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"Arcand, Jean-Louis"
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The economic impact of schistosomiasis
Background
The economic impact of schistosomiasis and the underlying tradeoffs between water resources development and public health concerns have yet to be quantified. Schistosomiasis exerts large health, social and financial burdens on infected individuals and households. While irrigation schemes are one of the most important policy responses designed to reduce poverty, particularly in sub-Saharan Africa, they facilitate the propagation of schistosomiasis and other diseases.
Methods
We estimate the economic impact of schistosomiasis in Burkina Faso via its effect on agricultural production. We create an original dataset that combines detailed household and agricultural surveys with high-resolution geo-statistical disease maps. We develop new methods that use the densities of the intermediate host snails of schistosomiasis as instrumental variables together with panel, spatial and machine learning techniques.
Results
We estimate that the elimination of schistosomiasis in Burkina Faso would increase average crop yields by around 7%, rising to 32% for high infection clusters. Keeping schistosomiasis unchecked, in turn, would correspond to a loss of gross domestic product of approximately 0.8%. We identify the disease burden as a shock to the agricultural productivity of farmers. The poorest households engaged in subsistence agriculture bear a far heavier disease burden than their wealthier counterparts, experiencing an average yield loss due to schistosomiasis of between 32 and 45%. We show that the returns to water resources development are substantially reduced once its health effects are taken into account: villages in proximity of large-scale dams suffer an average yield loss of around 20%, and this burden decreases as distance between dams and villages increases.
Conclusions
This study provides a rigorous estimation of how schistosomiasis affects agricultural production and how it is both a driver and a consequence of poverty. It further quantifies the tradeoff between the economics of water infrastructures and their impact on public health. Although we focus on Burkina Faso, our approach can be applied to any country in which schistosomiasis is endemic.
Graphical Abstract
Journal Article
Too much finance?
This paper examines whether there is a threshold above which financial depth no longer has a positive effect on economic growth. We use different empirical approaches to show that financial depth starts having a negative effect on output growth when credit to the private sector reaches 100 % of GDP. Our results are consistent with the \"vanishing effect\" of financial depth and that they are not driven by endogeneity, output volatility, banking crises, low institutional quality, or by differences in bank regulation and supervision.
Journal Article
The potential impact of novel tuberculosis vaccine introduction on economic growth in low- and middle-income countries: A modeling study
Most individuals developing tuberculosis (TB) are working age adults living in low- and middle-income countries (LMICs). The resulting disability and death impact economic productivity and burden health systems. New TB vaccine products may reduce this burden. In this study, we estimated the impact of introducing novel TB vaccines on gross domestic product (GDP) growth in 105 LMICs.
We adapted an existing macroeconomic model to simulate country-level GDP trends between 2020 and 2080, comparing scenarios for introduction of hypothetical infant and adolescent/adult vaccines to a no-new-vaccine counterfactual. We parameterized each scenario using estimates of TB-related mortality, morbidity, and healthcare spending from linked epidemiological and costing models. We assumed vaccines would be introduced between 2028 and 2047 and estimated incremental changes in GDP within each country from introduction to 2080, in 2020 US dollars. We tested the robustness of results to alternative analytic specifications. Both vaccine scenarios produced greater cumulative GDP in the modeled countries over the study period, equivalent to $1.6 (95% uncertainty interval: $0.8, 3.0) trillion for the adolescent/adult vaccine and $0.2 ($0.1, 0.4) trillion for the infant vaccine. These GDP gains were substantially lagged relative to the time of vaccine introduction, particularly for the infant vaccine. GDP gains resulting from vaccine introduction were concentrated in countries with higher current TB incidence and earlier vaccine introduction. Results were sensitive to secular trends in GDP growth but relatively robust to other analytic assumptions. Uncertain projections of GDP could alter these projections and affect the conclusions drawn by this analysis.
Under a range of assumptions, introducing novel TB vaccines would increase economic growth in LMICs.
