop conditions. The note is further limited to the analysis of STEs and not grain market regulation in general (i.e. market and price support, income support for grain producers). However, as is discussed, such regulation can be used to help an STE pursue certain objectives by enhancing its market power, and STEs are generally implemented as part of an overall grain market regulation strategy.
Users also downloaded
Showing related downloaded files
Publication Global Economic Prospects, January 2025(Washington, DC: World Bank, 2025-01-16)Global growth is expected to hold steady at 2.7 percent in 2025-26. However, the global economy appears to be settling at a low growth rate that will be insufficient to foster sustained economic development—with the possibility of further headwinds from heightened policy uncertainty and adverse trade policy shifts, geopolitical tensions, persistent inflation, and climate-related natural disasters. Against this backdrop, emerging market and developing economies are set to enter the second quarter of the twenty-first century with per capita incomes on a trajectory that implies substantially slower catch-up toward advanced-economy living standards than they previously experienced. Without course corrections, most low-income countries are unlikely to graduate to middle-income status by the middle of the century. Policy action at both global and national levels is needed to foster a more favorable external environment, enhance macroeconomic stability, reduce structural constraints, address the effects of climate change, and thus accelerate long-term growth and development.Publication Business Ready 2024(Washington, DC: World Bank, 2024-10-03)Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.Publication The Container Port Performance Index 2023(Washington, DC: World Bank, 2024-07-18)The Container Port Performance Index (CPPI) measures the time container ships spend in port, making it an important point of reference for stakeholders in the global economy. These stakeholders include port authorities and operators, national governments, supranational organizations, development agencies, and other public and private players in trade and logistics. The index highlights where vessel time in container ports could be improved. Streamlining these processes would benefit all parties involved, including shipping lines, national governments, and consumers. This fourth edition of the CPPI relies on data from 405 container ports with at least 24 container ship port calls in the calendar year 2023. As in earlier editions of the CPPI, the ranking employs two different methodological approaches: an administrative (technical) approach and a statistical approach (using matrix factorization). Combining these two approaches ensures that the overall ranking of container ports reflects actual port performance as closely as possible while also being statistically robust. The CPPI methodology assesses the sequential steps of a container ship port call. ‘Total port hours’ refers to the total time elapsed from the moment a ship arrives at the port until the vessel leaves the berth after completing its cargo operations. The CPPI uses time as an indicator because time is very important to shipping lines, ports, and the entire logistics chain. However, time, as captured by the CPPI, is not the only way to measure port efficiency, so it does not tell the entire story of a port’s performance. Factors that can influence the time vessels spend in ports can be location-specific and under the port’s control (endogenous) or external and beyond the control of the port (exogenous). The CPPI measures time spent in container ports, strictly based on quantitative data only, which do not reveal the underlying factors or root causes of extended port times. A detailed port-specific diagnostic would be required to assess the contribution of underlying factors to the time a vessel spends in port. A very low ranking or a significant change in ranking may warrant special attention, for which the World Bank generally recommends a detailed diagnostic.Publication Global Economic Prospects, June 2025(Washington, DC: World Bank, 2025-06-10)The global economy is facing another substantial headwind, emanating largely from an increase in trade tensions and heightened global policy uncertainty. For emerging market and developing economies (EMDEs), the ability to boost job creation and reduce extreme poverty has declined. Key downside risks include a further escalation of trade barriers and continued policy uncertainty. These challenges are exacerbated by subdued foreign direct investment into EMDEs. Global cooperation is needed to restore a more stable international trade environment and scale up support for vulnerable countries grappling with conflict, debt burdens, and climate change. Domestic policy action is also critical to contain inflation risks and strengthen fiscal resilience. To accelerate job creation and long-term growth, structural reforms must focus on raising institutional quality, attracting private investment, and strengthening human capital and labor markets. Countries in fragile and conflict situations face daunting development challenges that will require tailored domestic policy reforms and well-coordinated multilateral support.