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Economic development, institutional analysis, health systems, corruption, evaluation
Bill Savedoff is 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.
For this edition of the CGD Podcast I’m joined by Savedoff and Sandefur (who also leads our education research through the RISE project); they give a sneak peak of their contributions to, and offer an assessment of, the Learning Generation report.
I’ve been working on the idea of Cash on Delivery (COD) for some years under the hypothesis that if we could define good outcome indicators, someone would step forward to buy them. So what would happen if an organization came forward with a plan to supply a verified outcome in return for a set unit payment after delivery? In a sense, this is what Dispensers for Safe Water, an Evidence Action program, is currently doing.
Health aid pays for life-saving medicines, products, and services in the poorest countries in the world. Funding for such uses needs to be smooth and uninterrupted. But when fraud is detected, funds are subject to sudden stops and starts—the result of a sequence of events set off by the scandal cycle in health aid. We examine this idea in a new CGD policy paper.
Global health action has been remarkably successful at saving lives and preventing illness in many of the world’s poorest countries. This is a key reason that funding for global health initiatives has increased in the last twenty years. Nevertheless, financial support is periodically jeopardized when scandals erupt over allegations of corruption, sometimes halting health programs altogether.
What should tomorrow’s aid agencies look like in a landscape where the global goal is to ensure sustainable development? In the past, the role of aid has mainly been to “finance” specific projects or services, with a strong sense of donor identity and marked projections of donor interests. A modern approach to development assistance, however, focuses on the catalytic role of institutions and their capacity to mobilize expertise and resources towards shared objectives.
There are 20 pages covering the Addis Ababa Action Agenda. And while they are inevitably bubble-wrapped in diplo-speak and hat-tipping, there is a solid package of proposals nestled within. They cover domestic public finance, private finance, international public finance, trade, debt, technology, data and systemic issues. Amongst many other things, the Agenda calls for more tax and better tax (less regressive, more focused on pollution and tobacco). And it is long and specific on base erosion, tax evasion and competition and tax cooperation. It calls for financial inclusion and cheaper remittances. The draft discusses blended finance and a larger role for market-based instruments to support infrastructure rollout, as well as a new measure of “Total Official Support for Sustainable Development.” It calls for Multilateral Development Bank reform including new graduation criteria and scaling up. And it suggests a global compact to guarantee a universal package of basic social services and a second compact covering infrastructure. Finally, the draft has a good section on technology including the need for public finance and flexibility on intellectual property rights.
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.
The United Kingdom has been a stalwart funder and innovator in foreign assistance for almost 20 years. In 2011, it created the Independent Commission for Aid Impact (ICAI) to report to Parliament on the country’s growing aid portfolio. ICAI is a QUANGO in Brit-speak – a quasi-public non-governmental organization - with a 4-year mandate which is undergoing review this year. Recently, I took a look at the reports it has produced to see whether the organization is fulfilling its role in holding the country’s overseas development aid programs accountable. I found one fascinating report which shows what ICAI could be doing and many more reports that made me wonder whether ICAI is duplicating work already within the purview of the agency, Department for International Development (DFID), which accounts for most of the UK’s foreign assistance programs.
Energy is critical to human welfare, yet energy consumption in developing countries is extremely low relative to modern living standards. Conventional aid programs have invested in energy production with some success but also with many notable failures. This paper discusses how a distinctive approach to development aid—disbursing funds against improved outcomes—could make aid more effective in the energy sector. In particular, it explores the use of Cash on Delivery Aid (COD Aid) to resolve perennial difficulties encountered by conventional aid programs in energy sector development.