Journal Article
The Macroeconomic Impact of Increasing Investments in Malaria Control in 26 High Malaria Burden Countries: An Application of the Updated EPIC Model
Background: Malaria remains a major public health problem. While globally malaria mortality affects predominantly young children, clinical malaria affects all age groups throughout life. Malaria not only threatens health but also child education and adult productivity while burdening government budgets and economic development. Increased investments in malaria control can contribute to reduce this burden but have an opportunity cost for the economy. Quantifying the net economic value of investing in malaria can encourage political and financial commitment. Methods: We adapted an existing macroeconomic model to simulate the effects of reducing malaria on the gross domestic product (GDP) of 26 high burden countries while accounting for the opportunity costs of increased investments in malaria. We compared two scenarios differing in their level of malaria investment and associated burden reduction: sustaining malaria control at 2015 intervention coverage levels, time at which coverage levels reached their historic peak and scaling-up coverage to reach the 2030 global burden reduction targets. We incorporated the effects that reduced malaria in children and young adolescents may have on the productivity of working adults and on the future size of the labour force augmented by educational returns, skills, and experience. We calibrated the model using estimates from linked epidemiologic and costing models on these same scenarios and from published country-specific macroeconomic data. Results: Scaling-up malaria control could produce a dividend of US$ 152 billion in the modelled countries, equivalent to 0.17% of total GDP projected over the study period across the 26 countries. Assuming a larger share of malaria investments is paid out from domestic savings, the dividend would be smaller but still significant, ranging between 0.10% and 0.14% of total projected GDP. Annual GDP gains were estimated to increase over time. Lower income and higher burden countries would experience higher gains. Conclusion: Intensified malaria control can produce a multiplied return despite the opportunity cost of greater investments.
Journal Article
The Impact of Land Mines on Child Health: Evidence from Angola
This article estimates the causal impact of land mines on child health in Angola, controlling for conflict exposure. Our identification strategy is based on the geography of the Angolan civil war. We posit that distance between communes and rebel headquarters is an exogenous driver of land mine contamination. We find that land mine intensity is positively correlated with the distance to a set of rebel headquarters. Instrumental variables estimates, based on two household surveys and the Landmines Impact Survey, indicate that land mines have large and negative effects on weight-for-age and height-for-age. We discuss our results with respect to the costs and benefits of land mine clearance, as well as the long-term costs of early malnutrition. We also compare the magnitude of our estimates with those of related studies on the impact of conflict on child health.
Journal Article
Racial discrimination in the Brazilian labour market: wage, employment and segregation effects
The social science literature has done much to document pervasive racial discrimination in Brazil and there is little doubt that a very dark colour is a handicap to social advancement. Nevertheless, very few empirical economic studies have attempted to quantify the impact of ethnic discrimination in Brazil. Using data culled from the Pesquisa National por Amostra de Domicílios (PNAD), this paper fills this void by analysing ethnic wage and employment gaps, as well as occupational segregation in Brazil, using the Oaxaca decomposition methodology. Copyright © 2004 John Wiley & Sons, Ltd.
Journal Article
Too Much Finance?
This paper examines whether there is a threshold above which financial development no longer has a positive effect on economic growth. We use different empirical approaches to show that there can indeed be \"too much\" finance. In particular, our results suggest that finance starts having a negative effect on output growth when credit to the private sector reaches 100% of GDP. We show that our results are consistent with the \"vanishing effect\" of financial development and that they are not driven by output volatility, banking crises, low institutional quality, or by differences in bank regulation and supervision.
eBook
How to make a tragedy: on the alleged effect of ethnicity on growth
This paper questions the line of reasoning followed by several authors, notably Easterly and Levine according to which ethno‐linguistic fragmentation, because it leads to poor policies, is the main factor explaining the ‘tragedy’ of low African growth. A first set of criticism concerns the model itself and stresses that current empirical work is unable to convincingly identify the channels through which ethnic fragmentation affects growth: (i) polarization may be more relevant than fragmentation, (ii) the various tests of the effect of ethnicity on the quality of policy are far from being conclusive. A second set of remarks concerns the relevance of these studies to Africa: the African sub‐sample is often quite limited, and the relationship is unstable (according to Chow tests). It actually appears that ethnicity has a more important effect on growth in Africa than elsewhere. This still needs to be explained and is not as such an explanation for lower African growth. Copyright © 2000 John Wiley & Sons, Ltd.
Journal Article
Tax Compliance and Rank Dependent Expected Utility
Formulating the classic Allingham and Sandmo [1972] tax compliance problem under Rank Dependent Expected Utility (RDEU) provides a simple explanation for the \"excess\" level of full compliance observed in empirical studies, which standard Expected Utility (EU) theory is unable to explain. RDEU provides a compelling answer to this puzzle, without the need for the moral sentiments or stigma arguments that have recently been advanced in the literature. Formally, we show that the threshold audit probability or penalty rate at which full compliance becomes optimal for the decisionmaker are significantly lower under RDEU axiomatics than in the EU case, and that the optimal level of underreporting is lower under RDEU. Numerical simulations using various parameterizations of the probability weighting function illustrate the large quantitative differences between the two models, while a simulation of underreporting rates in the US over the past 50 years shows how RDEU can go some way towards explaining the tax-compliance puzzle.
Journal Article